Dialysis Center: Prevention and Treatment

Dialysis Center:

Renal failure is the dreaded ultimate complication of many kidney afflictions. It is considered to occur when the kidneys fail to adequately perform their functions, namely, the excretion of excess water and metabolic waste products. Other kidney functions, as regulation of bone mineralization and synthesis of red blood cells, are usually impaired as well. The degree of kidney failure is assessed by a laboratory study called creatinine clearance. The terminal phase of renal failure is called end- stage renal disease, and it mandates treatment with either renal dialysis or kidney transplantation.

End- stage renal disease may develop acutely (rapidly), within days to weeks, and in such cases it is usually reversible by correction of the offending cause, such as prolonged hypotension, dehydration, or urinary tract obstruction. Alternatively, it may develop as a chronic (gradual and slowly progressive) process. Hypertension and diabetes mellitus, particularly when uncontrolled, are among the most commonly incriminated causative disorders. They may lead to kidney scarring and irreversible damage.

Chronic kidney disease has got the formidable character of relentless progression to end- stage renal disease once started. However, recent scientific research has established specific guidelines for prevention of kidney disease progression and preservation of renal function. Some sensitive laboratory tests have been developed to detect renal disease at its early beginning, when it is most amenable to therapeutic intervention. Your doctor will tell you whether you are at risk for kidney disease, how to check for renal function and how to protect your kidneys.

The treatment of established renal failure comprises a list of dietary adjustments and medications. The cornerstone is adjustment of protein content of the diet to match the degree of renal function impairment. Equally important is the adjustment of water balance to avoid dehydration or fluid overload. Some antihypertensive drugs may be specifically selected for their known renoprotective effect. Some drugs may require dosage modification to prevent harmful accumulation in patients with renal impairment.

Consult your doctor once you notice any complaint possibly denoting a urinary tract disorder such as haematuria (blood in urine), dysuria (difficult or painful micturition) or flank pain. Avoid intake of non- prescription medications and maintain good control of your blood pressure and blood sugar.

The Haemodialysis Unit:

Haemodialysis is simply the process of clearance of the patient`s blood from excess water and metabolic waste products by exposing it to a standard solution (dialyzate) through a semipermeable membrane (dialyzer, filter, or artificial kidney). The dialyzer is preferably made from a biocompatible material, a substance that does not initiate potentially harmful biologic reactions on contact with blood. The control of blood and dialyzate flow haemodynamics and the rates of water and solute transport across the dialyzer membrane are controlled by a specially organized haemodialysis machine.

The haemodialysis unit in NJCH is destined for management of cases of acute and chronic renal failure at the highest professional standards. It contains 10 technically advanced haemodialysis machines surrounding a centrally placed doctor/nursing station. The water used for dialysis is made safe for medical use by a set of treatment steps done in a specially designed water treatment plant, which is

operated by a team of dedicated engineers and technicians whose regularly check the water at several ports to ensure its purity keeps to a set of strict physical, chemical and biological standards.

The haemodialysis session usually lasts for 4 hours and is repeated twice or thrice weekly. Sticking to strict aseptic precautions and infection control guidelines is pivotal in all processes that entail potential blood contact as needle placement or removal and getting rid of hazardous waste as dialyzers and blood lines. The machines are disinfected routinely between treatment sessions and the water plant is disinfected at a regular schedule.

Patients are checked at regular intervals for renal functions, serum electrolytes, blood picture, lipid profile, viral serology and other laboratory or radiologic tests as their condition dictates.

Patient care at the haemodialysis unit of NJCH is provided by a closely integrated multi- disciplinary team that comprises the consultant nephrologist, the registered dialysis nurses, the dietician, the psychiatrist and the social worker. The aim is enable patients and their families understand basic facts related to renal failure and dialysis therapy and participate an active role in the management program.