Renal Replacement Therapy

Hospital for Renal Replacement in Salem

Why do we need dialysis?

Our kidneys play an important role in filtering out waste and excess fluid from the body, which is then excreted through urine. When the kidneys fail to function properly toxins and excess fluids and electrolytes build up in the body leading to several complications such as high blood pressure, swelling in the extremities, nausea, vomiting, heart disease, weak bones, decreased immunity, etc. Without treatment, the worsening can progress leading to death. In such cases, the person needs medical support in the form of renal replacement therapy (RRT) or dialysis, which mimics the functioning of the kidneys. RRT is generally recommended when the kidney functions fall by 80-90% and the glomerular filtration rate (GFR is a test used to measure kidney function) is <15 ml/ms/1.7ml BSA.

If you are looking for a hospital for renal replacement therapy in Salem then book an appointment with Manipal Hospital now.

Can dialysis reverse kidney disease?

No, dialysis cannot reverse kidney disease. It only helps to carry out the functions of the kidneys, such as removing toxins and excess fluid from the body, maintaining electrolyte balance essential for normal body functioning and helping regulate blood pressure. 

Who requires dialysis?

Several conditions may require RRT, including:

  • Acute kidney Injury: when the kidney stops working suddenly due to snakebite/toxics or other health condition such as septic shock, dehydration, heart complications, enlarged prostate, high blood pressure in pregnancy, etc it is known as acute kidney injury. Acute kidney injury is reversible and the kidneys start functioning once the primary condition causing it is taken care of.

  • Chronic kidney disease: This condition is characterised by progressive worsening of kidney functions due to diabetes, hypertension etc leading to end-stage kidney disease, where the kidneys stop functioning completely. This condition is irreversible and the person is dependent on lifelong dialysis or renal transplant for survival. 

Are dialysis and RRT the same?

Technically speaking, dialysis is a type of RRT. 

RRT is carried out in patients with kidney failure to replace the filtration functions of the kidneys. RRT techniques include hemodialysis, peritoneal dialysis and continuous hemofiltration and hemodialysis. 

RRT is usually done periodically or continuously depending upon the patient condition. Continuous therapy is usually reserved for acute kidney injury patients. 

What is Haemodialysis?

  • This is the most common type of dialysis. 

  • During the procedure, a tube is attached to the needle in your arm, through which blood is made to pass into an external machine (dialyser), which filters it just like your kidneys. Post filtration, the purified blood is pumped back into the body through another tube in the arm. 

  • This can be done at home or at a dialysis centre, around 2-3 sessions a week each session lasting for about 2-6 hours depending upon patient conditions and severity. 

  • Complications of haemodialysis may include low blood pressure, skin itching, muscle cramps, dry mouth, and rarely blood-borne infections like hepatitis b &hepatitis C. Hence our centre does dialysis at segregated for HBV and HCV infected patients.

What is Peritoneal dialysis?

  • This process makes use of the internal lining of your abdomen also known as the peritoneum to filter out toxins and fluids instead of the machine. 

  • In this procedure, a tiny incision is made near your belly button and a catheter (thin tube) is inserted through it to reach the inside of the peritoneal cavity (protective sac around the abdomen). During every session, the dialysis fluid from a bag flows into the cavity through the catheter. When the bag is emptied, you need to remove it from the catheter opening and place a cap at the catheter tip so that you can move around with it. As blood passes through the tiny blood vessels lining the peritoneal cavity, the toxins and excess fluid is drawn out into the dialysis fluid from the blood. After a few hours, the dialysis solution with toxins is drained out from the body into an empty bag, which is discarded. 

  • The process needs to be repeated about 3-5 times a day or while you sleep at night. 

  • Peritoneal dialysis can be done manually or with a help of a machine, which automatically fills and discards fluids from the belly. 

  • Unlike haemodialysis, peritoneal dialysis needs to be done every day. The patient can set it done at home and need not visit the hospital for dialysis. However, it allows you a less restricted diet, better kidney function retainment and more flexibility to travel as compared to hemodialysis.

  • Complications of peritoneal dialysis may include infection of the abdominal cavity, weight gain as the dialysis fluid contains a high amount of sugar, hernia and inadequate filtration after a few years requiring haemodialysis. 

What are Continuous hemofiltration and haemodialysis?

The third type of dialysis is known as continuous hemofiltration and the hemodiafiltration procedure is generally used to remove toxins and excess fluids continuously throughout the day in patients with acute kidney injury in ICU settings, such as those with multiorgan failure or shock. This method of dialysis is far gentler than the other forms of dialysis and requires medical expertise for optimal outcomes. 

Manipal is one of the best hospital for renal replacement in Salem having a top nephrologist in Salem who is highly experienced in treating any type of kidney-related conditions.

 

Dr. Ashok Kumar R

Consultant - Nephrology

Manipal Hospital, Salem

 

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