What is kidney dialysis? Peculiarity of the procedure, diet, prognosis
For some kidney diseases, dialysis is the only way. This type of therapy is intended for excretion of metabolic products, harmful compounds and fluids from the patient. In short, if the kidneys fail, dialysis will take over the performance of their basic functions. Without it, all patients with a non-performing organ of excretion would be fatal.
What is dialysis?
The kidneys are a paired organ whose main function is to excrete products of metabolic processes and water. In some cases, the system may fail, causing the blood to stop being cleaned. Due to this, the body begins to accumulate harmful compounds that poison it. The natural outcome of this process is death.
Today, in medical practice, a method has been successfully applied, with the help of which it is possible to purify blood by artificial means.So what is kidney dialysis? This is a procedure involving the connection of a special apparatus to an organism that temporarily performs the basic functions of an organ. A special membrane is built into the equipment through which blood is pushed. Due to its porous structure, the liquid connective tissue is cleared of most of the harmful substances:
- urea, which is a product of protein processing;
- alcohol (both ethyl and methyl);
- poisons (like arsenic);
- medicines, the dosage of which has been exceeded.
In addition, in the process of dialysis, excess fluid is excreted from the body.
Removal of excess water and harmful substances leads to the following positive results:
- The severity of edema decreases, the likelihood of their occurrence in the joints, the heart, brain and lungs decreases.
- The blood is purified from most toxic substances, its electrolyte balance is restored, and the necessary level of acidity is maintained. Due to this, the body continues to function normally.
- The risk of blood clots is reduced.
The procedure is considered safe, as in the hospital it is carried out in accordance with all established standards.In addition, the equipment eliminates the entry of air bubbles into the blood due to the air trap.
It is important to understand that kidney dialysis is a type of substitution therapy to which, in most cases, a patient who has been waiting in line for a healthy organ transplant is tied for many years. The procedure can be carried out at home, which is especially important for such people. The main disadvantage is the cost of the device - it is about 20 thousand dollars.
The advantages of home dialysis are the absence of the need to wait for your turn in the hospital and a schedule suitable for the patient. But first you need to attend a course of study. During the lessons, patients are told about kidney dialysis, how to use the device correctly and how to prepare psychologically for the procedures.
The main pathologies and conditions under which artificial blood purification is prescribed are:
- renal failure, both acute and chronic;
- blockage of the urinary tract;
- glomerulonephritis and pyelonephritis in the acute stage;
- poisoning with potent toxic substances;
- hyperhydration (excess water in the body);
- electrolyte imbalance resulting from dehydration, fever, intestinal obstruction, etc .;
- poisoning with alcohol-containing drinks, narcotic and medicinal substances.
Preliminary research is being conducted. With the above illnesses, it is advisable to prescribe dialysis, if:
- daily diuresis is less than 0.5 liters;
- kidneys are able to clean no more than 0.2 liters of blood;
- the level of urea exceeds 35 mmol / l;
- the concentration of potassium in the blood is 6 mmol / l and more;
- creatinine level exceeds 1 mmol / l;
- standard bicarbonate content less than 20 mmol / l.
In addition, the procedure is carried out if edema of the lungs, heart and brain develops, and this condition cannot be eliminated with the help of drugs.
The adequacy of kidney dialysis treatment is assessed only by a doctor. In some cases, replacement therapy may be contraindicated.
Additional consultation of narrow specialists is required if the patient suffers from:
- cirrhosis of the liver;
- severe brain damage;
- hepatitis A;
- pathologies of the lungs.
After a thorough examination, the doctor decides on the possibility of the procedure.
This is one of the types of purification, which is carried out in a hospital. Its feature is the connection to the human body of an apparatus called “artificial kidney”.
The essence of the method consists in the following: a catheter is installed in the patient's vein, by means of which the blood, passing through the membrane embedded in the device for dialysis of the kidneys, is cleared of harmful compounds.
The equipment consists of the following units:
- Perfusion mechanism. Thanks to him, the blood moves inside the apparatus.
- Dialyzer This is the device in which the process of cleansing the liquid connective tissue is started.
- The mechanism responsible for the preparation and supply of dialysate.
- Monitor. It displays information about the current operation of the device, as well as the speed of blood flow.
Thus, the mechanism performing the main function is the dialyzer. It is built into the membrane, dividing the part of the equipment into 2 halves. The first is for the patient's biomaterial, the second for the cleaning solution.
The main advantage of this method is the possibility of its implementation at home. If, during hemodialysis, a catheter is inserted into a vein, in this case it is inserted into the abdominal cavity and remains in it until the patient needs an artificial cleaning procedure. The role of the membrane is played by a thin layer enveloping the liver and intestines.
The essence of peritoneal dialysis is as follows: approximately 2 liters of solution is poured into the abdominal cavity through the catheter. After some time, he and the metabolic products dissolved in it go out through the same silicone tube. Then a new dialysis solution is poured into the body. These manipulations must be carried out 4-5 times a day.
The attending physician should tell about all the advantages and disadvantages of each method when prescribing kidney dialysis, as well as recommend the most suitable for the patient. Both methods provide the same level of quality of life.
Hemodialysis is carried out according to the following algorithm:
- The patient is examined, his pressure, pulse and body temperature are measured.
- An artificial kidney apparatus is connected to the body using a catheter.
- During the whole procedure (on average 4-5 hours), the doctor observes the patient's condition.
- After the time has elapsed, the catheter is removed, and an aseptic dressing is applied to the site of its introduction.
Before the kidney dialysis is done by the peritoneal method, the patient is also examined. After that, a soft silicone tube, which does not exceed 30 cm in length, is implanted into the abdominal area. One part of the catheter will always be inside and the other outside.
The tube is equipped with special limiters, which are located under the skin. Due to this, the catheter is held and does not fall out. In addition, gradually limiters will overgrow with a cloth, which also eliminates the accidental removal of the tube. However, it is always fixed additionally.
After installing the catheter, it should take about 2 weeks, after which the regular dialysis procedures begin. The tube remains in the abdominal cavity for the entire period of replacement therapy.
As a rule, peritoneal dialysis is indicated in patients with renal insufficiency, the duration of treatment of which may be many years.
The composition of the cleaning solution
The concentration of the components of the dialysing fluid is selected individually for each person. As a rule, its composition is similar to blood plasma, if necessary, correct the content of potassium.
In addition, Heparin may be added to the dialysis solution to prevent the formation of blood clots.
Most people tolerate the procedure well.
However, after kidney dialysis, the following conditions may occur:
- nausea, passing into vomiting;
- decrease or increase in heart rate;
- muscle cramps;
- bronchial spasms;
- temporary loss of vision and hearing;
- pain in the back or chest.
These states are normal, they disappear independently after a while. But if the patient's well-being deteriorates sharply after each procedure, it is necessary to undergo an additional examination and identify the cause.
It is important to understand that the failure of the kidneys disrupts the functioning of the whole organism. With artificial cleansing is not always possible to avoid negative consequences.
Possible complications include the following conditions and diseases:
- numbness of the lower limbs;
- bone damage;
- low or, conversely, high blood pressure;
According to statistics, these complications occur only in isolated cases.
When dialysis kidney diet plays a crucial role. Immediately after the procedure, the state of the body significantly improves, to maintain it, you must follow certain rules of nutrition. Table 7 is shown to a person with impaired kidney function.
Its main principles are:
- Reduced electrolyte uptake.
- Potassium Intake Restriction.
- Food of animal origin, milk and dried fruits should be consumed in a minimum amount.
- It is forbidden to take drugs that contain aluminum. It is not recommended to even eat from dishes made of this metal.
- On the day you need to eat about 100 g of fat, 60 g of protein,
- 400 g of carbohydrates, 2 g of potassium. The calculation of the required amount of water is made by a doctor. As a rule, it does not exceed 1 l.
- Caloric intake during dialysis of the kidneys should be about 3000 kcal.
If for any reason the diet has been broken, you must immediately inform your doctor.This is important for timely adjustment of treatment.
To date, blood purification apparatus is the only way out for patients whose kidneys have failed. Thousands of healthy organ transplants are performed annually, but the list of those in need is enormous.
How much kidney dialysis lives depends on the severity of the pathology and the individual health characteristics of each patient. Previously, it was believed that the procedure can prolong life for several years, today it is proved that a person can exist on artificial cleansing until it is the turn for a healthy organ transplant.
Every year, huge sums are allocated from the state budget for the treatment of people suffering from renal failure. Dialysis for these patients is absolutely free.
If the procedure is one-time in nature (for example, in case of poisoning), it can be paid for in special clinics. The cost of kidney dialysis is different for each region of the country. The lowest price is fixed in the Tomsk region - 3500 rubles per session, the highest - in the Omsk region.Here, the cost of the procedure reaches 6000-7000 thousand rubles.
What should the patient be prepared for?
Every person who is shown dialysis is recommended to visit a psychologist. This is due to the fact that not everyone is ready for many years, and sometimes for life to follow a strict diet and regularly visit the hospital or live with a catheter in the abdominal cavity. In the initial stages of treatment, this is especially difficult psychologically. A specialist will help you morally prepare for a new lifestyle.
Kidney dialysis is a procedure by which blood is purified artificially. It is shown to persons with various kinds of poisoning, abnormalities in the work of the excretion organ, hyperhydration, etc. Most people tolerate the procedure well, however there is a risk of complications. Regarding how much they live on dialysis of the kidneys, doctors say - several decades. The procedure helps many to wait for their turn to transplant a healthy organ.