Hemodialysis,

Phosphorus and
Calcium,
Peritoneal Dialysis

Hemodialysis

What is a Dialysis
Dialysis is a way of cleaning your blood
when your kidneys can no longer do the
job. It gets rid of your body's wastes, extra
salt and water, and helps to control your
blood pressure.

What is Hemodialysis?
Hemodialysis is the most common method
used to treat advanced and permanent
kidney failure. Since the 1960s, when
hemodialysis first became a practical
treatment for kidney failure.
Hemodialysis is a therapy that filters
waste, removes extra fluid and balances
electrolytes (sodium, potassium,
bicarbonate, chloride, calcium,
magnesium and phosphate).

How is Hemodialysis done?

Blood is removed from the body and filtered through a
man-made membrane called a DIALYZER, or artificial
kidney, and then the filtered blood is returned to the
body. The average person has about 10 to 12 pints of
blood; during dialysis only one pint is outside of the body
at a time.There are three access types for hemodialysis:
arteriovenous AV fistula, AV graft and central venous
catheter. The AV fistula is the vascular access most
recommended.

Dialysis Machine
The dialysis machine
mixes and monitors
the dialysate.
Dialysate is the fluid
that helps remove the
unwanted waste
products from your
blood. It also helps
get your electrolytes
and minerals to their
proper levels in your
body.

Dialyzer
Acts as an
ARTIFICIAL KIDNEY.
They clean toxic
substances.

Types of Vascular Access for Hemodialysis

Arteriovenous Fistula (AV Fistula)

Arteriovenous Graft (AV Graft)
Venous Catheter
heRO (hemosphere, minneapolis, mn)

Arteriovenous Graft

If a patient is not a good

candidate for an arteriovenous
fistula, an arteriovenous graft
is considered. An
arteriovenous graft is a piece
of artificial tubing, generally
made out of teflon or fabric,
that is attached on one end to
an artery, and on the other end
to a vein. The tube is placed
entirely under the skin and the
tube itself is punctured during
dialysis

Venous Catheter
A third type of vascular
access is a venous
catheter. A venous
catheter is a plastic tube
which is inserted into a
large vein, usually in the
neck. An external portion
of the catheter is exposed
on the chest wall that
allows the tubing for the
dialysis machine to be
connected.

HeRO (hemosphere, minneapolis, mn)

A final alternative for access

creation for patients who are not
good candidates for arteriovenous
fistula is a device that is a hybrid
of an arteriovenous graft and a
catheter. This device is especially
designed for patients who have a
narrowing of the large central
veins in the chest that would
prevent a fistula or a graft from
functioning properly. The entire
device is placed underneath the
skin and can be used for long-term
vascular access. The
characteristics of the device are
similar to those described above
for arteriovenous graft.

Simplified Diagram of Hemodialysis

Diet for Hemodialysis Patient

The diet restrictions include limiting foods
that contain PHOSPHORUS,
POTASSIUM, SODIUM and drinking a
limited amount of fluid.

What's a hemodialysis diet?

The hemodialysis diet is an eating plan
tailored to patients who are on
hemodialysis. Its designed to reduce the
amount of fluid and waste that builds up
between hemodialysis treatments.

What can I eat?

In addition to enjoying a variety of
nutritious foods, the hemodialysis diet will
introduce a higher amount of high-quality
protein into your eating plan. Your dietitian
will determine the amount. High-protein
foods such as lean meat, poultry, fish and
egg whites provide all the essential amino
acids your body needs.

What cant I eat?

Foods containing high amounts of sodium,
phosphorus and potassium are restricted.
Your dietitian will provide you with food
lists that indicate which foods are allowed
and which ones you should avoid or limit.
You will also limit your fluid intake.

Why do I have to eat this way?

Your dietitian and doctor will strongly
recommend you follow the hemodialysis
diet, so your dialysis treatments will be
effective, and help reduce the risk of
health complications associated with
kidney disease and dialysis.

How does the hemodialysis diet help?

Potassium is easily removed by dialysis, but when it builds up in the blood

between treatments, it can cause muscle weakness and make your heart
stop beating. Certain fruits, vegetables, dairy products and other foods that
are high in potassium will need to be restricted from your diet.

Phosphorus is difficult for hemodialysis to filter from the blood so its

important to limit foods that contain the mineral. Phosphorus can build to
high levels in the bloodstream and cause weak bones, heart problems, joint
pain or skin ulcers. Your doctor may also prescribe a medicine called a
phosphorus binder to help keep phosphorus levels normal.

Sodium causes your body to hold onto more fluid and raises your blood
pressure. Eating less sodium and drinking less fluid can help you feel
comfortable before and after your dialysis sessions.

Too much fluid gain between hemodialysis sessions can cause discomfort,
including swelling, shortness of breath or high blood pressure. Fluid intake is
not limited to what you can drink; its also hidden in some foods you eat,
including gelatin, ice, sherbet, watermelon, sauces and gravies.

Peritoneal
Dialysis

What is a Peritoneal Dialysis?

In Peritoneal dialysis the inside lining of
your own belly acts as a natural filter.
Wastes are taken out by means of a
cleansing fluid called dialysate, which is
washed in and out of your belly in cycles.

How does peritoneal dialysis work?

A soft plastic tube (catheter) is placed in
your belly by surgery. A sterile cleansing
fluid is put into your belly through this
catheter. After the filtering process is
finished, the fluid leaves your body
through the catheter.

There are two kinds of peritoneal dialysis

Continuous Ambulatory Peritoneal Dialysis (CAPD) a
machine-free and done while you go about your normal
activities such as work or school. You do the treatment
by placing about two quarts of cleansing fluid into your
belly and later draining it. This is done by hooking up a
plastic bag of cleansing fluid to the tube in your belly.
Raising the plastic bag to shoulder level causes gravity
to pull the fluid into your belly. When empty, the plastic
bag is removed and thrown away.

Automated Peritoneal Dialysis (APD) differs from CAPD

in that a machine (cycler) delivers and then drains the
cleansing fluid for you. The treatment usually is done at
night while you sleep.

Dialysis Process

Hookup
Infusion
Diffusion (Fresh)
Diffusion (Waste)
Drainage

Hookup

Infusion

Diffusion (Fresh)

Diffusion (Waste)

Drainage