Dialysis Introduction Type And Principle Of Peritoneal Dialysis

Introduction:

Dialysis is the artificial process of getting rid of waste (diffusion) and unwanted water (ultrafiltration) from the blood. This process is naturally done by kidneys. Some people, however, may have failed or damaged kidneys which cannot carry out the function properly - they may need dialysis. In other words, dialysis is the artificial replacement for lost kidney function . Dialysis may be used for people who have become ill and have acute kidney failure (temporary loss of kidney function), or for fairly stable patients who have permanently lost kidney function (stage 5 chronic kidney disease). Dialysis  need  when people develop end stage kidney failure --usually by the time people lose about 85 to 90 percent of kidney function.

Types Of Dialysis:

There are two main types of dialysis.

1. Hemodialysis:

The blood circulates outside the body of the patient , it goes through a machine that has special filters. The blood comes out of the patient through a catheter (a flexible tube) that is inserted into the vein. The filters do what the kidney's do; they filter out the waste products from the blood. The filtered blood then returns to the patient via another catheter.

Patients need to be prepared for hemodialysis: A blood vessel, usually in the arm, needs to be enlarged. . The enlarged vein makes the insertion of the catheters possible. US researchers have developed a new way of growing blood vessels using patients' own skin cells to seed the growth of tissue and have tested it in dialysis patients with end stage kidney disease.

Hemodialysis usually lasts about 3 to 4 hours each week. The duration of each session depends on how well the patient's kidneys work, and how much fluid weight the patient has gained between treatments. Hemodialysis is either done in a special dialysis center in a hospital.

2. Peritoneal Dialysis :

A sterile (dialysate) solution rich in minerals and glucose is run through a tube into the peritoneal cavity, the abdominal body cavity around the intestine, where the peritoneal membrane acts as a semi-permeable membrane.

The abdomen is the area between the chest and hips , it contains the stomach, small intestine, large intestine, liver, gall bladder, pancreas and spleen. Peritoneal dialysis uses the natural filtering ability of the peritoneum ,the internal lining of the abdomen. In other words, peritoneal dialysis uses the lining of the abdomen as a filter of waste products from the blood.

The dialysate is left there for some time so that it can absorb waste products. Then it is drained out through a tube and discarded. This exchange, or cycle, is generally repeated several times during the day - with an automated system it is often done overnight. The elimination of unwanted water (ultrafiltration) occurs through osmosis - as the dialysis solution has a high concentration of glucose, it results in osmotic pressure which causes the fluid to move from the blood into the dialysate. Consequently, a larger quantity of fluid is drained than introduced.

Although peritoneal dialysis is not as efficient as hemodialysis, it is carried out for longer periods. The net effect in terms of total waste product and salt and water removal is about the same as hemodialysis.

Peritoneal dialysis is done at home by the patient; by a willing and motivated patient. It gives the patient a greater amount of freedom and independence because he/she does not have to come in to the clinic at multiple times each week. It can also be done while traveling with a minimum of specialized equipment. Peritoneal dialysis is said to 'save lives and save money'.

Before having peritoneal dialysis, the patient needs to have a small surgical procedure to insert a catheter into the abdomen. This is kept closed off, except when fluid is being introduced or taken out of the abdomen.

There are two principal types of peritoneal dialysis:

1. Continuous ambulatory peritoneal dialysis (CAPD) :

This requires no machinery and can be done by the patient or a caregiver. The dialysate is left in the abdomen for up to eight hours. It is then replaced with a fresh solution straight away. This happens every day, about four to five times per day.

2. Continuous cyclic peritoneal dialysis (CCPD) :

A machine does the dialysis fluid exchanges. It is generally done during the night while the patient sleeps. This needs to be done every night. Each session lasts from ten to twelve hours. After spending the night attached to the machine, the majority of people keep fluid inside their abdomen during the day. Some patients may require another exchange during the day. A study found that a significant number of patients prefer "dialysis while patient sleep" treatment.

Balance Diet For Tuberculosis Patient Some tips for a balanced diet

Balance Diet For Tuberculosis Patient 

Tuberculosis is a disease caused by an infection of a bacterium known as Mycobacterium tuberculosis. The  only  way to cure tuberculosis is through a rigorous course of antibiotics prescribed by  doctor. The average duration of treatment is around six months to a year. A healthy balanced diet can help prevent of  malnutrition .

Some tips for a balanced diet 

• Consume an adequate amount of fruit and vegetables but stay within the correct calorie level for a healthy weight. On a 2000-calorie diet, eat 2 cups of fruit and 2 and a half cups of vegetables per day. Eat more or less according to calorie needs.

• Eat a variety of fruit and vegetables each day. Choose from all five vegetable sub-groups (dark green, orange, legumes, starchy vegetables, and other vegetables) several times a week.

• Consume 3 or more ounce-equivalents of whole-grain foods each day, with the rest of the recommended grains coming from enriched or whole-grain products. At least half  grains should come from whole grains. Eating at least 3 ounce-equivalents of whole grains per day can reduce the risk of heart disease, may help with weight maintenance, and will lower health risk for other chronic diseases.

• Consume 3 cups per day of fat-free or low-fat milk or equivalent milk products. Adults and children can consume milk and milk products without worrying that these foods lead to weight gain. There are many fat-free and low-fat choices without added sugars that are available and consistent with an overall healthy dietary plan. If a person has difficulty drinking milk, ...choose alternatives within the milk food group, such as yogurt or lactose-free milk, or consume the enzyme lactase prior to the consumption of milk products. For people who must avoid all milk products (e.g. individuals with lactose intolerance, vegans), non-dairy calcium-containing alternatives may be chosen to help meet calcium needs.

• Eat a variety of protein rich foods, with more fish, beans, peas, nuts and seeds.

• Eat less than 2,300 mg (approximately 1 teaspoon of salt) of sodium per day.

• Choose low-sodium foods, and do not add salt when cooking. Also, eat potassium-rich foods, such as fruits and vegetables.