TYPES AND PROCEDURES IN BRIEF
Kidneys are the major organs concerned with filtering of waste materials from our blood. They also regulate Blood pressure, RBC production and Electrolytic balance in the body. Kidney Diseases are diagnosed through Blood tests by checking Creatinine content, Glomerular Filtration Rate etc. There will be a high BP for diabetic patients with Chronic Kidney Diseases. Urine tests to measure Protein, the presence of abnormal cells and the concentration of electrolytes can also detect CKD.
Kidney failure is due to the accumulation of waste products and excess fluids in the body which causes weakness, breathing difficulties, metallic taste in the mouth, Protein aversion, nausea and vomiting, loss of appetite, Oedema (swelling in the feet and ankle), lethargy, fatigue and confusion. Potassium concentration in the blood may lead to abnormal heart rhythms, brain encephalopathy, pericarditis or hypocalcemia and ultimately leads to sudden death. Lifelong efforts to control B.P and Diabetes can prevent Chronic Kidney Disease. (C.K.D).
The only treatment methods available to manage CKD may be Dialysis or Transplantation of Kidney. Some drugs are toxic to kidneys-Ibuprofen, Naproxen, Gentamycin, Tobramycin, Lithium, Iodine dyes etc.
DIALYSIS is the process of removing excess water, solutes and toxins from the blood in people whose kidneys can no longer perform their functions naturally. There are three different types of Dialysis.
• Haemodialysis – (HD) the most common type of Dialysis which can be done at home also.
• Peritoneal dialysis-involving surgery to implant a peritoneal dialysis Catheter into your abdomen
• Continuous Renal Replacement Therapy (CRRT) dialysis done continuously for 24 hours during renal failure.
Haemodialysis and Peritoneal Dialysis are two types of procedures adopted for purification of blood. This process will help in reducing the Blood Pressure and promotes the growth of RBC in the blood and maintain the content of Potassium, Sodium, Calcium, Bicarbonate, Chloride, Magnesium and Phosphate in the balanced state.
The Peritoneal Dialysis may be CAPD (Continuous Ambulatory Peritoneal Dialysis). CCPD (Continuous Cyclic Peritoneal Dialysis) and IPD (Intermittent Peritoneal Dialysis). PD can be done manually or using an automated device. CAPD does not require a machine. Exchanges can be done 3-5 days daily. CCPD and IPD needs a special dialysis machine that can be used in the home. This is done automatically, even while you are asleep. IPD achieves higher solute clearance than an automated one.
Major side effects are abdominal Pain, bleeding, catheter blockage, high or low blood volume. PD is considered as an effective form compared to HD since it reduces stress on the heart & blood vessels.
Haemodialysis is done at home or in a dialysis center or hospital by trained healthcare professionals. HD can be done several times in a week and lasts for 4-5 hours. It can be done three times a week. During treatment, you can read, write, sleep, talk or watch TV.
In HD, an arteriovenous (AV) fistula is placed in your arm to join an artery and vein together. Then connect to a large HD machine. The machine drains the blood, bathes it in a special dialysate solution to remove waste materials and fluid and then returns it to your bloodstream.
In HD, complications like muscle cramps and hypotension may occur. Low BP may cause dizziness, weakness or stomach upsets. This can be avoided by eating animal protein foods like meat and chicken, avoiding salt and restricting Potassium, limiting water intake, limiting protein-rich foods like milk, cheese, nuts, dried beans, soft drinks etc.
In Haemodialysis, a Dialyzing machine and a special filter called an artificial Kidney/Dialyzer is used to clean the blood. The Entrance into the blood vessels is done with a minor surgery into the arm of the patient. In Peritoneal Dialysis, the lining of the abdomen (Peritoneum) is used to filter the blood. A few weeks before starting the PD, a surgeon places a soft tube- catheter in your belly.
PD is much less expensive than HD. In India on an average, there is an increase of 2.5 lakhs patients per year having CKD and requiring Dialysis. The cost of Dialysis also is on the increase. On an average, Rupees 3500/- is required per week to do HD, excluding transportation, food and stay of the patient in the Hospital.
