Journal of Clinical Nephrology and Therapeutics

All submissions of the EM system will be redirected to Online Manuscript Submission System. Authors are requested to submit articles directly to Online Manuscript Submission System of respective journal.
Reach Us +1 (202) 780-3397

Perspective - Journal of Clinical Nephrology and Therapeutics (2022) Volume 6, Issue 4

Types of dialysis procedures and its mechanism

Alina Gomez*

Division of Nephrology, Schulich Medicine & Dentistry, Western University, 1151 Richmond St, Canada

Corresponding Author:
Alina Gomez
Division of Nephrology
Schulich Medicine & Dentistry
Western University
1151 Richmond St, Canada
E-mail: alineg@gmail.com

Received: 30-Jun-2022, Manuscript No. AACNT-22-68210; Editor assigned: 02-Jul-2022, PreQC No. AACNT-22-68210(PQ); Reviewed: 16-Jul-2022, QC No. AACNT-22-68210; Revised: 21-Jul-2022, Manuscript No. AACNT-22-68210(R); Published: 28-Jul-2022, DOI:10.35841/aacnt-6.4.120

Citation: Gomez A. Types of dialysis procedures and its mechanism. J Clin Nephrol Ther. 2022;6(4):120

Visit for more related articles at Journal of Clinical Nephrology and Therapeutics

Abstract

   

Introduction

Chronic renal failure (CRF) is the most pervasive, overall general medical condition of the elderly population. The primary cause of CRF is a harmed kidney. There are five phases of CRF in view of the glomerular filtration rate (GFR), and stage 5 (GFR < 15 ml/min/1.73 m2) is much of the time called an end-stage renal sickness (ESRD) [1]. In CRF, there is a collection of toxins and excess water because of compromised renal function. Dialysis is the favored method for treating ESRD and eliminate gathered toxins from the body. The cardiovascular risk related with dialysis is 10 to multiple times higher in patients going through dialysis than in typical individuals. The inflamed kidneys and the course of dialysis additionally influence endothelial capability, exasperating the risk of hypertension and cardiovascular issues. Consequently, the two doctors and patients ought to know about the outcomes of going through dialysis.

The course of removal of waste and additional water from blood is called dialysis. It is an artificial substitution of kidney functioning, particularly in renal failure cases. Dialysis can't totally perform lost kidney functions, yet, somewhat, deals with its activities through diffusion and ultrafiltration. It is used or done in chronic renal failure (CRF) when the glomerular filtration rate falls under 15 ml/min/1.73 m2. CRF is a condition where there is a deficiency of function capability over a time of months or years. CRF can be analyzed by estimating serum creatinine levels, which are a degradative result of muscle protein. Creatinine levels show the glomerular filtration rate (GFR) and in CRF, its activity are raised, demonstrating a decreased GFR. There are five phases of CRF based on the GFR, and dialysis is preferred in stage 5 (GFR < 15 ml/min/1.73 m2); this stage is additionally called end stage renal disease (ESRD). Dialysis is performed in CRF patients to eliminate aggregated toxins from the body [2]. This strategy might be responsible for the improvement of oxidative stress, because of an imbalance between the overproduction of reactive oxygen species or toxins and a decreased mechanism of the body. Oxidative stress disturbs the normal working of the cell.

The force with which blood moves through a vein when the heart pumps blood is called blood pressure (BP), and it is estimated with the assistance of a sphygmomanometer. In a healthy person, healthy person, the BP is 120/80 mmHg (systolic strain (heart siphons)/diastolic pressure (heart relaxes)). If it is 140/90 mmHg then the condition is called as hypertension. Hypertension increases the pressure of blood flow, which might harm veins. In the event that renal veins are involved, it prompts the gathering of poisons and liquids, which further raises the blood pressure [3]. It's obviously true that hypertension alone is a risk factor for kidney diseases, and if it is related with different inconveniences, it prompts CRF.

The renal functional capacity can be evaluated by estimating serum creatinine/blood urea nitrogen (BUN) or by urea and creatinine leeway. There are two kinds of dialysis procedures; it could be hemodialysis (utilizing a machine/artificial kidneylike apparatus) or peritoneal dialysis (involving a peritoneal membrane as a channel). Peritoneal dialysis is suggested for more young patients as a result of its adaptability and can be performed at home. Hemodialysis is done for patients with no remaining renal capability.

The mechanism of hemodialysis

In hemodialysis, the wastes and excess water are taken out by utilizing an external filter called a dialyzer, which contains a semipermeable film [4]. The disconnection of wastes is done by making a counter-current flow gradient, where blood flow is in one way and the liquid of the dialyzer is the other way. Peritoneal dialysis involves the peritoneum as a natural semipermeable film and eliminates waste and water into the dialysate (the material or liquid that goes through the membrane of the dialysis).

The essential rule involved with dialysis is the movement or diffusion of solute particles across a semipermeable film (diffusion). Metabolic byproducts, like urea and creatinine, diffuse down the concentration gradient from the flow into the dialysate (sodium bicarbonate (NaHCO3), sodium chloride (NaCl), corrosive concentrate, and deionized water). During their diffusion into the dialysate, the size of particles, thus, decides the pace of diffusion across the membrane. The bigger the size of the solute molecule, the slower is the pace of diffusion across the membrane. Here, arteries carrying oxygenated blood from the heart are associated with a vein forming an arteriovenous shunt, which makes the vein strong (by framing muscles around it like an artery) enough to be penetrated commonly; its pressure is additionally observed during the course of dialysis [5].

References

  1. Hakim RM, Lazarus JM. Initiation of dialysis. J Am Soc Nephrol. 1995;6(5):1319-28.

    2. Indexed at, Google Scholar, Cross Ref

  2. Lackland DT, Weber MA. Global burden of cardiovascular disease and stroke: hypertension at the core. Can J Cardiol. 2015;31(5):569-71.

    3. Indexed at, Google Scholar, Cross Ref

  3. Ifudu O. Care of patients undergoing hemodialysis. N Engl J Med. 1998;339(15):1054-62.

    4. Indexed at, Google Scholar, Cross Ref

  4. Macunluoglu B, Gumrukcuoglu HA, Atakan A, et al. Lowering dialysate sodium improves systemic oxidative stress in maintenance hemodialysis patients. Int Urol Nephrol. 2016;48(10):1699-704.

    5. Indexed at, Google Scholar, Cross Ref

  5. Volodarskiy A, Kumar S, Amin S, et al. Optimal treatment strategies in patients with chronic kidney disease and coronary artery disease. Am J Med. 2016;129(12):1288-98.

    6. Indexed at, Google Scholar, Cross Ref

Get the App