Hemodialysis and peritoneal dialysis are the most widely used renal replacement therapy. They are suitable for most uremic patients. For patients with well controlled renal complications, uremia can survive for decades with adequate dialysis treatment. So, how do you differentiate between hemodialysis and peritoneal dialysis?
Dialysis therapy mainly utilizes diffusion and convection in physics. Hemodialysis including conventional hemodialysis, hemofiltration and hemodiafiltration three methods, conventional hemodialysis is blood (containing high concentrations of uremic toxins) and dialysate (excluding uremic toxins) and the introduction of dialyzers (the two opposite direction), dialysis from the square root of hollow fiber and hollow fiber bundle. The wall is a semi permeable membrane, there are many small holes on the membrane, the flow of blood in the hollow fiber, fiber in reverse dialysis fluid flow in the membrane concentration under the action of small molecule toxins, high concentration of potassium in the blood plasma membrane through a small hole on the diffusion into the dialysate is eliminated. And then the appropriate negative pressure on the dialysate side, under the action of transmembrane pressure, the water can also be removed through the semipermeable membrane in vitro, dialysate calcium ions, bases and other small molecules through the semipermeable membrane into blood. But the blood of the larger molecular weight of the macromolecular toxins, because the blood concentration is not high, so the membrane pressure difference between the inside and outside, coupled with the dialyzer semipermeable membrane pore size is small, so the conventional dialysis on macromolecular toxin removal Ability is weak. Blood filtration using a larger diameter membrane, the treatment of the outer membrane in the application of strong negative pressure, in the role of strong transmembrane pressure, the blood of a large number of water mixed with a variety of different molecular weight toxins through the filter The wells are removed from the body (each treatment can remove tens of liters of plasma water), while adding a normal electrolyte, base components of the replacement solution. Hemofiltration can efficiently remove the molecular toxins and some macromolecular toxins, but compared with hemodialysis, the ability to remove small molecules toxin is weak. Hemodialysis filtration will be combined with the two methods, combined with the advantages of both, both through the dispersion and efficient removal of small molecule uremic toxins, but also through the convection efficient removal of molecular toxins and some macromolecular toxins. Hemodialysis treatment generally 2 times a week ~ 3 times, each time 4 hours. Whether hemodialysis or hemofiltration treatment need to lead the patient's blood in vitro, the blood flow in the cardiopulmonary bypass to 200 ml to 400 ml per minute, and usually the blood flow within the arm only tens of milliliters, far from To meet the needs of treatment, so maintenance hemodialysis treatment requires patients to receive autologous arteriovenous fistula surgery for several months in advance to meet the needs of long-term hemodialysis. But for some of their own poor vascular conditions in patients with arteriovenous fistula effect is poor. In addition, hypotension shock, severe cardiac insufficiency or coronary heart disease, severe hypertension, severe bleeding tendency, cerebral hemorrhage should not be hemodialysis treatment.
Peritoneal dialysis therapy is the use of peritoneal membrane as a semipermeable membrane, through the special peritoneal peritoneal peritoneal dialysate into the peritoneal dialysis fluid, the blood through the peritoneal capillary wall, diffuse into the peritoneal dialysis solution to be removed, while the peritoneal dialysate Plus glucose or other ingredients to improve the peritoneal dialysis fluid osmotic pressure, excessive water in the blood can penetrate into the peritoneal dialysate, to achieve the purpose of ultrafiltration dehydration. The general daily replacement of 3 to 4 times peritoneal dialysis solution, at night peritoneal dialysis solution can be left over the night. Peritoneal dialysis on the removal of water and toxins relatively stable, no need to rely on the machine, easy to operate, relatively low prices, can be carried out in the primary health care units. Although peritoneal dialysis and hemodialysis indications are similar, but each has its own advantages and disadvantages, should be based on the patient's primary cause, condition and medical, economic conditions for the appropriate choice. The following circumstances should give priority to peritoneal dialysis: ① old age, poor cardiovascular system function; ② the establishment of hemodialysis vascular access difficulties; ③ bleeding tendency can not be severe hemodialysis of the body heparin; ④ urine more, peritoneal dialysis More help to maintain urine output, protect residual kidney function.
The above description is how to distinguish between hemodialysis and peritoneal dialysis methods, hope to help you, if you want to know more about the relevant knowledge, please consult our online doctor.