The Functioning of Dialysis
Kidneys are essential organs in animal bodies and, more importantly, humans. They perform vital roles such as the filtration of blood to retain an appropriate electrolyte and fluid balance as well as the removal of waste. Such unwanted materials are toxic, and their continued existence is harmful to the health of individuals. Other functions include the dissemination of hormones necessary for controlling blood pressure and trigger the production of red blood cells, and the activation of vitamin D, which is crucial for healthy bones. All these are critical tasks that maintain the optimal performance of the body. In this view, properly working kidneys are an essential aspect of the overall health of an individual. While dialysis does not cure damaged kidneys, the treatment helps the body to continue with its renal functions.
Renal dialysis is an artificial scientific intervention to replace kidney functioning by restoring fluid balance through the systematic elimination of waste from the blood. The process cannot perform the entire responsibilities of the renal system but assists patients with kidney failure in excretion through ultrafiltration and diffusion. It is usually recommended when the glomerular filtration rate (GFR) goes below 15 ml/min/1.73m2 (Vadakedath & Kandi, 2017). This is the standard level of product elimination that is used to determine the ability of the kidneys to continue executing their roles.
Dialysis procedures are divided into three primary types based on patient characteristics. The first one is referred to as hemodialysis, which is performed using an external machine, which looks like kidneys and mimics their functioning (Vadakedath & Kandi, 2017). It is usually recommended for people who have experienced complete renal shutdown. The removal of excess water and other wastes is done using a semipermeable membrane contained in an external filter called a dialyzer. Separation is done by creating a counter-current flow where the patient’s blood flows in the opposite direction as the machine’s fluid.
The second type of dialysis is the peritoneal procedure, which uses a peritoneal membrane to serve as a filter. It is a flexible technique that can also be performed at home and is usually practiced on younger patients (Vadakedath & Kandi, 2017). A peritoneum is used as a natural semipermeable tissue which removes excess water and wastes into the dialysate. It employs the principle of diffusion, which enables the soluble particles to pass through a semipermeable membrane. Materials such as creatinine and urea diffuse down the dialysate from the circulation section, where they are consequently eliminated.
The final form of dialysis is continuous renal replacement therapy (CRRT), which is used on critically sick people. Mostly, these are patients suffering from acute kidney failure and hemodynamic instability (Tandukar & Palevsky, 2019). CCRT is a slow process which entails the venovenous passing of a patient’s blood through a hemofilter tubing, which gets rid of unwanted materials and excess water before it is redirected back into the body (Krans & Gotter, 2018). Usually, the ultrafiltration is slow, meaning that the process is performed in a series of repeated cycles to achieve the right blood-solute balance. The approach aims at providing ample time for the body to replenish cell fluid and minimize the risk of high blood pressure (Tandukar & Palevsky, 2019). Equally, the technique seeks to mimic and maintain, as close as possible, the ordinary kidney functions, hence avoiding disruption of other body operations for vulnerable patients.
References
Krans, B., & Gotter, A. (2018, May 30). Dialysis: Purpose, Types, risks, and more. Retrieved from https://www.healthline.com/health/dialysis
Tandukar, S., & Palevsky, P. M. (2019). Continuous renal replacement therapy. Chest, 155(3), 626–638. doi: 10.1016/j.chest.2018.09.004
Vadakedath, S., & Kandi, V. (2017). Dialysis: A review of the mechanisms underlying complications in the management of chronic renal failure. Cureus. doi: 10.7759/cureus.1603