The main function of dialysis is to “clean” the blood of the toxins generated, excess water and electrolytes, such as sodium and potassium, which is caused by a defect in its elimination by the kidney. Dialysis in Delhi is applied in patients with acute renal failure (reversible) and mainly in those patients with chronic renal failure in the terminal phase 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 substances following diffusion phenomena, Osmosis, and filtration.

What are the indications of dialysis?

The fundamental indication of dialysis in Delhi is the chronic renal failure treatment in Delhi, which should always be comprehensive, this is with options for changing from one technique to another and the possibility of kidney transplant in Delhi in case there is no contraindication.

The diseases that lead to renal 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 poisonings.

Type of Dialysis in Delhi

1. Hemodialysis

When the semipermeable membrane is artificial. These can be cellulosic or synthetic in nature and because of their structure they can be capillary fiber or flat membrane. They vary by their permeability, surface, thickness, electric charge and adsorption capacity.

What is required and how is hemodialysis performed?

A permanent access route to the intravascular torrent is required (preferably an internal arteriovenous fistula, possible a cannula, etc.), an artificial kidney (consisting of a blood pump, a monitor and the dialyzer where the semipermeable membrane is located and where the exchange between the fluid or dialysis bath and the blood takes place).

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 outpatient dialysis unit or even at the patient’s own home under the guidance of a nephrologist in Delhi.

What complications can occur in hemodialysis?

The main complications are insufficient blood flow (the ideal is greater than 300 cm./min.), Dialysate rupture with blood loss, hypotension, dizziness, headache, nausea or vomiting, itching, cramping, etc. Currently, with modern automatic machines and various variants of bicarbonate dialysis, complications are minimal and largely rectifiable.

2. Peritoneal dialysis

When the semipermeable membrane is natural, as in the case of the patient’s peritoneum (a layer that covers the internal organs of the abdomen and that has multiple capillaries and large surface area).

What is required for peritoneal dialysis?

dialysis-in-delhi

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, about two liters with replacement every 4-6 hours during the day and about 8 hours at night, every day of the year.

This method of dialysis in Delhi is called continuous ambulatory peritoneal dialysis and is performed by the patient himself after a period of hospital learning. It can also be done with a machine or cycler that performs the spare parts 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 the loss of fluid through the catheter access tunnel, the tunnel or catheter infection, catheter obstruction, peritonitis, abdominal hernias, protein losses, etc. All of them are solved with treatment.

Can the patient choose the type of dialysis in Delhi?

The patient can and should choose, with the help of the treating nephrologist in Gurgaon, the dialysis method (peritoneal dialysis or hemodialysis and its multiple variants) that best suits him by his characteristics (age, work, family circumstances, distance to the unit dialysis, type of kidney disease and other concomitant diseases, possibilities or not of access to the intravascular torrent, previous abdominal operations, etc.).

The best nephrologist in Delhi must inform you about all the differences between the different dialysis modalities and the advantages and disadvantages in general and in the specific case of the patient. In addition, since the treatment of terminal chronic renal failure is integrated, it is always possible to switch from one type of dialysis to another in case of intolerance or unresolvable problems.

Dr. Vinant Bhargava

Dr. Vinant Bhargava, M.B.B.S., DNB (General Medicine), DNB (Nephrology), MNAMS...

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