kidney dialysis treatment

Dialysis treatment at the Clinic




The main function of dialysis will be to "clean" the blood of toxins generated, excess water and electrolytes, such as sodium and potassium, which is caused by a defect in its elimination by the kidney.

It is applied in patients with acute renal failure (reversible) and fundamentally in those patients with end-stage chronic renal failure and incompatible with life.

It is based on the movement of solutes (ions, urea, creatinine, uric acid, etc.) and solvents (water) through the pores of a semipermeable membrane in relation to the different concentrations of the substances following the phenomena of diffusion, osmosis and filtration.

What are the indications for dialysis?

The fundamental indication of dialysis is the treatment of chronic renal failure, which must always be comprehensive, that is, with options to change from one technique to another and the possibility of kidney transplantation if there is no contraindication.
The diseases that lead to kidney failure are multiple, but the main ones are: glomerulonephritis, pyelonephritis, interstitial nephritis, vascular nephropathies and diabetic nephropathy. Dialysis is also indicated in acute renal failure and in some intoxications.

When the semipermeable membrane is artificial. These may be of cellulosic or synthetic nature and by their structure may be capillary fiber or flat membrane. They vary in their permeability, surface, thickness, electric charge and adsorption capacity.
What is needed and how is hemodialysis performed?
A permanent access route to the intravascular stream is required (preferably an internal arteriovenous fistula, possibly a cannula, etc.), an artificial kidney (it consists of a blood pump, a monitor and the dialyzer where the semipermeable membrane is located). where the exchange is made between the dialysis fluid or bath and the blood).

Usually, the dialysis session in chronic patients takes place three days a week (Monday, Wednesday and Friday, or Tuesday, Thursday and Saturday), with a duration of 4 hours per session, in morning, afternoon or evening shifts. It can be carried out in the hospital, in an out-of-hospital dialysis unit or even in the patient's own home.

What complications can occur in hemodialysis?
The main complications are an insufficient flow of blood (the ideal is greater than 300 cm./min.), Rupture of the dialyzer with blood loss, hypotension, dizziness, headache, nausea or vomiting, itching, cramps, etc.

Currently, with the modern automatic machines and various dialysis variants with bicarbonate, the complications are minimal and largely rectifiable.

Peritoneal dialysis

When the semipermeable membrane is natural, as in the case of the patient's peritoneum (layer that covers the internal organs of the abdomen and that has multiple capillaries and large surface area).
What is needed for peritoneal dialysis?
Peritoneal dialysis requires the placement of a soft, multi-perforated catheter in the abdomen, through which dialysis solution (similar to the liquid part of the blood but without waste products) is infused, of about two liters with replacement each 4-6. hours during the day and about 8 hours during the night, every day of the year.

This dialysis method is called continuous ambulatory peritoneal dialysis and is performed by the patient after a period of hospital learning. It can also be done with a machine or cycler that carries out the replacements on a scheduled basis at night, allowing the patient to be free throughout the day and this is called automated peritoneal dialysis.

What complications can occur in peritoneal dialysis?
The main ones are loss of fluid through the catheter access tunnel, infection of the tunnel or catheter, obstruction of the catheter, peritonitis, abdominal hernias, protein losses, etc. All of them are solved with treatment.

Learn more about dialysis

At the Clínica Universidad de Navarra we have a Dialysis Unit composed of a team of multidisciplinary professionals specialized in this treatment: nephrologists, nurses, nutritionists, etc.

Upon arrival for each session, a nurse and a nursing assistant will receive you and be responsible for your care. In addition, the nephrolologist of the Unit will be at your disposal for whatever you need.

In recent years, important advances have been made in dialysis techniques that allow it to be an aid in the treatment of certain diseases such as heart failure, liver failure, multiple myeloma, etc.

During hemodialysis, the patient will be seated in a recliner chair. During that time, besides being able to sleep, listen to the radio, read or talk, you can connect to the internet via wifi or watch TV. You will also have a breakfast, lunch or snack, depending on the time.