Dialysis and kidney transplantation are the treatments for renal replacement applied in end-stage renal disease. There are two types of dialysis: hemodialysis and peritoneal dialysis.
When the kidneys are not working efficiently enough, the waste products (toxins) and fluid build up in the blood. Dialysis takes over the function of the kidneys are failing and removes liquid and wastes.Kidney transplantation is fully recovered renal function.
Here we talk about the pros and cons of these treatment options. You and your family with your doctor should talk about all the options that you have made the appropriate decision about your future medical treatment.
WHEN kidney dialysis or a kidney transplant be necessary? - At the beginning of the disease using drugs which preserves renal function and delay the need for dialysis and transplantation. These early treatment effect on renal disease, secondary factors (such as hypertension) that accelerate the development of renal disease and complications of chronic kidney disease.
As the kidneys lose their function, fluid and waste material began to accumulate in the blood. Dialysis should be started before the disease has progressed so much to report life-threatening complications.The need for dialysis / transplant occurs usually after months or even years of diagnosis of chronic renal disease, although severe kidney failure is sometimes the first time revealed in people who previously did not know they are suffering from chronic kidney disease.
Dialysis is best to start when the disease is advanced, but while still feeling unwell. About when you start dialysis decide together with the physician after considering several factors, including renal function (as measured by blood tests and urine tests), overall health and personal preferences.
KIDNEY TRANSPLANTATION - Kidney transplantation is considered the best treatment for all patients with renal failure because of the quality of life and survival are often better than in people treated with dialysis. However, due to lack of organs for transplantation, many patients who are candidates for a kidney transplant are waiting lists and dialysis they need until they find a suitable organ for transplantation.
The kidney can be obtained from living relatives, living person with whom the patient is not related by blood or cadaver (donor kadaverski) In general, life donor organs function better and longer than when coming from deceased donors.
Some people with kidney failure are not candidates for transplantation. For the elderly or patients with severe heart and vascular disease is safer to remain on dialysis than to undergo the transplant. Other conditions that prevent kidney transplant may include:
Active or recently treated for cancer
Severe chronic ooljenja other organs
Poorly controlled mental illness (psychosis)
Severe obesity (body mass index over 40)
The current abuse of drugs or alcohol
Some chronic viral infections
The majority of centers in the world off from the transplant program people who are HIV-positive. In some cases, however, people with HIV may be eligible for a kidney transplant if the disease is well controlled.
People with other medical conditions are assessed on a case by case basis to determine whether kidney transplantation is a viable option.
Benefits - Kidney transplantation is the best treatment for many patients with end-stage renal disease.Successful kidney transplantation can improve quality of life and reduce the risk of death due to kidney disease. In addition, people who undergo kidney transplantation will not waste time on daily dialysis.
Disadvantages - Kidney transplantation is a major surgical procedure that has risks both during surgery and afterwards. Risks of the surgery include infection, bleeding and damage to surrounding organs. Can come to death, although this rarely happens.
After kidney transplantation, the patient needs to take medication and go on frequent monitoring to reduce the risk of rejection; goes with it throughout life. Medications that the patient must be taken to have a significant and serious side effects.
HEMODIALYSIS - In hemodialysis, the patient's blood is pumped through a dialysis machine to remove waste products and excess fluid. The patient is connected to the machine via surgical napravljenog vascular access, which is commonly called fistula or graft. It allows taking blood from the body of the patient, blood flow through the machine where it purifies the blood and return blood to the body of the patient.
Hemodialysis can be done at home or in the center. When performed in the center is usually done three times a week and lasts for three to five hours. Home dialysis is usually performed three to seven times a week and lasts from three to ten hours after the procedure (often while the patient is asleep).
Advantages - It is unclear whether hemodialysis has clear advantages over other type of dialysis (peritoneal dialysis) when it comes to survival. The choice between these two types of dialysis is usually based on other factors such as personal preferences, support at home and basic medical problems. You need to start dialysis that you and your doctor think is best, although it's possible switch to another type of dialysis if the circumstances and preferences change.
Disadvantages - The most common complication of hemodialysis is low blood pressure, and may be accompanied by lightheadedness, shortness of breath, stomach cramps, nausea and vomiting. In the case of these problems, there are treatments and preventive measures. In addition, vascular access may be infected, or it may appear blood clots.
Peritoneal dialysis - Peritoneal dialysis (PD) is usually performed at home. To perform PD abdominal cavity is filled with dialysis fluid (called dialysate) through a catheter (flexible tube). The catheter is surgically introduced into the stomach, near the navel.
The liquid is a certain time (called the retention time) leaves the stomach. The tissue that lines the abdominal cavity (peritoneal membrane) acts as a membrane that allows the diffusion of excess fluid and waste products from the bloodstream into the dialysate. The used dialysate is then derived from the stomach and discarded. The peritoneal cavity is then filled again dialysate. This process is called an exchange.
Editing can be done manually, four to five times a day. Editing can also be done automatically by the device (called a cycler) while you sleep.
Benefits - Advantages of peritoneal dialysis compared to hemodialysis include fewer withdrawal time for work, family and social obligations. Most patients using PD can continue to work at least part-time, especially if the changes are working in a dream.
Disadvantages - People who use PD must know how to use the equipment for PD and how to do change fluid in the abdomen. If you can not do that, you need the help of a family or household who has previously trained to perform this procedure.
Disadvantages of peritoneal dialysis include an increased risk of hernia (hernia) due to the fluid pressure within the abdominal cavity. In addition, you can gain weight and a higher risk of infection in the catheter and inside the abdomen (peritonitis - inflammation of the peritoneum).
Which treatment is best for me? - Kidney transplantation is the optimal treatment for most patients.Patients who are not candidates for a kidney transplant or who have to wait for a kidney is usually treated either by hemodialysis or peritoneal dialysis.
The choice between hemodialysis and peritoneal dialysis is a complex problem that can best solve together with the doctor, and often consult family members or caregivers after careful consideration of all other factors.
For example, hemodialysis involves rapid changes in fluid balance in the body and not all patients can tolerate that. Some patients are not suitable candidates for a kidney transplant, while others do not have support at home or the necessary skills to perform peritoneal dialysis. Overall health status, personal preferences and situations in the home are only part of the factors that must be taken into account. It is possible to switch from one type of dialysis to another over time if options or preferences change.
When the kidneys are not working efficiently enough, the waste products (toxins) and fluid build up in the blood. Dialysis takes over the function of the kidneys are failing and removes liquid and wastes.Kidney transplantation is fully recovered renal function.
Here we talk about the pros and cons of these treatment options. You and your family with your doctor should talk about all the options that you have made the appropriate decision about your future medical treatment.
WHEN kidney dialysis or a kidney transplant be necessary? - At the beginning of the disease using drugs which preserves renal function and delay the need for dialysis and transplantation. These early treatment effect on renal disease, secondary factors (such as hypertension) that accelerate the development of renal disease and complications of chronic kidney disease.
As the kidneys lose their function, fluid and waste material began to accumulate in the blood. Dialysis should be started before the disease has progressed so much to report life-threatening complications.The need for dialysis / transplant occurs usually after months or even years of diagnosis of chronic renal disease, although severe kidney failure is sometimes the first time revealed in people who previously did not know they are suffering from chronic kidney disease.
Dialysis is best to start when the disease is advanced, but while still feeling unwell. About when you start dialysis decide together with the physician after considering several factors, including renal function (as measured by blood tests and urine tests), overall health and personal preferences.
KIDNEY TRANSPLANTATION - Kidney transplantation is considered the best treatment for all patients with renal failure because of the quality of life and survival are often better than in people treated with dialysis. However, due to lack of organs for transplantation, many patients who are candidates for a kidney transplant are waiting lists and dialysis they need until they find a suitable organ for transplantation.
The kidney can be obtained from living relatives, living person with whom the patient is not related by blood or cadaver (donor kadaverski) In general, life donor organs function better and longer than when coming from deceased donors.
Some people with kidney failure are not candidates for transplantation. For the elderly or patients with severe heart and vascular disease is safer to remain on dialysis than to undergo the transplant. Other conditions that prevent kidney transplant may include:
Active or recently treated for cancer
Severe chronic ooljenja other organs
Poorly controlled mental illness (psychosis)
Severe obesity (body mass index over 40)
The current abuse of drugs or alcohol
Some chronic viral infections
The majority of centers in the world off from the transplant program people who are HIV-positive. In some cases, however, people with HIV may be eligible for a kidney transplant if the disease is well controlled.
People with other medical conditions are assessed on a case by case basis to determine whether kidney transplantation is a viable option.
Benefits - Kidney transplantation is the best treatment for many patients with end-stage renal disease.Successful kidney transplantation can improve quality of life and reduce the risk of death due to kidney disease. In addition, people who undergo kidney transplantation will not waste time on daily dialysis.
Disadvantages - Kidney transplantation is a major surgical procedure that has risks both during surgery and afterwards. Risks of the surgery include infection, bleeding and damage to surrounding organs. Can come to death, although this rarely happens.
After kidney transplantation, the patient needs to take medication and go on frequent monitoring to reduce the risk of rejection; goes with it throughout life. Medications that the patient must be taken to have a significant and serious side effects.
HEMODIALYSIS - In hemodialysis, the patient's blood is pumped through a dialysis machine to remove waste products and excess fluid. The patient is connected to the machine via surgical napravljenog vascular access, which is commonly called fistula or graft. It allows taking blood from the body of the patient, blood flow through the machine where it purifies the blood and return blood to the body of the patient.
Hemodialysis can be done at home or in the center. When performed in the center is usually done three times a week and lasts for three to five hours. Home dialysis is usually performed three to seven times a week and lasts from three to ten hours after the procedure (often while the patient is asleep).
Advantages - It is unclear whether hemodialysis has clear advantages over other type of dialysis (peritoneal dialysis) when it comes to survival. The choice between these two types of dialysis is usually based on other factors such as personal preferences, support at home and basic medical problems. You need to start dialysis that you and your doctor think is best, although it's possible switch to another type of dialysis if the circumstances and preferences change.
Disadvantages - The most common complication of hemodialysis is low blood pressure, and may be accompanied by lightheadedness, shortness of breath, stomach cramps, nausea and vomiting. In the case of these problems, there are treatments and preventive measures. In addition, vascular access may be infected, or it may appear blood clots.
Peritoneal dialysis - Peritoneal dialysis (PD) is usually performed at home. To perform PD abdominal cavity is filled with dialysis fluid (called dialysate) through a catheter (flexible tube). The catheter is surgically introduced into the stomach, near the navel.
The liquid is a certain time (called the retention time) leaves the stomach. The tissue that lines the abdominal cavity (peritoneal membrane) acts as a membrane that allows the diffusion of excess fluid and waste products from the bloodstream into the dialysate. The used dialysate is then derived from the stomach and discarded. The peritoneal cavity is then filled again dialysate. This process is called an exchange.
Editing can be done manually, four to five times a day. Editing can also be done automatically by the device (called a cycler) while you sleep.
Benefits - Advantages of peritoneal dialysis compared to hemodialysis include fewer withdrawal time for work, family and social obligations. Most patients using PD can continue to work at least part-time, especially if the changes are working in a dream.
Disadvantages - People who use PD must know how to use the equipment for PD and how to do change fluid in the abdomen. If you can not do that, you need the help of a family or household who has previously trained to perform this procedure.
Disadvantages of peritoneal dialysis include an increased risk of hernia (hernia) due to the fluid pressure within the abdominal cavity. In addition, you can gain weight and a higher risk of infection in the catheter and inside the abdomen (peritonitis - inflammation of the peritoneum).
Which treatment is best for me? - Kidney transplantation is the optimal treatment for most patients.Patients who are not candidates for a kidney transplant or who have to wait for a kidney is usually treated either by hemodialysis or peritoneal dialysis.
The choice between hemodialysis and peritoneal dialysis is a complex problem that can best solve together with the doctor, and often consult family members or caregivers after careful consideration of all other factors.
For example, hemodialysis involves rapid changes in fluid balance in the body and not all patients can tolerate that. Some patients are not suitable candidates for a kidney transplant, while others do not have support at home or the necessary skills to perform peritoneal dialysis. Overall health status, personal preferences and situations in the home are only part of the factors that must be taken into account. It is possible to switch from one type of dialysis to another over time if options or preferences change.
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