دیالیز چیست؟ – انواع دیالیز و روش های آن


Kidneys play a very important role in the human body and the health of the body depends on them. In a healthy person, the kidneys are responsible for maintaining the balance between water and other minerals in the body. Minerals such as sodium, potassium, chlorine, calcium, phosphorus, magnesium and sulfur. Kidneys also have the task of purifying the blood and removing waste materials that are not removed through breathing and converting them into urea. This body organ also plays a role in the production of some hormones that are effective in building red blood cells and bone formation. But what if the kidneys are not working properly? If a person’s kidneys do not work properly or fail completely, that person may need dialysis. Dialysis is a treatment method that is used as a replacement for kidney function and can filter the waste materials in the body’s blood and filter the blood. Of course, dialysis cannot completely replace the kidney. Kidney failure and the increase of waste materials and fluids in the blood, if not treated, can cause disease and then death. Therefore, kidneys play a vital role in the body, and in their absence, dialysis is necessary; Because it can purify the blood and remove excess substances before these events occur. Dialysis is a treatment method to replace kidneys. Why is dialysis needed? Dialysis, to some extent, replaces the kidneys in the body. Of course, it is not a complete and perfect substitute. So, if a person’s kidneys fail one day, the treatment method that does not endanger the person’s life and does not suffer from severe symptoms of the disease is dialysis. Of course, the way and duration of dialysis can be different and depends on various factors. In some people, the kidney failure may be temporary and after some time it will start working again. As a result, these people only need dialysis for a limited time until their kidneys return to normal activity. In other cases, a person with kidney problems will need a kidney transplant. However, it is not always possible to perform a kidney transplant immediately and sometimes the patient has to wait for a long time to find a suitable and qualified donor. So the patient’s dialysis will continue until that time. There are other conditions that make a patient have to undergo dialysis for the rest of his life. For example, when the patient’s body is weak and cannot tolerate surgery, it is preferred that he use dialysis for the rest of his life. There are two general types of dialysis. Hemodialysis, in which the blood is removed from the body by a machine, purified and returned to the body, and peritoneal dialysis, in which the dialysis fluid is injected into the empty space of the abdomen, and the blood purification process takes place there. Hemodialysis Before starting dialysis, hemodialysis is needed to place the graft or fistula area in the lower leg. The job of a fistula is to establish a connection between an artery and a vein. Connecting the artery and vein makes the blood vessel bigger and stronger. This makes the flow of blood to the dialysis machine and then its return to the body easier and better. The operation of placing the fistula in the hand usually lasts between 4 and 8 weeks. This causes the tissue and skin around the fistula to regenerate itself. Of course, if a person’s vein is so thin that the fistula cannot be placed in it, there are other alternative methods. Also, as an urgent and emergency procedure, a tube may be connected to the jugular vein for dialysis. In this method, a small and narrow tube is connected to the jugular vein. Most people who use hemodialysis need 3 dialysis sessions per week. Each session lasts about 4 hours. Hemodialysis can be done both in the hospital and at home. Two narrow needles are attached to the fistula located in the lower leg. The task of one of these needles is to transfer blood from the body to the dialysis machine. The second needle also returns the blood purified by the dialysis machine to the body. A patient undergoing hemodialysis in a treatment clinic. The dialysis machine is made of membranes that act like a filter and purify the blood. There is also a special fluid called dialysis fluid in this machine. The excess and waste materials of the blood that are separated by the membranes flow towards this liquid. Then the used dialysis fluid is directed out of the dialysis machine. Hemodialysis will not be painful for the patient. Of course, the patient may feel weak and nauseous or his muscles may ache while doing the work. The reason for this is the sudden decrease and increase in the blood level in the body during dialysis. During the hemodialysis process, the patient can sit or lie down. Meanwhile, he will be able to study, listen to music, use his mobile phone or even sleep. After the completion of the hemodialysis operation, the needles are removed from the hand and their place is covered to prevent bleeding. Also, after the completion of this process, the patient can leave the hospital after a short period of time. If you use hemodialysis, you must follow a special diet and the amount of fluids you consume must be limited and completely controlled. The reason for this happens is that the dialysis machine cannot remove the extra fluids that you have consumed in 2-3 days from your blood in just four hours, and that is why you need to follow the fluid intake. Otherwise, the residual waste in your blood can cause serious problems in your blood, tissues, and kidneys. How much water and fluids each person undergoing dialysis should consume is directly related to their weight and height. In general, most of these people are allowed to consume 1000 to 1500 ml of liquids during the day. Proper diet is also very important for people who use dialysis. Because minerals such as salt, potassium and sulfur, which enter the body through food and are purified by the kidneys, can reach dangerous levels in the interval between hemodialysis sessions and due to the failure of the kidneys. The diet plans may be different for each person, and in this case, a doctor should be consulted. Peritoneal dialysis is a type of dialysis in which the blood is purified by a special membrane in the abdominal cavity called the peritoneal membrane. This type of dialysis itself is divided into two categories. Permanent outpatient peritoneal dialysis and automatic peritoneal dialysis. In the first type, your blood is filtered several times throughout the day without the need for direct intervention. In the second method, during the night and when you are sleeping, you can filter your blood with the help of a special device. Both of these methods can be done at home and there is no need to go to medical centers. Before performing any of these two methods, the same process for preparing the patient must go through. In this process, an incision is made in the patient’s abdomen and a narrow tube called a dialysis catheter is placed in it. Then it takes about a few weeks for the incision to heal and dialysis to begin. The task of the tube placed in the abdomen is to accelerate the transfer of dialysis fluid into the empty abdominal cavity. The dialysis catheter will be permanently attached to the patient’s abdomen. Some may not get used to this state, in which case they can remove this tube during another process and use hemodialysis. In permanent peritoneal dialysis, you need two bags. The first bag contains dialysis fluid and is connected to the tube located in the abdomen with the help of special clamps. This type of dialysis fluid can move to the abdominal cavity and stay there for several hours. The second bag is also the bag into which the used liquid is poured after leaving the abdominal cavity. When the dialysis fluid is in the abdominal cavity (peritoneal cavity), excess blood and fluid flow through the peritoneal membranes to it, and then hours later, this fluid moves through the tube connected in the abdomen to the second bag. After the used liquid is drained, the new liquid goes back into the abdominal cavity through the first bag and stays there until the next permanent peritoneal dialysis process. This process takes about 30 to 40 minutes each time. It’s also not painful to do. Of course, the patient may feel strange at first when the abdominal cavity is filled with dialysis fluid, but after doing this several times and getting used to it, this problem will be solved. Most people who use this dialysis method need to repeat this whole process 4 times a day. At the end of each time this process is performed, the bags are separated from the abdomen and the entrance of the dialysis catheter connected to the abdominal cavity is also sealed. Placement of permanent outpatient peritoneal dialysis components. The process of performing automatic peritoneal dialysis is the same as the previous type, with the difference that this time all the work is done by a special device and during the night and while sleeping. The bag containing the dialysis fluid is connected to the machine and this machine changes the dialysis fluid in the abdominal cavity several times during the night. Normally, this device needs 8 to 10 hours to complete the entire work process. Of course, problems may occur during dialysis with this method. For example, the patient may need to use the bathroom. In this case, the device will temporarily stop working. Or the power may go out during the night and stop the dialysis machine. However, if you do dialysis regularly every 24 hours, losing a night due to such problems is not very dangerous. If you use peritoneal dialysis, you have less food restrictions compared to patients who use hemodialysis. Because the number of peritoneal dialysis sessions is more than hemodialysis. However, it is still necessary to follow certain diets and take care of the amount of fluids you drink. An animated image of a person undergoing automatic peritoneal dialysis. Advantages and disadvantages of different types of dialysis. Both hemodialysis and peritoneal dialysis are equally effective. However, in some situations, it may be recommended to use one of these two types. It should also be noted that at any time, it is possible to change the dialysis method and choosing any of these two methods does not mean breaking the bridges behind the head. For example, the use of peritoneal dialysis is recommended for children under 2 years of age, people whose kidneys still have limited activity, and also people who do not have other underlying diseases such as heart disease. Hemodialysis is generally recommended for people who cannot perform peritoneal dialysis themselves. Such as people who have vision problems or are not in a good health condition. Another advantage of hemodialysis is that there are 4 days a week without treatment. Because in this type of method, it is only necessary to go to the medical center and perform dialysis 3 times a week. However, it is necessary for the sick person to go to the medical center 3 times. Of course, it goes without saying that hemodialysis can be done at home and even while sleeping if you have the necessary training and the possibility of getting the machine. Also, before traveling, the sick person needs to coordinate with the medical centers of the destination so that he can use their facilities for dialysis. On the other hand, peritoneal dialysis, unlike hemodialysis, can be done at home (or while traveling) without the need to visit medical centers. But the negative point of this method is that the process of peritoneal dialysis must be done every day, which may not be compatible with the life schedule of some patients. Another disadvantage of peritoneal dialysis is the possibility of infection around the dialysis catheter. Also, the use of dialysis fluid in the body can reduce the level of protein in the body, which can cause problems for the patient. Gaining weight can be another side effect of this type of dialysis. Hemodialysis and peritoneal dialysis at a glance Pregnancy when using dialysis is another important issue for this category of patients. Having a healthy pregnancy is possible for dialysis patients. Although doing this sometimes can be dangerous for mother and child. If the patient intends to carry out her pregnancy, she must be more closely monitored by dialysis centers and will probably need more and longer dialysis sessions. Dialysis is a treatment method that can largely fill the place of kidney function for patients whose kidney function has stopped. Despite many problems, many sick people have been undergoing dialysis for years and have taken up their normal life, and this improvement in the quality of life of such people is increasing day by day. Common questions about dialysis What is the life expectancy of patients who use dialysis? Life expectancy in dialysis patients depends on various factors including other disease areas. The average life expectancy for dialysis patients is between 5 and 10 years, although many of these patients live up to 20 or even 30 years. What is the main reason for dialysis? When a person’s kidneys fail, the ability to filter blood in this person’s body is lost, and dialysis becomes a relative replacement for doing this. The lack of regular filtering of waste materials in the blood causes dangerous diseases. After starting dialysis, is it possible for the kidneys to return to the cycle of work and be cured? If the factors that cause problems in kidney function are diagnosed and treated, it is possible that even after the start of dialysis, kidney function will return to the previous and their problem will be solved. Until then, dialysis is necessary. Can dialysis patients urinate? Due to dialysis, the amount of urine in these patients decreases to a great extent. But dialysis doesn’t stop urine completely. Dialysis patients may only need to urinate once a day, which is not dangerous at all.

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