Dialysis is a treatment that removes waste and excess fluid from the blood for people with kidney failure. There are two main types - hemodialysis which uses a machine to filter the blood outside of the body, and peritoneal dialysis which uses the lining of the abdomen. Dialysis is needed when the kidneys are no longer able to properly clean the blood and regulate chemicals and fluid levels. Risks include low blood pressure, infection, and neurological issues from chemicals in the dialysis fluid.

2. DIALYSIS
GM SIDDIQUI
CLINICAL INSTRUCTOR/STAFF NURSE
THE KIDNEY CENTER PGTI

3. Dialysis
Is a process for removing waste and excess water
from the blood and is used primarily as an artificial
replacement for lost kidney function in people with
kidney failure
Overview
The function of your kidneys is to purify your
body by removing waste and excess fluid. Dialysis
is a treatment used for people whose kidneys don't
work properly. It's a common treatment that has
been used for people with kidney problems since
the 1940s.

4. Purpose of Dialysis
A properly functioning kidney helps prevent salt, extra
water, and waste from accumulating in your body. It
also helps control blood pressure and regulates
important chemicals in the blood, such as sodium (salt)
and potassium. When your kidneys don't perform these
functions due to disease or injury, dialysis can help
purify the blood and remove waste.

5. Types.
There are two different types of dialysis:
1. Hemodialysis
2. Peritoneal dialysis

6. Hemodialysis involves using an artificial kidney,
known as a hemodialyzer, to remove waste and
chemicals from the blood. It accesses the blood
through a minor surgical procedure in the arm or
leg, or through a plastic tube in the neck called a
catheter.

8. Peritoneal Dialysis involves the surgical
implantation of a catheter into your stomach area.
During treatment, a special fluid called dialystate is
pumped into the abdomen where it draws waste out of
the bloodstream.

10. The length of treatment depends on the patient's size,
the levels of waste in their body, and whether
hemodialysis or peritoneal dialysis is used. Typical
hemodialysis treatments last about four hours and are
needed about three times a week. Peritoneal dialysis can
be done at home, at work, or during sleep, depending
on the style of treatment your doctor recommends.

11. Risks
Dialysis carries several risks, although many can be
avoided through proper procedure and careful use of
equipment. Risks associated with dialysis include:
• Bleeding at the access site
• Low blood pressure
• Irregular heartbeat
• Infection
• Nausea
• Air bubbles in the blood

12. There are other long-term risks associated with dialysis.
One of the most common is called dialysis dementia, a
neurological syndrome caused by aluminum
compounds in the dialysis fluid. Symptoms of dialysis
dementia include seizures and physical and speech
problems.
If you experience any of these symptoms during
dialysis treatment, notify your doctor to discuss options
and ways to lower your risks.

13. Routes For Hemodialysis.
1. Dialysis Catheter.
2. Arteriovenous (AV) Fistula
3. Arteriovenous (AV) Graft

14. Dialysis Catheter.
A dialysis catheter is a catheter used for exchanging
blood to and from the hemodialysis machine from the
patient.
The dialysis catheter contains two lumens:
• Venous
• Arterial

15. This is a confusing terminology for layperson, because
both lumens are in the vein. The arterial lumen
(typically red) withdraws blood from the patient and
carries it to dialysis machine, while the venous lumen
(typically blue) returns blood to the patient (from the
dialysis machine). Flow rates of dialysis catheters range
between 200 to 500 ml/min.

16. Arteriovenous (AV) Graft For
Hemodialysis
An Arteriovenous (AV) graft is created by connecting a
vein to an artery using a soft plastic tube. After the
graft has healed, hemodialysis is performed by placing
two needles; one in the arterial side and one in the
venous side of the graft. The graft allows for increased
blood flow. Grafts tend to need attention and upkeep.
Taking good care of your access may limit problems.

18. Arteriovenous (AV) Fistula for Hemodialysis
A fistula used for hemodialysis is a direct connection of an
artery to a vein. Once the fistula is created it is a natural part of
the body. This is the preferred type of access because once the
fistula properly matures and gets bigger and stronger; it provides
an access with good blood flow that can last for decades. After
the fistula is surgically created, it can take weeks to months
before the fistula matures and is ready to be used for
hemodialysis. People with kidney disease can do exercises
including squeezing a rubber ball to strengthen the fistula before
use.