HEMODIALYSIS

Hemodialysis is a process that blood is purified at the out of the body by a machine. It is performed in the hospital's hemodialysis units, two or three times a week according to the patient's status. Each hemodialysis procedure duration is 4-5 hours. In order to perform the hemodialysis procedure, a high flux vascular access is needed. So, it is necessary to make a connection between arterial and venous sistem. (Arteriovenous fistula)

Advantages of Hemodialysis :
• Toxic materials can be removed from the body quickly.
• It is performed by specialists.
• It allow the patient deal with other patients.
• It is performed 2-3 times a week.

Disadvantages of Hemodialysis :
• Although the patients can think the hemodialysis sessions are tiresome they feel better after hemodialysis.
• Patients are connected to the machina by a needle.
• Restriction of liquid and a certain diet is necessary.
• A surgical procedure is needed.
• Blood pressure changes can occur during hemodialysis.

PERITONEAL DIALYSIS

Peritoneal dialysis is a procedure that toxic materials can be removed from the body by a special solution given to the peritoneal membrane.

Procedure: A fine plastic tube inserted to the abdominal cavity by a surgical procedure. According to the patient's status, 1.5-2 liters of special solution is given to the abdominal cavity. Solution exchange is performed every 4-6 hours in the abdominal cavity. During this period clearence of toxic materials and ultrafiltration of excess liquid are of performed. This type of peritoneal dialysis procedure is called "continuous ambulatuary peritoneal dialysis" (CAPD) There are also some other peritoneal dialysis types that are performed by the help of a machine.

Advantages of peritoneal Dialysis:
• A better blood pressure control can be achieved than hemodialysis.
• A better liquid control can be achieved than hemodialysis. More ultrafiltration can be done by each dwell.
• There is less diet restriction.
• Kalp ve damar sistemine daha az yüklenme olduğundan yaşlı ve kalp problemi olan hastalarda daha tercih edilmektedir.
• Precedure is performed by the patient. Patient has less contact with the hospital. This is especially important in patients with physical disabilities and noncompliant to hemodialysis due to psychological problems.
• Procedure is simple.

Disadvantages of CAPD:
• Risk of infection
  • Infections related to the catheter.
  • Peritonitis (Infection of abdominal membrane)
• Procedure must be performed daily.
• Patient needs a clean place for each dwell every 4-6 hours.
• Small surgical procedure must be performed in the beginning.

Automated Peritoneal Dialysis: Peritoneal dialysis performed during night in a hospital or at home by a machine. Machine is programmed by a nephrologist according to the dialysis need of the patient. Patient connects the peritoneal catheter to the machine during the night and machine makes the dwells automatically according to the program given. The advantages and disadvantages are nearly the same as CAPD. It needs electricity.