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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 ...
Hemodialysis, also spelled haemodialysis, or simply dialysis, is a process of filtering the blood of a person whose kidneys are not working normally. This type of dialysis achieves the extracorporeal removal of waste products such as creatinine and urea and free water from the blood when the kidneys are in a state of kidney failure .
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.
As of 2017, hemodialysis is the most widely available renal replacement modality found in 96% of countries whereas peritoneal dialysis (PD) is only available in 75% of countries. [12] In 2016, the proportion of people receiving peritoneal dialysis (PD) was estimated at 11% with wide differences between different countries and regions. [ 33 ]
[22] [23] Severe disease requires hemodialysis, peritoneal dialysis, or a kidney transplant for survival. [9] Chronic kidney disease affected 753 million people globally in 2016 (417 million females and 336 million males.) [1] [24] In 2015, it caused 1.2 million deaths, up from 409,000 in 1990.
SCUF is a continuous renal replacement therapy (CRRT) generally used to remove fluid from fluid overloaded patients with acute kidney failure. During SCUF blood is continuously removed from the body, passed through an extracorporeal circuit through a hemofilter , and send back to the body.
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.
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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