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Dialysis

Dialysis

Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...

Peritoneal Dialysis I: Introduction and Procedure

Peritoneal Dialysis I: Introduction and Procedure

Peritoneal dialysis (PD) is a procedure that facilitates the exchange of solutes, waste products, electrolytes, and excess fluid between the blood in the peritoneal capillaries and a dialysis solution introduced into the peritoneal cavity.Principles of Peritoneal Dialysis (PD)Diffusion: Waste products such as urea and electrolytes move from high concentrations in the blood to low concentrations in the dialysate across the peritoneal membrane. This mechanism is driven by the concentration...

Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...

Hemodialysis I: Introduction

Hemodialysis I: Introduction

Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...

Hemodialysis II: Procedure and Complications

Hemodialysis II: Procedure and Complications

DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...

Hemodialysis III: Nursing Management

Hemodialysis III: Nursing Management

The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this measurement...

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Related Experiment Video

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A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice

A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice

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Catheter access for hemodialysis: an overview.

D W Butterly¹, S J Schwab

¹Division of Nephrology, Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA.

Seminars in Dialysis

|February 20, 2002

Summary

Tunneled dialysis catheters offer convenient central circulatory access for hemodialysis but increase risks of infection, vein stenosis, and mortality. Arteriovenous fistulae and grafts remain preferred for long-term, safer hemodialysis vascular access.

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Area of Science:

Nephrology
Vascular Surgery
Infectious Diseases

Background:

Hemodialysis necessitates reliable central circulatory access.
Arteriovenous fistulae (AVF) and arteriovenous grafts (AVG) are traditional long-term access methods.
Tunneled dialysis catheters (TDCs) are increasingly used for chronic hemodialysis.

Purpose of the Study:

To evaluate the role and risks of TDCs in chronic hemodialysis.
To compare TDCs with AVF and AVG for long-term vascular access.

Main Methods:

Review of current literature on hemodialysis vascular access.
Analysis of complication rates associated with TDCs versus AVF/AVG.
Assessment of patient outcomes related to different access modalities.

Main Results:

TDCs offer immediate usability and ease of placement.
TDCs are associated with significantly higher risks of bacteremia.
TDCs increase the likelihood of central vein stenosis and mortality compared to AVF/AVG.

Conclusions:

While convenient, TDCs pose substantial risks for chronic hemodialysis patients.
AVF and AVG remain superior for long-term hemodialysis due to lower complication rates.
Careful consideration of risks versus benefits is crucial when selecting TDC for maintenance hemodialysis.