Dialysis-Principle, Advantages and Disadvantages

Kidney problem is a complication that continues to be recorded in the medical field. There is, therefore, need to address this issue. In an attempt to solve this problem, patients and the medical practitioners face many challenges. Among the encountered problems, there is unavailability of kidneys to be used as replacements for the infected kidneys. There are few kidney donors and they cannot meet the demand of the needed kidneys by patients. Even if one is lucky to receive kidneys, there is also a problem of incompatibility, and, therefore, such patients cannot receive kidney transplant on such grounds. There are also patients who have medical reasons due to which, they cannot receive another organ. Kidney transplant is also expensive, which only few people can afford. Because of these issues, there has to be an alternative measure. This alternative treatment for kidney complications is the use of dialysis for kidney complications. This paper looks into at the meaning of dialysis and the types of dialysis available. The paper also discusses the principles of dialysis, and then it finally looks at the advantages and disadvantages of dialysis.

What is dialysis?

The word “dialysis” in medicine is derived from a Greek term “dialusis”, which means dissolution. It is derived from two words, “dia” which means “through”, and “lysis” which means “loosening”. This is a process through which excess water and waste products are eliminated from the blood. This method is used to provide an artificial replacement for the kidney dysfunction for people who suffer from renal failure. Dialysis is used for people who have had chronic kidney dysfunction and acute kidney disturbances. It is also used to help people who have been sick and have lost their kidney functions temporarily. It is also applicable for patients who are healthy but have permanently lost their kidney functions.

Chronic kidney failure can neither be reversed nor treated, unlike Acute Renal Failure (ARF) or even Acute Kidney Injury (AKI). The only remedy for such cases is the replacement of the lost kidney with kidney transplant. However, this method of kidney transplant is not always reliable and convenient for all people. This is because kidney transplant may prove to be expensive for most people. Others do not prefer it for other reasons (some of which are religious). Others are not medically fit to receive kidney transplant. Other people may not be in a position to receive kidney transplant because of lack of kidney donors. Because of these, most patients suffering from ESKD have dialysis as the only measure to secure their health by replacing the water and waste removing function of the kidney. A healthy body requires that the level of water and minerals like potassium, sodium, chloride, phosphorus, magnesium, and sulfate among others are kept at equilibrium. Kidney helps in keeping this equilibrium, and if there is a malfunction of the kidney, then there has to be a way of maintaining this for the body to remain healthy. The kidney has also important function in the body. This one helps in the formation of the white blood cells. Therefore, its absence in the body causes many damages. Though dialysis helps in the bodily waste management, it does not replace the endocrine function of the kidney. It stands, therefore, as an imperfect mode of treatment.

There are two different types of dialyses: hemodialysis and peritoneal dialysis.

Hemodialysis

This is the removal of waste outside the body through special filter. In this type of dialysis, blood flows through dialyzer, which is a semi permeable membrane that helps in toxin removal. Here, dialysis uses quite specific methods of accessing blood in the blood vessels, since hemodialys is condition when there is stronger blood flow than the normal supply. However, this access is made temporary by dialysis catheters, and it can be permanently made by the surgical joining of an artery to the vein. In this, the blood is then transferred from an access point in the body of the patient to the dialysis machine. In the machine, chemical imbalance is rectified and the blood is purified. Then, the clean blood is sent back to the body. Patients undergo this kind of treatment for hemodialysis three sessions each week.

Peritoneal dialysis

Peritoneal dialysis works with the help of using peritoneal membrane, which is located inside the abdomen of the patient. In the abdomen, solutions that remove toxins remain for a period and later, they disappear from the body. This exercise is done daily. This is an exercise that cannot be performed in the hospital. It is recommended that it should be done at home. Patients are given advice on how to fulfill this task on their own.

Principles of dialysis

Dialysis applies the principle of diffusion of solutes and ultra filtration of fluids across semi-permeable membrane. There is a possibility of substance, which is soluble, to dissolve in water. Soluble substances always move from the region of high concentration to the region of low concentration. In the process of dialysis, dialysate (a special fluid of dialysis) is made to flow in the opposite direction to the flow of blood. A semi permeable membrane separates this flow of dialate and blood (Ronco and Dinna 145). Due to this flow, small particle move across the membrane, while large particle of the blood like red blood cells are blocked, since the pores in the membrane are very small. This process replaces the process that takes place in the kidney, where larger particles are separated from the smaller particles in the glomerulus. The two types of dialysis remove wastes from the blood in different ways. Hemodialysis uses the external filter to remove water and waste products from the body, which has a semi permeable membrane. In this, blood and dialysate flow in the opposite direction. The removal of more urea and creatine is maximized by the counter current flow, which maximizes the concentration gradient between the blood and the dialysate. The concentration of unwanted solutes in the blood is high in the blood but low in the dialysate. This disparity in the concentration and constant replacement of dialysate enables these toxic substances to be removed from the blood constantly. Dialysate has chemical levels that are in the correct measure, as they should be in the body. They, therefore, cause no complication in the body of the patient. In the case of peritoneal dialysis, peritoneal membrane is used in the removal of waste and water from the blood inside the body. In this, waste is removed in the abdominal cavity, where wastes are removed in the body using peritoneal membrane.

Advantages of dialysis

1. It does not use needles: the use of a needle can increase the level of pains of the patient. This also ensures that the patient is to heal quickly. The use of needle can also lead to the contraction of some diseases if the used needle is contaminated.
2. Center visit at regular intervals: this enables the patient to be under constant check. Constant visits also enable the patient to receive regular guidance on how to handle him/her in regards to her condition. The center visit is also necessary, since it is easier to detect any health complication that may arise (Ronco and Dinna 76).
3. A flexible lifestyle and independence: the patient does not have to rely on other people, since the system is set in such a manner that the patient’s body functions normally. The patient does not have to stop his daily routine to be on the sick bed. One has to observe the guidance that is given by the doctor, and, thus, be able to run his life normally.
4. Provides continuous therapy, which operates like the normal kidney: dialysis provides the normal therapy which is difficult to differentiate from the normal kidney. It performs kidney’s functions. It regulates the ph of the body, hence, enabling the body to maintain the homeostasis. This capability of dialysis enables one to run his life comfortably without changing one’s lifestyle.
5. Easy do therapy while traveling: one’s life does not have to be immobile. One can practice the therapy while on the move, since it is easy to do. It does not have long procedures which would draw many complications, thus, making one’s life complicated and restricted.
6. Ability to do the therapy while sleeping: the therapy is also doable when one is sleeping, since it is automatic and not restricted to a particular state of consciousness.
7. Dialysis also minimizes chances of complications that could arise because of incompatibility of kidney transplant. Most patients who have received kidney transplant complain of health complications, some of which are severe, thus, even leading to death of the patient. Kidney transplant is also expensive, and sometimes it is difficult to find a donor. This leaves dialysis to be the best option for patients with kidney problems. It is cheaper and easily available.
8. For patients who do not prefer kidney transplant due to various reasons, dialysis can be an alternative measure to the treatment of their kidney complications.

Disadvantages of dialysis

1. Needs to schedule exchanges into one’s daily routine seven days a week: this automatically interferes with one’s schedule and the normal way of life. It is an obstruction and attention is of course divided.
2. Requires a permanent catheter, outside the body: this requirement adds an extra weight that one has to concentrate on daily. It interferes with one’s mode of dressing.
3. Runs some risk of infection: there are chances of infections, as the catheter outside the body can be infected easily.
4. May cause weight gain or larger waistline:  because the catheter is outside the body, the introduction of new system in the body may increase one’s weight. This is a problem, as excess weight is unhealthy.
5. Very large people may need extra therapy: people with heavy weight may be forced to go for extra therapy to enable their bodies to function effectively. It is expensive and it also increases other chances of infections.
6. Needs storage space in one’s home for supplies: there is need for an extra space where the supplies can be kept. Keeping these things at home may not be safe, since they may be infected or stolen, thus, leaving one suffering.
7. Needs space in one’s bedroom for equipment (APD), which may not even be enough.

CONCLUSION

Dialysis stands to be an alternative means of kidney transplant. It is true that the whole population cannot have an access to kidney transplant. Although dialysis has various disadvantages, it helps in preserving life, since there is no way of reversing kidney failure. With keen care and observation of the guidance of the doctors, one can assume a normal life to function effectively, as they had been doing before. The principles that are applied in dialysis are also effective, since they ensure that homeostasis of the body remains constant.

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