What are the types of dialysis?
There are two main types of dialysis : hemodialysis and peritoneal dialysis.
Hemodialysis: In hemodialysis (HD), waste products and excess fluids
are removed from the blood by passing the blood through a special
filter or artificial kidney called a dialyzer, aided by a dialysis machine.
Peritoneal dialysis: In peritoneal dialysis (PD), a soft tube or catheter
is inserted through the skin, into the abdominal cavity and dialysis solution
is infused into the abdominal cavity to remove waste products and excess
fluid from the body. This is done at home, usually without a machine.
Which factors determine selection of dialysis modality in
ESKD patients?
Hemodialysis and peritoneal dialysis both are effective modalities in
ESKD patients. No single dialysis modality is best suited for all patients.
After considering advantages and disadvantages of each dialysis
modality, selection of HD or PD is made jointly by the patient, family
members and the nephrologist. Major factors determining this selection
are cost of therapy, age, comorbid conditions, distance of hemodialysis
center, educational status, physician bias and the patient’s preferences
and lifestyle. Because of low cost and easy availability, hemodialysis is
preferred by a large number of patients in India.
Dialysis can not cure kidney failure, but helps patients to
live comfortably in spite of kidney failure.
Do dialysis patients need to restrict their diet?
Yes. Common dietary recommendations for dialysis patients are
restriction of sodium, potassium, phosphorus and fluid intake. Dialysis
patients must follow these dietary advices but dietary restrictions are
reduced after dialysis is initiated in CKD. Most patients on dialysis are
advised to take more protein compared to their pre-dialysis
prescriptions, with adequate calories, water-soluble vitamins and
minerals. It is advisable that patients on dialysis consult a dietitian to
adequately plan their diets.
What is “dry weight”?
In patients undergoing dialysis, the “dry weight” is the weight of the
patient after all excess fluid is removed by dialysis. The “dry weight”
may need to be adjusted from time to time as the actual weight of the
patient may change. This is also known as the edema-free weight, the
patient has no lung congestion and the hemodynamic status is not
compromised (BP is not low nor do they have any symptoms).
Even after starting dialysis, dietary
restrictions must be continued.