Hemodialysis, Phosphorus and Calcium,Peritoneal Dialysis

Hemodialysis

What is a Dialysis

• Dialysis is a way of cleaning your blood when your kidneys can no longer do the job. It gets rid of your body's wastes, extra salt and water, and helps to control your blood pressure.

What is Hemodialysis?

• Hemodialysis is the most common method used to treat advanced and permanent kidney failure. Since the 1960s, when hemodialysis first became a practical treatment for kidney failure.

• Hemodialysis is a therapy that filters waste, removes extra fluid and balances electrolytes (sodium, potassium, bicarbonate, chloride, calcium, magnesium and phosphate).

How is Hemodialysis done?

• Blood is removed from the body and filtered through a man-made membrane called a DIALYZER, or artificial kidney, and then the filtered blood is returned to the body. The average person has about 10 to 12 pints of blood; during dialysis only one pint is outside of the body at a time.There are three access types for hemodialysis: arteriovenous AV fistula, AV graft and central venous catheter. The AV fistula is the vascular access most recommended.

Dialysis Machine

• The dialysis machine mixes and monitors the dialysate. Dialysate is the fluid that helps remove the unwanted waste products from your blood. It also helps get your electrolytes and minerals to their proper levels in your body.

Dialyzer

• Acts as an ARTIFICIAL KIDNEY.

• They clean toxic substances.

Types of Vascular Access for Hemodialysis

• Arteriovenous Fistula (AV Fistula)

• Arteriovenous Graft (AV Graft)

• Venous Catheter

• heRO (hemosphere, minneapolis, mn)

Arteriovenous Graft

• If a patient is not a good candidate for an arteriovenous fistula, an arteriovenous graft is considered. An arteriovenous graft is a piece of artificial tubing, generally made out of teflon or fabric, that is attached on one end to an artery, and on the other end to a vein. The tube is placed entirely under the skin and the tube itself is punctured during dialysis

Venous Catheter

• A third type of vascular access is a venous catheter. A venous catheter is a plastic tube which is inserted into a large vein, usually in the neck. An external portion of the catheter is exposed on the chest wall that allows the tubing for the dialysis machine to be connected.

HeRO ® (hemosphere, minneapolis, mn)

• A final alternative for access creation for patients who are not good candidates for arteriovenous fistula is a device that is a hybrid of an arteriovenous graft and a catheter. This device is especially designed for patients who have a narrowing of the large central veins in the chest that would prevent a fistula or a graft from functioning properly. The entire device is placed underneath the skin and can be used for long-term vascular access. The characteristics of the device are similar to those described above for arteriovenous graft.

Simplified Diagram of Hemodialysis

Diet for Hemodialysis Patient

• The diet restrictions include limiting foods that contain PHOSPHORUS, POTASSIUM, SODIUM and drinking a limited amount of fluid.

What's a hemodialysis diet?

• The hemodialysis diet is an eating plan tailored to patients who are on hemodialysis. It’s designed to reduce the amount of fluid and waste that builds up between hemodialysis treatments.

What can I eat?

• In addition to enjoying a variety of nutritious foods, the hemodialysis diet will introduce a higher amount of high-quality protein into your eating plan. Your dietitian will determine the amount. High-protein foods such as lean meat, poultry, fish and egg whites provide all the essential amino acids your body needs.

What can’t I eat?

• Foods containing high amounts of sodium, phosphorus and potassium are restricted. Your dietitian will provide you with food lists that indicate which foods are allowed and which ones you should avoid or limit. You will also limit your fluid intake.

Why do I have to eat this way?

• Your dietitian and doctor will strongly recommend you follow the hemodialysis diet, so your dialysis treatments will be effective, and help reduce the risk of health complications associated with kidney disease and dialysis.

How does the hemodialysis diet help?

• Potassium is easily removed by dialysis, but when it builds up in the blood between treatments, it can cause muscle weakness and make your heart stop beating. Certain fruits, vegetables, dairy products and other foods that are high in potassium will need to be restricted from your diet.

• Phosphorus is difficult for hemodialysis to filter from the blood so it’s important to limit foods that contain the mineral. Phosphorus can build to high levels in the bloodstream and cause weak bones, heart problems, joint pain or skin ulcers. Your doctor may also prescribe a medicine called a phosphorus binder to help keep phosphorus levels normal.

• Sodium causes your body to hold onto more fluid and raises your blood pressure. Eating less sodium and drinking less fluid can help you feel comfortable before and after your dialysis sessions.

• Too much fluid gain between hemodialysis sessions can cause discomfort, including swelling, shortness of breath or high blood pressure. Fluid intake is not limited to what you can drink; it’s also hidden in some foods you eat, including gelatin, ice, sherbet, watermelon, sauces and gravies.

Peritoneal Dialysis

What is a Peritoneal Dialysis?

• In Peritoneal dialysis the inside lining of your own belly acts as a natural filter. Wastes are taken out by means of a cleansing fluid called dialysate, which is washed in and out of your belly in cycles.

How does peritoneal dialysis work?

• A soft plastic tube (catheter) is placed in your belly by surgery. A sterile cleansing fluid is put into your belly through this catheter. After the filtering process is finished, the fluid leaves your body through the catheter.

There are two kinds of peritoneal dialysis

• Continuous Ambulatory Peritoneal Dialysis (CAPD) a machine-free and done while you go about your normal activities such as work or school. You do the treatment by placing about two quarts of cleansing fluid into your belly and later draining it. This is done by hooking up a plastic bag of cleansing fluid to the tube in your belly. Raising the plastic bag to shoulder level causes gravity to pull the fluid into your belly. When empty, the plastic bag is removed and thrown away.

• Automated Peritoneal Dialysis (APD) differs from CAPD in that a machine (cycler) delivers and then drains the cleansing fluid for you. The treatment usually is done at night while you sleep.

Dialysis Process

• Hookup

• Infusion

• Diffusion (Fresh)

• Diffusion (Waste)

• Drainage

Hookup

Infusion

Diffusion (Fresh)

Diffusion (Waste)

Drainage