Kidney Dialysis in End Stage Renal Disease (ESRD): Major Complication of Diabetic
The stage where kidneys become damaged and can no longer function well enough is known as end stage renal disease (ESRD). At this stage kidney dialysis is required.This is one of the major complications of diabetic.
Kidneys are the most vital organ of human body which remove waste fluid from your body, maintain your blood pressure and keep your bones strong. They also ensure that you have the right amount of potassium and sodium , in your blood. They produce the hormone that causes your body to create red blood cells. Prolonged high sugar will cause chronic kidney disease which requires kidney dialysis. Dialysis is a treatment that filters and purifies the blood using a machine.
Types of Kidney Dialysis:
There are two types of kidney dialysis.
Hemodialysis is the most common type of dialysis. In this process a hemodialyzer that is an artificial kidney is used to remove the waste fluid and chemicals from your blood. Surgically a vascular access or an entrance point is created to get the blood to flow to the artificial kidney, into your blood vessels. This vascular access will allow a larger amount of blood to flow through your body during hemodialysis treatment in order to filter and purify the blood.
We have two kinds of vascular access designed for long-term dialysis treatments .
- An arteriovenous (AV) fistula, which connects an artery and a vein and an AV graft, which is a looped tube.For short-term use, a catheter may be inserted into the large vein in your neck.
- Hemodialysis needed three times per week and usually last three to five hours.The amount of time for treatment depends on your body size and the amount of waste in your body.
The peritoneum is a membrane which lines our abdomen. It is capable of filtering waste products out of the blood in a similar way does the kidneys,since it has large quantity of small blood vessels.
We have two types of peritoneal dialysis.
- Continuous Ambulatory Peritoneal Dialysis (CAPD): In this process dialysis fluid flows into your abdominal cavity through a catheter. The fluid remains in the abdominal cavity for several hours and enables the peritoneum to filter waste products out of the blood into the dialysis fluid. It usually takes about 30 to 40 minutes to drain the fluid into the peritoneal cavity. your abdomen is filled and drained multiple times each day in this process.
- Automated Peritoneal Dialysis (APD): In this process an APD machine controls the drainage of fluid. Your abdomen will be connected to the machine for 8 to 10 hours .During the day you will keep dialysis fluid in your peritoneal cavity which will be drained away in the evening. So this will be done overnight as you sleep.
Advantages and Disadvantages of Types of kidney Dialysis:
Advantages of Haemodialysis :
Daily dialysis is not required. You can plan it as your convenience.
Disadvantages of Haemodialysis :
- Diet and fluid intake are restricted.
- If you travel for several days, you will need to ensure access to the dialysis machine on that place.
- Low blood pressure, anemia, or not having enough red blood cells, muscle cramping, difficulty sleeping, itching, high blood potassium levels, depression, pericarditis, which is an inflammation of the membrane around the heart are the most common side effects of haemodialysis.
Advantages of Peritoneal Dialysis:
It is easier to travel if on CAPD as it fit in with work and other activities.
There are fewer restrictions on diet and fluid intake.
Disadvantages of Peritoneal Dialysis:
- Peritoneal dialysis needs to be carried out each day and CAPD will be done through out the day.
- Peritoneal dialysis can lead to peritonitis, an infection of the peritoneum which have symptoms such as severe abdominal pain, episodes of shivering, fever and vomiting.
- Peritoneal dialysis can lead to lethargy or malnutrition resulting from losses in protein, weight gain , abdominal muscle weakening and high blood sugar due to the dextrose in the dialysate are the possible side effects.
Long-term dialysis treatments may develop amyloidosis. This disease can occur when amyloid proteins produced in bone marrow build up in the kidneys, liver, heart, and other organs. This will have symptoms of joint pain, stiffness, and swelling. Some people may also develop depression after being diagnosed with long-term kidney failure.