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Renal replacement therapy includes dialysis (hemodialysis or peritoneal dialysis), hemofiltration, and hemodiafiltration, which are various ways of filtration of blood with or without machines. Renal replacement therapy also includes kidney transplantation, which is the ultimate form of replacement in that the old kidney is replaced by a donor ...
Hemofiltration is sometimes used in combination with hemodialysis, when it is termed hemodiafiltration. Blood is pumped through the blood compartment of a high flux dialyzer, and a high rate of ultrafiltration is used, so there is a high rate of movement of water and solutes from blood to dialysate that must be replaced by substitution fluid that is infused directly into the blood line.
Hemodialysis is the choice of renal replacement therapy for patients who need dialysis acutely, and for many patients as maintenance therapy. It provides excellent, rapid clearance of solutes. [2] A nephrologist (a medical kidney specialist) decides when hemodialysis is needed and the various parameters for a dialysis treatment. These include ...
However, only a small portion of dialysis patients use peritoneal dialysis treatment because it requires large amounts of dialysate to be stored and disposed. A healthy individual's kidneys filter blood 24 hours/day, 168 hours/week compared to an individual with end-stage renal disease whose dialysis treatment plan is approximately 12 hours a week.
Peritoneal dialysis was first carried out in the 1920s; however, long-term use did not come into medical practice until the 1960s. [35] The timeline was 1923 – Georg Ganter performs the first peritoneal dialysis in a guinea pig and attempts the procedure in humans, without success. Hypertonic saline was used as the dialysate. [35] [36]
Schematic of semipermeable membrane during hemodialysis, where blood is red, dialysing fluid is blue, and the membrane is yellow. Kidney dialysis (from Greek διάλυσις, dialysis, 'dissolution'; from διά, dia, 'through', and λύσις, lysis, 'loosening or splitting') is the process of removing excess water, solutes, and toxins from the blood in people whose kidneys can no longer ...
Treatment of chronic failure may include hemodialysis, peritoneal dialysis, or a kidney transplant. [2] Hemodialysis uses a machine to filter the blood outside the body. [2] In peritoneal dialysis specific fluid is placed into the abdominal cavity and then drained, with this process being repeated multiple times per day. [2]
Dialysis disequilibrium syndrome is a reason why hemodialysis initiation should be done gradually, i.e. it is a reason why the first few dialysis sessions are shorter and less aggressive than the typical dialysis treatment for end-stage renal disease patients. [citation needed]
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