The advantages and disadvantages of hemodialysis

Hemodialysis has the following advantages:
① to carry out a long time, a wide range of the vast majority of the country above the county level medical units were carried out; ② small molecule toxins for removal of moisture and good results, combined with other treatment modalities hemoperfusion can be cleared, the macromolecular toxins and metabolic waste; ③ fixed time every week to the hospital for treatment, other times life is not affected by the medical staff on behalf of operation, without the presence of home dialysis supplies.
Hemodialysis has the following drawbacks: 
① currently in the country can only be implemented by professionals to the hospital treatment, can not be treated at home, and the treatment must be 3 to 5 hours during the restricted activity; ② blood-borne infections high probability than peritoneal dialysis, bleeding tendency or activity bleeding in patients with high risk hemodialysis; ③ have a direct effect on the circulatory system, cardiovascular function on the basis of certain requirements; ④ protective effect of residual renal function poor; ⑤ control requirements than peritoneal dialysis diet high.

Hemodialysis causes anemia do?

Hemodialysis patients accumulated a large amount of blood loss, mainly dialyzer clotting, rupture, back when the blood dialyzer and pipeline flushing is not complete, blood residues more relevant. On the other hand, blood tests are also the main reason for loss of blood. Female dialysis patients ovulation disorders, menstruation and menstrual bleeding between periods, after increasing and often caused by heparin occult gastrointestinal bleeding. Does not mean hemodialysis aggravate renal anemia Instead adequate dialysis clearable Toxic increase patient appetite improve systemic nutritional status eliminate affect erythrocyte lifetime uremia environment reduce erythrocytes autolysis increase marrow red Department for erythropoietin response, improved coagulation and platelet function, inhibition of the skin, gastrointestinal tract and other parts of the bleeding. Therefore, if adequate dialysis, hemodialysis patients anemia can be improved.
Affect the efficacy of erythropoietin main factors:
1, the infection can be significantly reduced on erythropoietin response to control infection and inflammation after the resumption. Its possible through inflammatory cytokines mediated inhibition with erythropoietin;
2, chronic blood loss can lead to iron deficiency and erythropoietin response to weaken;
3, aluminum intoxication affect the performance of the bone marrow to extend the time required to achieve the target hemoglobin;
4, folic acid and vitamin B12 is necessary for hemoglobin synthesis substances, if deficiency can lead to lack of raw materials, affecting the efficacy of erythropoietin;
5, malnutrition can lead to lack of raw materials synthesis of hemoglobin, and so on.

Can I Stop Peritoneal dialysis

Peritoneal dialysis is a dialysis . Patients with renal failure is also frequently used method , however, if there will be a lot of frequent side effects of dialysis , peritoneal dialysis , after consulting some patients can stop it ? For this problem , we asked the experts to give us a detailed description under the bar .

Peritoneal dialysis can stop it ? Jingdong American Hospital experts said , peritoneal dialysis is comparable primitive dialysis methods, but there are many improvements in recent years , is still in the blood purification disciplines for a place . Peritoneal dialysis over hemodialysis concerned has its own advantages . That is peritoneal dialysis at home can stop , do not need to go to the hospital , at a cost of less than hemodialysis . Meticulous detail below talk about common method of peritoneal dialysis :

1 continuous ambulatory peritoneal dialysis (CAPD): refers to the last saved dialysis fluid in the abdominal cavity , the daily change 3-5 times daily 1 to 2 liters poured into the peritoneal dialysis , the patient can be out of bed , so most patients are able to tolerate , and even able to participate in normal activities or work .

2 Intermittent peritoneal dialysis : That is the first use of peritoneal dialysis as a method used manually, or automatically with a loop machine reverse osmosis peritoneal dialysis machine, mainly conform to bedridden, mobility or need home care patients.

( 1) The manual method : each dialysis solution 2 liters daily exchange 8 to 10 times, each time for 1 hour, i.e. into the liquid for 30 minutes, kept for 10 minutes and the liquid for 10 minutes every 4 to 5 days of dialysis , rest 2, 2009, in the day to stop dialysis , features without leaving the abdominal cavity during dialysis dialysate .

( 2 ) application of peritoneal dialysis machine approach : liquid volume 40 liters per week , 30 minutes a second exchange of dialysis fluid into the liquid for 5 minutes, stay for 15 minutes, the liquid for 10 minutes, dialysis 10 hours a day , can be used with a good dialysate , the machine can also be used to reverse osmosis concentrated solution of 30% sugar diluted to 1.5% dialysate .

3 continuous cyclic peritoneal dialysis : a peritoneal dialysis machine is stopped by means of a method . Daylight saving peritoneal dialysis , dialysis machine at night before going to bed with 4 to 5 times of convergence stop dialysis , the morning will be the last bag of dialysate stay in the abdominal cavity, can work as usual .

Peritoneal dialysis is easy to attack water and electrolyte imbalance and acid-base imbalance , hypotension, pulmonary infection and abdominal effusion, cardiovascular complications , abdominal complications , disequilibrium syndrome , and chronic complications of peritoneal dialysis and other adverse reactions , Therefore stage renal failure , thyrotoxicosis peritoneal dialysis patients should be carefully chosen .

Why Hemodialysis Have Headache

Why Hemodialysis Have Headache

Many people undergoing hemodialysis headache occurs when the phenomenon, then, this is how it happened?
Dialysis headache incidence of about 5%, common causes
① disequilibrium syndrome, often occurs in new patients entering dialysis treatment for the late or on dialysis occurred shortly after the end of the dialysis related to dizziness, headaches and other neurological symptoms of the syndrome.
② high blood pressure, elevated blood pressure in dialysis can cause headaches due. Sublingual nifedipine, captopril and other effective, severe hypertension treated blood pressure is still not down, shall terminate dialysis, hemofiltration later be replaced by dialysis or hemofiltration.
③ intracranial hemorrhage, dialysis patients often complicated by hypertension and cerebral arteriosclerosis, cerebral hemorrhage corresponding increase in cases of a sudden increase in blood pressure, excessive use of anticoagulants or minor trauma, are likely to be the cause of bleeding.
④ other reasons, such as hemolysis occurred during dialysis, on acetate intolerance, hard water syndrome can also cause headaches.

What Diet For Dialysis

1.Note that low-protein diet: Many dialysis patients that dialysis should eat a low-protein diet, and this is wrong. Because dialysis, a portion of the protein will be lost as the dialysis fluid, the patient should instead increase protein intake, daily intake of 1 ~ 1.2g/kg. Should also be adequate intake of calories, 30 ~ 35kcal/kg daily intake of calories. To reduce lipid metabolism uremic patients should eat less animal offal, animal fats, etc., eat eggs, fish, beef and other high-quality animal protein.
2.Water restrictions: hemodialysis patients should be strictly controlled water intake, such as too much water, there may be heart failure, hypertension, acute pulmonary edema and even death. If a large number of ultrafiltration, will appear hypotension, vomiting, muscle cramps, fatigue and other after penetration. To alleviate thirst, you should avoid drinking tea, espresso drinks can add lemon slices or mint leaves, or will be part of a drink made ​​of ice, in the mouth has a good thirst quencher effect.
3.Limit sodium, potassium : phosphate salts: Dialysis patients should strictly control the sodium, potassium, phosphorus and salt intake, eating salt 6 grams a day or so, if severe hypertension or edema, should be limited to 3g / day. Hemodialysis patients with elevated serum potassium is easy, hyperkalemia can lead to serious arrhythmia and even cardiac arrest.
In the diet, should avoid eating high-potassium foods, such as citrus, grapes, bananas, peanuts and so on. To minimize the amount of potassium in the diet, green leafy vegetables can be soaked for half an hour or more, eat soup, root vegetables should be peeled, sliced, after immersion in water to cook. In addition, patients should eat more calcium phosphorus foods such as egg yolks, organ meats, bone marrow, nuts food phosphorus more, should avoid eating more.

When To Start Dialysis Treatment

Many people feel that uremia is a disease, but Beijing Jingdong American Hospital experts to tell you is not an independent disease uremia is progressive chronic end stage renal failure, then what uremia When dialysis is good? we still see specialists introduction.
When dialysis is best? From the perspective of the medical profession in fact, neither is the sooner the better dialysis (dialysis prematurely did not significantly improve the prognosis), nor is it as late as possible (too late for dialysis patients prone to complications affecting life quality and long-term survival), but the best time to select the best kidney dialysis.
Then how to choose the best time to do kidney dialysis? We know the usual case, according to the degree of renal dysfunction, chronic renal failure can be divided into four:
1, renal decompensation: Although this loss of renal reserve capacity, but for the secretion of urine, discharge of metabolic waste, toxins and drugs, regulate water and electrolyte and acid-base balance is still good, so no special clinical manifestations, blood creatinine and blood urea nitrogen is usually normal or mildly elevated sometimes.
2, azotemia: This term moderate renal damage, renal dysfunction concentrated, there nocturia or polyuria, varying degrees of anemia, often azotemia, serum creatinine, blood urea nitrogen levels. Clinically, accompanied by nausea, loss of appetite and general mild discomfort. This period of protection, such as neglect of renal function, such as the emergence of severe vomiting, diarrhea, caused by hypovolemia, severe infection and the use of nephrotoxic drugs, etc., can cause rapid kidney function decline and failure.
3, renal kidney failure period (uremia preliminary): This period has been severely impaired renal function, severe loss of renal reserve capacity, unable to maintain the body's metabolism and water and electrolyte and acid-base balance. Impossible to maintain a stable internal environment, resulting in serum creatinine, blood urea nitrogen increased significantly dilute urine concentration dysfunction, acidosis, sodium retention, calcium, high phosphorus, potassium and other balance disorders performance. Can have significant anemia and gastrointestinal symptoms such as nausea, vomiting, loss of appetite. May also have neuropsychiatric symptoms, such as fatigue, inability to concentrate, listlessness and so on.
4, uremia: This period is late chronic renal failure, that uremia, clinical manifestations, symptoms become more pronounced, the performance of multiple organ pipe failure, such as the gastrointestinal tract, nervous system, cardiovascular, hematopoietic system, respiratory system, skin and metabolic system imbalance. Clinically manifested as nausea, vomiting, irritability, increased blood pressure, palpitation, chest tightness, not supine, breathing difficulties, severe anemia, convulsions, and even severe cases can be in the long-term coma. This period need to rely on dialysis to sustain life. Often due to hyperkalemia, cerebral edema, pulmonary edema, heart failure and sudden death.
From four, as long as the patient has renal failure to uremia shall be timely initiation of dialysis therapy, specifically, is the best time to achieve the following targets dialysis began: creatinine clearance less than 10 ml / (min · 1.73m2), serum creatinine greater than or equal 8mg/dl may be considered when starting dialysis, diabetes complications due to their earlier, more and more serious and should be appropriate for early dialysis; creatinine clearance less than 15 ml / (min · 1.73m2) when to start dialysis.
For absolutely no clinical signs and symptoms of uremia may be appropriate to delay dialysis patients, but in no case, creatinine clearance less than 10 ml / (min · 1.73m2) should begin dialysis. If nausea, vomiting and other symptoms of uremia, but nor explain reasons other than uremia and conservative treatment can not be alleviated, even if did not meet the standard of renal function should also be prepared to consider dialysis. When acute heart failure, uremia encephalopathy, severe hyperkalemia and acidosis and other serious complications after drug treatment can not be effectively controlled, it is urgent dialysis indications. In addition, for malnourished patients, despite positive non-dialysis treatment is still not correct, should also consider starting dialysis.

Real Story : Can I Get Rid Of Dialysis

A 61 years old patient from Bobby New Guinea has got renal failure and done dialysis in his country for 10 months. He did dialysis 3 times per week and urine volume was 80ml per day.
You know he wanna live a healthy life and improve his quality of life, so with her daughter's help, he came to our hospital to treat his kidney disease on 8th of May in 2013.
On that day before he did hemoperfusion his creatinine level was 636umol/L  , after doing dialysis was 327umol/L .
On 12th May before he did dialysis his creatinine level was 495umol/L and after doing dialysis it was 233umol/L.
On 16th May before he did dialysis his creatinine level was 437umol/L and after doing dialysis it was 200 umol/L
On  24th May before he did dialysis his creatinine level was 285umol/L and after doing dialysis it was 142umol/L
On 29th May before he did dialysis his creatinine level was 242umol/L and after doing dialysis it was 115umol/L
On 3th June before he did dialysis his creatinine level was 218umol/L and after doing dialysis it was 96umol/L
On 9th June he has stopped dialysis for 6 days, his creatinine level is 204umol/L
On 12th June his creatinine level was 185 umol/L he has stopped dialysis for 11 days.
He will be discharged from our hosptial on 19th June and get rid of dialysis.
Not only him but also his family feel very happy.