Kidney Dialysis In order for blood to perform its essential functions of bringing nutrients and oxygen to the cells

of the body, and carrying waste materials away from those cells, the chemical composition of the blood must be carefully controlled. Blood contains particles of many different sizes and types, including cells, proteins, dissolved ions, and organic waste products. Some of these particles, such as proteins like hemoglobin, are essential for the body. Others, such as urea (a waste product from protein metabolism), must be removed from the blood or they will accumulate and interfere with normal metabolic processes. The Kidneys maintain the balance of chemistry within the blood. The Kidneys are a pair of organs located just behind the lining of the abdominal cavity. It is the job of the kidneys to remove the harmful particles from the blood and to regulate the blood's ionic concentrations, while keeping the essential particles in the blood. When the kidneys fail to filter and balance the bloods chemistry, dialysis maybe required. There are three types of kidney dialysis; Hemodialysis, Home Hemodialysis, and Peritoneal Dialysis. Hemodialysis uses a membrane that is immersed in a large volume of fluid. The blood is pumped through this tubing, and then back into the patient's vein. The membrane has a molecular-weight cut-off that will allow most solutes in the blood to pass out of the tubing but retain the proteins and cells. The external solution in which the tubing is immersed is a salt solution with ionic concentrations near or slightly lower than the desired concentrations in the blood. This filtering process usually happens in a clinical setting. The typical dialysis takes 3-4 hours per treatment and is required 3 times a week on average. Home Hemodialysis is very similar to Hemodialysis as described above but uses a smaller filtering machine that can be used in a patient's home. It allows the patient to more flexibility then traditional set dialysis appointments. Peritoneal dialysis does not use an artificial membrane, but rather uses the lining of the patient's abdominal cavity, known as the peritoneum, as a dialysis membrane. Dianeal fluid is infused into the peritoneal cavity and excess body fluid by osmosis and diffusion. After several hours, the fluid is drained and replaced with new denial fluid. The patient is free to perform normal activities between fluid changes. Frequently Asked Questions and Dialysis 1. What do the doctors do? Each month the nephrologists take turns at each dialysis unit to meet with you on an individual basis: they discuss your lab work and offer suggestions related to your diet and physical health, they prescribe specific medications and/or treatment options to improve your health; they will also listen to your problems and offer other recommendations to help with your ailments. At your office appointment, they perform a thorough physical, review your medications, and review your medical issues in more detail than when rounding at the units.

2. Why did my kidneys stop working? There are many causes of kidney disease. The number one cause is high blood pressure. The longer you leave your high blood pressures go untreated the greater chance for kidney disease. Diabetes is the second leading cause for kidney failure. Good blood sugar control can prevent or delay kidney failure. However, even if on dialysis good blood sugar control is important to prevent further complications from diabetes. Genetics may also contribute to high blood pressure and/or kidney disease.

3. Will dialysis shorten my life? It can, but dialysis is also keeping you alive. When your kidneys fail, dialysis and/or a transplant are needed for you to stay alive. You can prolong your life by following your diet recommendations, exercising, coming to dialysis every treatment, staying your entire prescribed treatment time, stop smoking, quit using illegal drugs, and taking all of your prescribed medications as directed.

4. Will my kidney function ever come back? It is possible, but extremely rare. It depends on the cause of your kidney failure to begin with. If the cause is high blood pressure or diabetes, your kidney function most likely will not return. You will most likely need to stay on dialysis for the rest of your life to stay alive, unless you receive a kidney transplant. This is a topic that should be discussed with your physician. Also, be sure to speak with your Nephrologist to see if you are a good candidate for a kidney transplant.