John P. Cunha, DO, FACOEP
John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha’s educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
Charles Patrick Davis, MD, PhD
Dr. Charles “Pat” Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Dialysis definition and facts
- Kidney dialysis is a procedure that is a substitute for many of the normal functions of the kidneys.
- Dialysis allows people with kidney failure (renal failure) a chance to live productive lives.
- When kidney function decreases to a critical level or complications arise, a person may need to start dialysis.
- There are two main types of dialysis, hemodialysis and peritoneal dialysis.
- Hemodialysis uses a machine and a filter to remove waste products and water from the blood.
- Peritoneal dialysis uses a fluid (dialysate) that is placed into the patient’s abdominal cavity to remove waste products and fluid from the body.
- Each type of dialysis has advantages and disadvantages.
- People often can choose which type of long term dialysis that best matches their needs.
- Dialysis gives some people an extended life, and in others, it provides additional time to locate an appropriate donor kidney for a kidney transplant (renal transplant).
What is dialysis?
The kidneys are responsible for filtering waste products from the blood. Dialysis is a procedure that is a substitute for many of the normal functions of the kidneys. The kidneys are two organs located on either side in the back of the abdominal cavity. Dialysis can allow individuals to live productive and useful lives, even though their kidneys no longer work adequately. Statistics from 2015, U.S. Renal Data System Annual Data Report (USRDS), showed approximately 468,000 patients were receiving dialysis in the United States. More than an additional 193,000 patients had a functioning kidney transplant for end stage renal disease.
Dialysis helps the body by performing the functions of failed kidneys. The kidney has many roles. An essential job of the kidney is to regulate the body’s fluid balance. It does this by adjusting the amount of urine that is excreted on a daily basis. On hot days, the body sweats more. Thus, less water needs to be excreted through the kidneys. On cold days, the body sweats less. Thus, urine output needs to be greater in order to maintain the proper balance within the body. It is the kidney’s job to regulate fluid balance by adjusting urine output.
Another major duty of the k >
Hemodialysis: Treatment for Kidney Failure
How Hemodialysis Works
In hemodialysis, your blood is allowed to flow, a few ounces at a time, through a special filter that removes wastes and extra fluids. The clean blood is then returned to your body. Removing the harmful wastes and extra salt and fluids helps control your blood pressure and keep the proper balance of chemicals like potassium and sodium in your body.
When do patients require dialysis?
When the kidneys fail to filter the blood effectively, and fluid and waste products build up in the body to a critical level a person may need to start dialysis. The two main causes of kidney failure and need for dialysis treatment are diabetes and high blood pressure.
When a person’s levels of waste products in their body become so high they start to become sick from them, he or she may need dialysis. The level of the waste products usually builds up slowly. Doctors that specialize in diseases and conditions of the kidneys are called nephrologists. To help nephrologists decide when dialysis is necessary for a patient, he she will order tests that measure several blood chemical levels in the patient’s body. The two major blood chemical levels that are measured are the “creatinine level” and the “blood urea nitrogen” (BUN) level. As these two levels rise, they are indicators of the decreasing ability of the kidneys to cleanse the body of waste products.
Doctors use a urine test, the “creatinine clearance,” to measure the level of kidney function. The patient saves urine in a special container for one full day. The waste products in the urine and in the blood are estimated by measuring the creatinine. By comparing the blood and urine level of this substance, the doctor has an accurate idea of how well the kidneys are working. This result is called the creatinine clearance. Usually, when the creatinine clearance falls to 1 below 10 cc/minute, the patient needs dialysis.
The doctor also uses other indicators of the patient’s status to decide about the need for dialysis. If the patient is experiencing a major inability to rid the body of excess water, or is complaining of problems with the heart, lungs, or stomach, or difficulties with taste or sensation in their legs, dialysis may be indicated even though the creatinine clearance has not fallen to the 10 cc/minute level.
What are the types of dialysis? How do they work?
There are two main types of dialysis, hemodialysis and peritoneal dialysis.
How hemodialysis works
Hemodialysis uses an external machine and a special type of filter to remove excess waste products and water from the blood.
During hemodialysis, blood passes from the patient’s body to the dialysis machine through sterile tubing and into a filter, called a dialysis membrane. For this procedure, the patient has a specialized vascular tube placed between an artery and a vein in the arm or leg (called a gortex graft). Sometimes, a direct connection is made between an artery and a vein in the arm. This procedure is called a Cimino fistula. Needles are then placed in the graft or fistula, and blood passes to the dialysis machine, through the filter, and back to the patient. If the patient requires dialysis before a graft or a fistula is placed, a large diameter catheter (hemodialysis catheter) is placed directly into a large vein in the neck or leg in order to perform dialysis. In the dialysis machine, a solution on the other side of the filter receives the waste products from the patient.
How peritoneal dialysis works
Peritoneal dialysis uses a fluid that is placed into the patient’s abdominal cavity through a plastic tube (peritoneal dialysis catheter) to remove excess waste products and fluid from the body.
Peritoneal dialysis uses the patients own body tissues ins >
Creatinine Blood Test
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