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💧 What is Dialysis? Dialysis is a medical treatment that mimics kidney function by removing waste, toxins, and excess fluids from the blood when the kidneys are no longer able to do so adequately — usually due to end-stage renal disease (ESRD) or severe acute kidney injury (AKI). 🧪 When is Dialysis Needed? Indications include: ESRD (GFR < 15 ml/min/1.73 m²) Severe electrolyte imbalance (e.g., hyperkalemia) Fluid overload not responsive to diuretics Uremic symptoms (nausea, confusion, pericarditis) Metabolic acidosis unresponsive to treatment 🔄 Types of Dialysis 1. Hemodialysis (HD) How it works: Blood is removed from the body, filtered through a machine (dialyzer), and returned. Schedule: Typically 3 times per week for 3–5 hours each session. Access types: AV Fistula (preferred, long-lasting) AV Graft Central Venous Catheter (temporary) Pros: Efficient toxin/fluid removal Supervised in-center treatment Cons: Time-consuming Vascular access complications Requires transportation (if in-center) 2. Peritoneal Dialysis (PD) How it works: A catheter is inserted into the abdomen; the peritoneum (lining of the abdominal cavity) acts as a natural filter. Dialysate fluid is instilled and drained out several times daily. Types: Continuous Ambulatory Peritoneal Dialysis (CAPD): Manual exchanges 4–5 times/day Automated Peritoneal Dialysis (APD): Done overnight using a cycler machine Pros: Home-based and portable Gentler, more continuous filtration Preserves residual kidney function longer Cons: Risk of peritonitis Daily commitment Not ideal in patients with abdominal surgery/scarring 3. Continuous Renal Replacement Therapy (CRRT) Used in critically ill patients with unstable blood pressure (usually in ICU). Continuous, slow dialysis over 24 hours. 💊 Supportive Aspects of Dialysis Care Diet & Fluid Restrictions: Low sodium, potassium, phosphorus; controlled protein intake; fluid limits. Medications: Phosphate binders, erythropoietin (for anemia), antihypertensives, vitamin D analogs. Psychosocial Support: Depression, anxiety, and lifestyle limitations are common. Transplant Evaluation: Patients on long-term dialysis may be evaluated for a kidney transplant. 🧭 Choosing Between HD and PD Depends on: Lifestyle and independence preferences Home support and ability to learn PD Medical history (e.g., previous abdominal surgeries) Access availability Risk of infection or cardiovascular issues ⏳ Complications to Watch For Hemodialysis: Hypotension Muscle cramps Infection or clotting of access Disequilibrium syndrome Peritoneal Dialysis: Peritonitis Exit site infections Hernias Catheter blockage

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