Renal dialysis: how does it work?

Dialysis is a treatment indicated for advanced renal disease, that is, when a person has significant (or terminal) renal failure.

The person can still urinate (or not), but the kidneys no longer play their role, and fail to filter and eliminate some substances in the blood. These substances accumulate and become toxic to the body. Moreover, water and salt in the body are also not properly eliminated, which promotes a rise in blood pressure.

Before the development of dialysis techniques (around the 1950s), patients with a very advanced form of renal failure would die of uremia. Dialysis can be used in cases of acute renal failure, while the kidneys are functioning normally, or in cases of chronic renal failure when the kidneys are unfortunately permanently affected.

There are several dialysis techniques, the most common being hemodialysis which directly filters the patient's blood through an artificial membrane and through a device called a dialyzer. The other is peritoneal dialysis which uses the peritoneum, the very large natural membrane surrounding the digestive organs, to filter and remove toxic substances from the blood. This filtering is done by an exchange between the patient's blood and a specific liquid introduced into the patient's abdomen.

Even though this dialysis treatment can save many lives (when patients have access to this care), the kidney transplant is much less restrictive for the patient, leaving him more freedom (even if this transplant is not without risk). There is currently a lack of kidneys (grafts) to transplant. And dialysis is a treatment used by many patients (more than 40, 000 in France). He is a nephrologist, kidney disease specialist, and dialysis-trained nurses who care for these patients. The intervention of dieticians with patients is also necessary to properly apply certain nutritional advice.

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Read also :

> The functioning of the kidneys
> Kidney disease
> Kidney failure

Author: Dr. Nicolas Evrard.
Expert consultant: Professor Michel Omer, nephrologist.

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