Dialysis is a method of treatment of terminal renal failure. When the kidneys are no longer working effectively, waste products (toxins) and fluid builds up in the body. Dialysis takes over the functions of the kidneys are failing and removes waste products and fluid.
Dialysis is usually required when the lost 90 percent or more of kidney function. This behavior usually occurs several months or years after the diagnosis of chronic kidney disease. At the beginning of kidney disease used other types of therapies that help maintain kidney function and delay the need for renal replacement therapy.
What type DIALYSIS BEST? - When dialysis becomes necessary, the patient (with the doctors) examine the pros and cons of the two types of dialysis:
Hemodialysis (in the center or at home)
Peritoneal Dialysis
The choice between hemodialysis and hemodialysis peritonumske influenced by many factors such as availability, convenience, underlying medical problems, the situation in the home and age. This decision is best made after discussion with your doctor about the risks and benefits of both types of dialysis.
When you start dialysis - Together with the doctor, the patient decides on the time of starting dialysis, according to the kidney failure. The decision affect renal function (as measured by blood tests and urine tests), overall health, nutritional status, symptoms, quality of life, personal preferences and other factors. Doctors recommend that dialysis begin much before the kidney disease has progressed so much that can be life-threatening complications.
Many patients have to start dialysis when renal function is 8 to 12 percent of normal, even though it varies from patient to patient.
In some situations, dialysis must immediately begin. If the blood tests suggest that this is a very poor kidney function or non-existent, or if there are symptoms such as confusion or bleeding associated with kidney disease, the application of dialysis should be started immediately.
Preparation for hemodialysis - Preparation for hemodialysis should be made at least a few months before it becomes necessary. In particular, the procedures needed "vascular access" (described below) for a few weeks or months before treatment.
Vascular access - Vascular access to collect blood from the bodies of patients, its treatment in the dialysis machine and back into the body of the patient. There are three main types of vascular access: primary AV fistula, synthetic AV grafts and central venous catheter. Other names for access to the fistula or shunt.
The approach needs to be made before the start of dialysis because of the time needed for its "maturity". Consultation on Access to begin even earlier, because he has to avoid injury to the vessels that will be used for it. Intravenous infusion or frequent blood sampling from the arm that will be used to create vascular access can damage veins, which subsequently makes it impossible to use those for vascular access. Access is usually on the right hand that is not dominant; lefthanded people will have access to the left hand.
After the formation of vascular access is very important to monitor it and take care of him.
Primary AV fistula - Primary AV fistula is the most common type of vascular access. Requires a surgical procedure that makes a direct connection between arteries and veins. This is often done on the forearm, but it can on the upper arm. Sometimes, the veins that normally would not be useful for creating AV fistulas may be moved so that it is accessible and this can often be performed on the upper arm.
Regardless of the position or the way in which it is made, access under the skin. During dialysis, the approach introduces two pins. Through a needle of blood out of the body, passes through the dialysis machine and back into the body through another needle.
Primary AV fistulae usually makes two to four months before they will be used for dialysis. During this time, the wound will heal and access will be fully developed and "mature."
Synthetic graft - Sometimes the veins in the hand of the patient are not suitable for the creation of the fistula. In this case, the surgeon can use a flexible rubber tube in order to make a path between arteries and veins. This is called a synthetic graft. Graft under the skin and is used in the same way as the fistula.
Graft heals faster than fistulas can often be used for two weeks after installation. However, complications such as narrowing of the blood vessels and infection occur more frequently than in the case of graft AV fistula.
Central venous catheter - Central venous catheter using a thin flexible tube that is inserted into a large vein (usually a door). Recommended if dialysis must immediately begin, and the patient does not have a functioning AV fistula or graft. This type of approach is usually used only temporarily. In some cases, however, there may be problems with the maintenance of AV fistula or graft, and central venous catheter permanent access.
Catheters have the highest risk of infection and the worst position in comparison with other approaches; should be used only if the primary fistula or synthetic graft can not be sustained.
Changes in diet - Some patients, especially those made in the dialysis center, it will have to make changes in your diet before and during treatment. These changes are provided to prevent overloading and liquids to enter a balanced amount of protein, calories, vitamins and minerals.
Can you recommend a diet low in sodium, potassium and phosphorus, and fluids (drinks and food) may be limited. A dietitian can help patients when choosing foods that are compatible with dialysis treatment.
LOCATION hemodialysis treatment - hemodialysis can be performed at home or in the center.
Home treatment - treatment for pets is essential that the patient and members of his / her family educated and constant support physicians experienced in the treatment of patients on home hemodialysis. This usually means nephrologist (kidney specialist) and too specialized nurse.
Patients treated with hemodialysis at home usually can lead an independent life and often have longer survival compared to patients treated in a dialysis center. This is partly due to the fact that patients on home hemodialysis have more frequent and longer dialysis treatments of patients at the center.
Home hemodialysis is generally performed three to seven times a week and lasts between three and ten hours after treatment. Hemodialysis, which is done during the day usually takes three to four hours a day, four to seven times a week. Hemodialysis, which is done at night (nocturnal hemodialysis takzvana) is usually performed three to seven times a week while the patient sleeps. Preparation and cleaning needed more time.
Home dialysis can be done at a time that suits the patient. Usually require the participation of another person (family member, friend or technician) who helps the patient before, during and after dialysis.The doctor has to be a phone available in case of problems or issues; daily (or nightly) dialysis schedule provides additional benefit compared to treatment at the center, which is done three times a week. More frequent dialysis results in a significant increase in health, reduce symptoms during and between dialysis and improves the quality of žifvota. Home dialysis can improve quality of life as to download more responsibilities related to care of themselves and to staying in the comfort of the apartment during the treatment. In addition, patients who use home hemodialysis can usually keep their job.
Equipment - For home dialysis is necessary that the patient has a dialysis machine at home. In addition, the system is required for the preparation of water for hemodialysis (reverse osmosis), dialyzers, dialysis solutions, disinfectants, syringes, needles, drugs, blood lines and sets to test the waters. Some devices need electrical and plumbing modifications of the house in which dialysis is performed. Currently available equipment for the size of night-table.
Treatment center for dialysis - Dialysis can be performed in a hospital, clinic associated with a hospital or an independent clinic. The centers employ doctors, nurses and carers and all involved in the care.Generally, the dialysis center takes between three and five hours (an average of three and a half to four hours) and is performed three times a week. During treatment the patient can sleep or read and usually has access to a television. The HD unit consumption of food and beverages, as well as visits are usually limited.
Travel Tools - Dialysis centers are located all over the world. Patients who need dialysis, but who want to travel scheduling consultations in the center of the village in which they want to travel (temporary center). Many dialysis centers have an employee, nurse or social worker, to help in organizing the visit; planning should be done six to eight weeks prior to travel to ensure a place.
Dialysis center where the patient has regular treatments temporary center must provide the patient's medical history, including the results of recent tests and information about treatment, list of medications, insurance information, and any other necessary information.
Patients with chronic medical problems, including those requiring dialysis, the trip must be carefully planned.
Monitoring the quality HEMODIALYSIS
In patients treated with hemodialysis are regularly doing lab tests to check the quality or adequacy of hemodialysis. Modern dialysis machines have all the modules during dialysis showed the same quality.Based on the results of these tests are set conditions hemodialysis (blood flow velocity, length of dialysis, type of dialysis filter, etc.).. Numerous clinical studies have shown that the efficiency and adequacy of hemodialysis affect survival of patients as well as in the quality of life. Assessing the adequacy of dialysis should be done at least once a month.
Monitoring body weight - After failing kidneys that can not remove the required amount of fluid from the body, the task must be performed dialysis. Accumulation of fluid between two hemodialysis treatments can lead to complications. Most patients measure the weight before and after dialysis and are looking for an everyday weight control at home. If the patient's weight between the two treatments increased more than normal, he must contact his or her doctor.
Care Access - It is very important to take care of vascular access in order to prevent complications.Complications can occur even when the patient is alert, but less if you take certain precautions:
Access daily washing with soap and water, and always before starting. The patient should not be slate or removes scabs.
Every day check whether there are symptoms of infection such as redness or to the temperature.
Daily check to see if there is access to the blood flow. You need to feel the vibrations through access.Tell your doctor if there is none, or change. Blood flow is sometimes controlled by ultrasound (Doppler). Monitoring the flow and velocity of blood flow through the access during treatment.
Hand with approach must not be violated; patient should not wear tight clothes, jewelry, or heavy things to sleep on that arm. You should not allow blood tests or blood pressure in the arm.
Unwanted effects on hemodialysis - Most patients well tolerated hemodialysis. However, I can report adverse events. Low blood pressure is the most common complication and may be accompanied by dizziness, shortness of breath, abdominal cramps and muscle pain, nausea and vomiting.
For any inconvenience that may occur during hemodialysis, treatments and preventive measures.Many side effects are associated with excess salt and fluid accumulation between treatments, which is minimized by carefully monitoring the amount of salt and fluid enters the patient between two dialysis.
Dialysis is usually required when the lost 90 percent or more of kidney function. This behavior usually occurs several months or years after the diagnosis of chronic kidney disease. At the beginning of kidney disease used other types of therapies that help maintain kidney function and delay the need for renal replacement therapy.
What type DIALYSIS BEST? - When dialysis becomes necessary, the patient (with the doctors) examine the pros and cons of the two types of dialysis:
Hemodialysis (in the center or at home)
Peritoneal Dialysis
The choice between hemodialysis and hemodialysis peritonumske influenced by many factors such as availability, convenience, underlying medical problems, the situation in the home and age. This decision is best made after discussion with your doctor about the risks and benefits of both types of dialysis.
When you start dialysis - Together with the doctor, the patient decides on the time of starting dialysis, according to the kidney failure. The decision affect renal function (as measured by blood tests and urine tests), overall health, nutritional status, symptoms, quality of life, personal preferences and other factors. Doctors recommend that dialysis begin much before the kidney disease has progressed so much that can be life-threatening complications.
Many patients have to start dialysis when renal function is 8 to 12 percent of normal, even though it varies from patient to patient.
In some situations, dialysis must immediately begin. If the blood tests suggest that this is a very poor kidney function or non-existent, or if there are symptoms such as confusion or bleeding associated with kidney disease, the application of dialysis should be started immediately.
Preparation for hemodialysis - Preparation for hemodialysis should be made at least a few months before it becomes necessary. In particular, the procedures needed "vascular access" (described below) for a few weeks or months before treatment.
Vascular access - Vascular access to collect blood from the bodies of patients, its treatment in the dialysis machine and back into the body of the patient. There are three main types of vascular access: primary AV fistula, synthetic AV grafts and central venous catheter. Other names for access to the fistula or shunt.
The approach needs to be made before the start of dialysis because of the time needed for its "maturity". Consultation on Access to begin even earlier, because he has to avoid injury to the vessels that will be used for it. Intravenous infusion or frequent blood sampling from the arm that will be used to create vascular access can damage veins, which subsequently makes it impossible to use those for vascular access. Access is usually on the right hand that is not dominant; lefthanded people will have access to the left hand.
After the formation of vascular access is very important to monitor it and take care of him.
Primary AV fistula - Primary AV fistula is the most common type of vascular access. Requires a surgical procedure that makes a direct connection between arteries and veins. This is often done on the forearm, but it can on the upper arm. Sometimes, the veins that normally would not be useful for creating AV fistulas may be moved so that it is accessible and this can often be performed on the upper arm.
Regardless of the position or the way in which it is made, access under the skin. During dialysis, the approach introduces two pins. Through a needle of blood out of the body, passes through the dialysis machine and back into the body through another needle.
Primary AV fistulae usually makes two to four months before they will be used for dialysis. During this time, the wound will heal and access will be fully developed and "mature."
Synthetic graft - Sometimes the veins in the hand of the patient are not suitable for the creation of the fistula. In this case, the surgeon can use a flexible rubber tube in order to make a path between arteries and veins. This is called a synthetic graft. Graft under the skin and is used in the same way as the fistula.
Graft heals faster than fistulas can often be used for two weeks after installation. However, complications such as narrowing of the blood vessels and infection occur more frequently than in the case of graft AV fistula.
Central venous catheter - Central venous catheter using a thin flexible tube that is inserted into a large vein (usually a door). Recommended if dialysis must immediately begin, and the patient does not have a functioning AV fistula or graft. This type of approach is usually used only temporarily. In some cases, however, there may be problems with the maintenance of AV fistula or graft, and central venous catheter permanent access.
Catheters have the highest risk of infection and the worst position in comparison with other approaches; should be used only if the primary fistula or synthetic graft can not be sustained.
Changes in diet - Some patients, especially those made in the dialysis center, it will have to make changes in your diet before and during treatment. These changes are provided to prevent overloading and liquids to enter a balanced amount of protein, calories, vitamins and minerals.
Can you recommend a diet low in sodium, potassium and phosphorus, and fluids (drinks and food) may be limited. A dietitian can help patients when choosing foods that are compatible with dialysis treatment.
LOCATION hemodialysis treatment - hemodialysis can be performed at home or in the center.
Home treatment - treatment for pets is essential that the patient and members of his / her family educated and constant support physicians experienced in the treatment of patients on home hemodialysis. This usually means nephrologist (kidney specialist) and too specialized nurse.
Patients treated with hemodialysis at home usually can lead an independent life and often have longer survival compared to patients treated in a dialysis center. This is partly due to the fact that patients on home hemodialysis have more frequent and longer dialysis treatments of patients at the center.
Home hemodialysis is generally performed three to seven times a week and lasts between three and ten hours after treatment. Hemodialysis, which is done during the day usually takes three to four hours a day, four to seven times a week. Hemodialysis, which is done at night (nocturnal hemodialysis takzvana) is usually performed three to seven times a week while the patient sleeps. Preparation and cleaning needed more time.
Home dialysis can be done at a time that suits the patient. Usually require the participation of another person (family member, friend or technician) who helps the patient before, during and after dialysis.The doctor has to be a phone available in case of problems or issues; daily (or nightly) dialysis schedule provides additional benefit compared to treatment at the center, which is done three times a week. More frequent dialysis results in a significant increase in health, reduce symptoms during and between dialysis and improves the quality of žifvota. Home dialysis can improve quality of life as to download more responsibilities related to care of themselves and to staying in the comfort of the apartment during the treatment. In addition, patients who use home hemodialysis can usually keep their job.
Equipment - For home dialysis is necessary that the patient has a dialysis machine at home. In addition, the system is required for the preparation of water for hemodialysis (reverse osmosis), dialyzers, dialysis solutions, disinfectants, syringes, needles, drugs, blood lines and sets to test the waters. Some devices need electrical and plumbing modifications of the house in which dialysis is performed. Currently available equipment for the size of night-table.
Treatment center for dialysis - Dialysis can be performed in a hospital, clinic associated with a hospital or an independent clinic. The centers employ doctors, nurses and carers and all involved in the care.Generally, the dialysis center takes between three and five hours (an average of three and a half to four hours) and is performed three times a week. During treatment the patient can sleep or read and usually has access to a television. The HD unit consumption of food and beverages, as well as visits are usually limited.
Travel Tools - Dialysis centers are located all over the world. Patients who need dialysis, but who want to travel scheduling consultations in the center of the village in which they want to travel (temporary center). Many dialysis centers have an employee, nurse or social worker, to help in organizing the visit; planning should be done six to eight weeks prior to travel to ensure a place.
Dialysis center where the patient has regular treatments temporary center must provide the patient's medical history, including the results of recent tests and information about treatment, list of medications, insurance information, and any other necessary information.
Patients with chronic medical problems, including those requiring dialysis, the trip must be carefully planned.
Monitoring the quality HEMODIALYSIS
In patients treated with hemodialysis are regularly doing lab tests to check the quality or adequacy of hemodialysis. Modern dialysis machines have all the modules during dialysis showed the same quality.Based on the results of these tests are set conditions hemodialysis (blood flow velocity, length of dialysis, type of dialysis filter, etc.).. Numerous clinical studies have shown that the efficiency and adequacy of hemodialysis affect survival of patients as well as in the quality of life. Assessing the adequacy of dialysis should be done at least once a month.
Monitoring body weight - After failing kidneys that can not remove the required amount of fluid from the body, the task must be performed dialysis. Accumulation of fluid between two hemodialysis treatments can lead to complications. Most patients measure the weight before and after dialysis and are looking for an everyday weight control at home. If the patient's weight between the two treatments increased more than normal, he must contact his or her doctor.
Care Access - It is very important to take care of vascular access in order to prevent complications.Complications can occur even when the patient is alert, but less if you take certain precautions:
Access daily washing with soap and water, and always before starting. The patient should not be slate or removes scabs.
Every day check whether there are symptoms of infection such as redness or to the temperature.
Daily check to see if there is access to the blood flow. You need to feel the vibrations through access.Tell your doctor if there is none, or change. Blood flow is sometimes controlled by ultrasound (Doppler). Monitoring the flow and velocity of blood flow through the access during treatment.
Hand with approach must not be violated; patient should not wear tight clothes, jewelry, or heavy things to sleep on that arm. You should not allow blood tests or blood pressure in the arm.
Unwanted effects on hemodialysis - Most patients well tolerated hemodialysis. However, I can report adverse events. Low blood pressure is the most common complication and may be accompanied by dizziness, shortness of breath, abdominal cramps and muscle pain, nausea and vomiting.
For any inconvenience that may occur during hemodialysis, treatments and preventive measures.Many side effects are associated with excess salt and fluid accumulation between treatments, which is minimized by carefully monitoring the amount of salt and fluid enters the patient between two dialysis.
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