Dialysis involves the artificial filtration and removal of waste from the bloodstream through diffusion, osmosis, and ultrafiltration. There are two main types: hemodialysis and peritoneal dialysis. Hemodialysis is performed using an artificial kidney machine to filter blood through a dialyzer, usually via arteriovenous fistula or graft. Peritoneal dialysis uses the peritoneum as a natural semipermeable membrane and involves manually infusing and draining a dialysate solution into the abdominal cavity. Both procedures help remove waste and excess fluid but come with risks like infection, hypotension, and disequilibrium.

1. DIALYSIS

2. HD
• It is a technique of artificial filtration and
removal of waste products
Dialysis acts upon 3 principles:
1. Diffusion
2. Osmosis
3. Ultrafiltration

3. 1. Diffusion: The solute particle movement from
higher concentration to lower concentration
is called diffusion. E.g. Creatinine, urea, K+,
PO4, Uric acid.
2. Osmosis: The solvent particle movement from
lower concentration to higher concentration.
E.g. Glucose, water, heparin, Antibiotic, Na+.
3. Ultrafiltration: the fluid movement from
higher pressure to lower pressure through a
semipermeable membrane is called
ultrafiltration.

4. • There are two type od dialysis:
• Hemodialysis
• Peritoneal dialysis

5. • HD is performed by the help of artery and veins by
making fistula and graft known as a.v fistula or a.v
graft.
• * Most common use artery and veins are radial artery
and cephalic vein.

7. Complication
• Hypotension
• Septic shock
• Disequilibrium syndrome: N/V, restlessness,
confusion

8. Some Important Points
₰ Don’t take temperature from affected extremities
₰ Don’t take BP from affected arms.
₰ Don’t infuse any type of drug in graft and fistula.
₰ HD commonly performed between radial artery and cephalic
vein.
₰ It may be performed between femoral catheter and
subclavian vein for temporary.
₰ Graft is reliable for 1-2 year.
₰ Glucose is added in dialysate solution to increase the removal
of waste products.
₰ HD in a week 3 times
₰ HD maximum 4hours because it cause hypotension.

9. Peritoneal Dialysis
• PD is commonly used for short term.
• It is used for drug toxicity.
• The semipermeable membrane is peritoneum.
• Peritoneum is very rich in blood supply.

12. Continuous ambulatory peritoneal dialysis (CAPD)
You fill your abdomen with dialysate, let it remain
there for a prescribed dwell time, then drain the
fluid. Gravity moves the fluid through the catheter
and into and out of your abdomen.
• You may need three to five exchanges during the
day and one with a longer dwell time while you
sleep
• You can do the exchanges at home, work or any
clean place
• You're free to go about your normal activities
while the dialysate dwells in your abdomen

13. Continuous cycling peritoneal dialysis (CCPD)
• Also known as automated peritoneal dialysis (APD), this
method uses a machine (automated cycler) that performs
multiple exchanges at night while you sleep. The cycler
automatically fills your abdomen with dialysate, allows it
to dwell there and then drains it to a sterile bag that you
empty in the morning.
• You must remain attached to the machine for about 10 to
12 hours at night.
• You aren't connected to the machine during the day. But
in the morning you begin one exchange with a dwell time
that lasts the entire day.

14. Complication
• Peritonitis
• Bladder Perforation
• Bowel Perforation
• Chronic abdominal pain
• Bleeding
• Septicemia