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What is Dialysis?

Dialysis is a procedure that removes waste products from the body.


When the kidneys are not functioning correctly, these waste products build
up and remain in the blood. As the quantity of these waste products rise in
the blood, the patient becomes sick with symptoms such as progressive
nausea and vomiting, lack of appetite, muscle cramps and itching. This is
called uremia. Family members may notice that the person with uremia
may become sleepy, tired or weak.
Dialysis is a cleansing procedure that removes toxins and excess water
from the blood (replacing the job the patient's kidneys were doing before
they stopped functioning correctly). This is necessary when the kidneys are
no longer able to filter these waste products and remove the extra fluid
that accumulates. Dialysis is required when your kidneys are no longer
performing enough of their function of cleansing the blood of waste and
excess fluid (End Stage Renal Disease [ESRD] has set in). A person can lose
approximately 80-90% of their kidney function before its the time for dialysis.
There are two types of dialysis, hemodialysis and peritoneal dialysis.

Hemodialysis
Hemodialysis is done using an artificial kidney machine that directly filters
the blood. This occurs by removing the blood from the body via a vein (called
a "vascular access," typically in the forearm), running it through the artificial

kidney machine (which performs the cleansing step), and reinjecting the
blood back into the same vein (but in a slightly different location).
Hemodialysis usually occurs either in a dialysis center or in the home. The
dialysis center has televisions for viewing. Most dialyzing patients will either
watch TV, read a book or magazine or nap. Most folks who dialyze via
hemodialysis are placed on a schedule that includes three days per week of
dialyzing for approximately 4 hours. This schedule will typically be either
Mon.-Wed.-Fri. or Tues.-Thurs.-Sat., and will either occur in the morning or
during the afternoon.

Peritoneal Dialysis
Peritoneal dialysis (PD) is a procedure in which the natural lining of the
abdominal cavity is used as a filter. This lining, called the
peritoneal membrane, is richly supplied with small blood vessels. Types of PD
include continuous ambulatory peritoneal dialysis (CAPD) and continuous
cycling peritoneal dialysis (CCPD).
PD is done by instilling about two quarts of a special fluid (dialysate)
through a catheter into the abdominal cavity and periodically draining and
replacing the fluid. PD requires that a permanent catheter be placed into the
abdominal cavity. This soft plastic tube is about 12 inches long with only 45 inches remaining outside the body. It is placed below the level of the
umbilicus (belly button) and usually to either side of it. The catheter

iinsertion is performed in the operating room and often with local


anesthesia. The main concern with peritoneal dialysis is the risk of infection.
Since the catheter is a direct opening into the abdomen, strict guidelines
are used to avoid infection. Patients are examined monthly as outpatients
and blood work is done to make sure that the dialysis is adequate.
CAPD requires no external machine. The dialysis is done by connecting the
bag of dialysate to the abdominal catheter and allowing the fluid to flow into
the abdominal cavity. At this point, the patient can return to their normal
activity. After about 4-6 hours, the dialysate is allowed to flow back out of the
cavity into the bag (via gravity). At this point the full bag of removed fluid is
disconnected and a new bag of dialysate is attached. CAPD patients perform
four exchanges per day, seven days per week. The exchanges are typically
done once at wakeup, once at bedtime and two more times during the day
CCPD is a modification of CAPD. People who select CCPD dialyze via an
automated machine at nighttime.

Continuous Cycling Peritoneal Dialysis (CCPD)

Continuous Ambulatory Peritoneal Dialysis (CAPD)

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