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Peritoneal dialysis is a treatment for kidney failure that uses lining of abdomen to filter blood in the body. This lining is called as peritoneum. Surgeon puts a catheter which is like a soft tube in the abdomen, few weeks before starting the peritoneal dialysis. The main function of kidneys is to eliminate the metabolic wastes in the human bodies, when this process gets affected, the kidney may fail. Dialysis is the process which helps to make an artificial way to eliminate the waste from the body and filter the blood in the abdomen.
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Key Terms: Peritoneal dialysis, Renal failure, Hemo-dialysis, Diffusion, Osmosis, Ultra-filtration, red blood cells, Chronic kidney damage
What is Dialysis?
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The main function of the kidney in the human body is to filter the blood. On an average, a kidney filters about 100 to 150 quarts of blood every day. When kidneys do not function in the proper way because of any existing diseases, the waste in the human body gets stored in the blood. This in turn results in some major disease and sometimes death. To make an artificial way to filter out the blood and throw the metabolic wastes out of the body, the patient is put on dialysis.
Dialysis Procedure
The dialysis process helps to better the functioning of kidney in the following ways:
- Dialysis helps to prevent the body from chemicals such as bicarbonate, potassium and sodium. Because they can cause harm when reached to the high levels.
- Dialysis removes the excess water which is present in the blood.
- Helps to remove metabolic wastes from the human body.
- Helps to balance and control the blood pressure.
When is Dialysis Used?
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Dialysis is required when the kidney's functioning is affected. A person is put on dialysis when his kidney loses more than 90% of its efficiency and the glomerular filtration also goes less than 15%. Patients with major kidney diseases like renal failure will generally put on dialysis. Dialysis can be continued for years because the kidney failures don’t get recovered easily and are irreversible.
Principles of Peritoneal Dialysis
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Principles of the peritoneal dialysis are as follows:
- Peritoneal dialysis filters the waste products in the body.
- It balances the chemicals present in the body.
- It removes the fluid from the abdomen which is also called ultra-filtration.
The process of peritoneal dialysis needs the mixture of electrolytes and fluids to perform the procedure. This fluid is called Peritoneal Dialysis Fluid.
Principles of Peritoneal Dialysis
Diffusion
The repetitive movement of the molecules is called Diffusion. The movement of the molecules is from the peritoneal membrane from the high to low concentrated areas. Molecules such as sodium, potassium, urea, electrolytes are used as medications as well as toxins.
Osmosis
The movement of water in the peritoneal membrane from low solute to high solute areas of concentration is called Osmosis.
Ultra-filtration
Ultra-filtration is the process which is calculated when you remove the volumes filled from the volumes removed. This process allows you to remove the water as much as you want it. Ultra-filtration is the most important procedure in dialysis. It is important to establish accurate tables to log these volumes since you will have different volumes to fill and drain. Measuring the net removal of the fluid is really very important in the process of Ultrafiltration.
Also read: Difference Between Secretion and Excretion
Procedure of Peritoneal Dialysis
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Fill Time
When the peritoneal fluid is filled into the peritoneal cavity, this time is called the Fill time. The time that is taken to fill the fluid is about 5 to 10 minutes.
Dwell Time
When the peritoneal dialysis fluid leaves the peritoneal cavity, that time is called Dwell time. The dwell time is about 35 to 40 minutes. It is easy to combine the fill time and dwell time when you don’t have any machinery to pump the fluid into the body. It usually takes 45 to 50 minutes after combining these two procedures.
Drain Time
When peritoneal dialysis fluid is removed from the peritoneal cavity, this time is called Drain time. Generally, it takes about 10 minutes. If you set the drain time longer you can remove more fluid. Therefore, the peritoneal dialysis cycle includes the fill time, dwell time and the drain time. The drain time is also called the exchange time.
Procedure of Peritoneal Dialysis
Benefits of Peritoneal Dialysis
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- Peritoneal dialysis is a very simple process which can even be conducted at home.
- Equipment that are used for the peritoneal dialysis are less bulky and can be easily carried along with the patients.
- Peritoneal dialysis can be carried out every day.
- It is a very comfortable process of dialysis in which the patients can even do other simple activities like reading books, listening to songs etc. while on dialysis.
Things to Remember
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- Peritoneal dialysis uses the lining of the abdomen to filter the blood. This abdominal lining is called peritoneum in medical terms.
- A kidney filters about 100 to 150 quarts of blood every day on an average day. When the kidney stops filtering the blood, the dialysis needs to be done.
- The process of peritoneal dialysis needs the mixture of electrolytes and fluids to perform the procedure. This fluid is called peritoneal dialysis fluid.
- Peritoneal dialysis filters the blood in the body and also balances the chemicals that are present in the human body.
- Peritoneal dialysis is a simple process which can be carried out even at the patient’s home with the proper precautions.
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Sample Questions
Ques. Dialysis is a temporary method for kidney diseases. Justify this sentence. (2 Marks)
Ans. Kidney diseases are usually irreversible. If the kidneys repair by themselves and function properly, the dialysis can be viewed as a temporary method to cure it. But if a patient has a chronic kidney disease, the kidneys cannot be repaired by themselves. In this case, the medical situation of the patient starts getting worse. At this stage, the patient requires dialysis regularly.
Ques. What is diffusion? (2 Marks)
Ans. The movements of molecules again and again in the peritoneal membrane from the high concentration areas to the low concentration areas are known as the process of diffusion. These molecules are electrolytes, sodium, urea, creatinine etc. They can also be used as medications as well as toxins.
Ques. What is the difference between peritoneal dialysis and hemo-dialysis? (2 Marks)
Ans. In peritoneal dialysis, a catheter is inserted in the stomach which helps to circulate the dialysate. The dialysate absorbs all the waste and filters the blood in the patient’s body. On the other hand, in the process of hemo-dialysis, the blood is removed from the body then gets filtered in the dialysis machine and returned to the body using the tubes.
Ques. Define Dialysis. (2 Marks)
Ans. Dialysis is the process which is used to remove the excess water and toxins from the blood in the patients who are suffering from kidney diseases. This process is also known as renal replacement therapy in the clinical language. The dialysis is used to filter the blood in the body and improve the efficiency and the working of the kidneys. There are two different types of dialysis 1) Peritoneal dialysis and 2) Hemo-dialysis.
Ques. When does a patient require dialysis? (2 Marks)
Ans. When the functioning of the kidney is affected in the human body, dialysis is required. If a patient has grave kidney damage and previously had renal failure is usually put on dialysis. Because the kidney loses 90% or more of its efficiency and glomerular filtration also goes less than 15. So, the patient will be put on dialysis.
Ques. What are the different types of dialysis? (3 Marks)
Ans. There are two different types of dialysis. They are as follows: -
- Peritoneal Dialysis: The process which is done by putting a catheter in the abdomen of the patient is called Peritoneal dialysis. The dialysate which is a cleaning fluid is circulated in the catheter which then absorbs the waste materials from the blood. Then the blood is taken out and removed. It is easier and more convenient than that of hemo-dialysis.
- Hemo-dialysis: - The patient’s blood is purified with the help of a dialysis machine and then returned to the patient’s body. This process is called hemo-dialysis.
Ques. What are the advantages of peritoneal dialysis? (3 Marks)
Ans. The advantages of the peritoneal dialysis are as follows: -
- It is a very comfortable process of dialysis in which the patients can even do other simple activities like reading books, listening to songs etc. during the procedure.
- Equipment that are used for the peritoneal dialysis are less bulky and can be easily carried along with the patients.
- Peritoneal dialysis is a very simple process which can even be carried out at the patient’s home.
Ques. What do you mean by Ultra-filtration process? (3 Marks)
Ans. The process in which you minus the volumes filled from the volumes removed, this process is called Ultra-filtration. This process allows you to remove the water as much as you want it. Ultra-filtration is the most important procedure in dialysis.
It is important to establish accurate tables to log these volumes since you will have different volumes to fill and drain. Measuring the net removal of the fluid is really very important in the process of Ultrafiltration. Dextrose is used to pull the water out of the body. Hence, in this process, the higher dextrose concentration will allow a high level of water removal than the usual.
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