Renal Replacement Therapy: Hemodialysis vs Peritoneal Dialysis, Animation
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- Опубликовано: 14 окт 2024
- (USMLE topics) Principles of hemodialysis and peritoneal dialysis, pros and cons.
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Dialysis is a therapy that artificially removes wastes from the blood of patients whose kidneys can no longer perform this function adequately. There are two main types of dialysis: hemodialysis and peritoneal dialysis.
In hemodialysis, blood is filtered outside the body, in a dialysis machine. The patient’s blood is pumped to the machine, cleansed, then returned to the body. To prepare for regular hemodialysis treatments, a one-time minor surgery is performed to create a vascular access, which is essentially a large and strong vein, enough to sustain the high flow rate through the machine. This can be accomplished by fusing an artery to a vein, forming a fistula; or by adding a graft. For emergency treatment, a catheter can be used for temporary access.
Once inside the machine, blood flows within tiny tubes surrounded by a dialysis solution, called dialysate. The walls of the tubes act as semipermeable membranes that allow only small molecules, such as water, nitrogenous wastes and electrolytes, to pass through. The filtration occurs by osmosis and diffusion, where water and solutes move from higher to lower concentration. The dialysis fluid contains solutes at the levels similar to those in healthy blood. Urea, potassium and other solutes that are present at higher levels in patient’s blood, move out to the dialysate, which is constantly replaced and discarded. At the same time, other substances can be added to the dialysis fluid to be administered to the patient. These may include: bicarbonate, to adjust the patient’s blood pH; erythropoietin, to compensate for its low production by the failing kidneys; and certain medications. Because of the increased risks of blood clotting associated with its contact with foreign surfaces, an anticoagulant such as heparin is usually added. The composition of dialysis fluid is typically prescribed by a nephrologist based on the patient’s needs.
Hemodialysis frequency of treatment: 4-hour treatments, 3 times a week, in a dialysis center. Complications: risks of blood infection, thrombosis, internal bleeding due to the added anticoagulant.
In peritoneal dialysis, the dialysis fluid is introduced into the patient’s abdominal cavity via a catheter. The lining of the abdomen, the peritoneum, serves as the natural filtering membrane. The fluid remains in the body for several hours, allowing exchange and equilibrium with the blood running in the underlying vessels, before being discarded. The therapy can also be done automatically at night during sleep.
Peritoneal dialysis is less effective than hemodialysis, but because it can be performed for longer periods of time, the result is comparable. Peritoneal dialysis advantages: more flexibility, is better tolerated by patients, and less expensive; disadvantages: more often complicated with abdominal infections.
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Was helpful to me in my exam
👍
After having two parents on dialysis my father did hemodialysis and my mother is doing peritoneal and I’m more hands on with my mother and I favor peritoneal dialysis all day everyday
May i ask how long your mom has been undergoing PD?
@@postalapostle6847 one year and I’ll tell you I don’t think if she did hemodialysis she would have made it this far and she 79 years old with PD the patient has to take their blood pressure before and after treatment so they know which bags to use but I’m glad my mother was an educator and an administrator so she knows how to keep good records, but I’d advise anyone who can’t keep good records at least ask someone to help them with their record keeping and show them because my dad did hemodialysis and my mom did PD and the doctors have told my mom hemodialysis is harder on the heart and I saw how hemodialysis use to wear my dad down then he’d have less than 24 hours before he’s feeling energized and he’s back to treatment but moms gets does her treatment at night time and then in the morning she’s up fixing her breakfast and some days at 79 she’ll get in her Mercedes suv and run her errands to the hairdresser or market so I’m glad she is doing PD and I’m here almost every day to check up and help her.
Is peritoneal dialysis safe or not
@@ShuhbB97 It needs to be done maintaining proper hygiene and safety in order to avoid chances of any infection. If maintained well it works good for a longer time!
@@roshani5068 thank you🤗
Thank you so much ! Short and good explanation!
Great explanation
thats really beautiful & helpful
Very well explain and with subtitles. Thanks
Great video, now I understand
Helpful Video.... Thank you❤❤❤❤
Great explanation!👍🏻
thanks
Thanks!
Welcome! And Thank You!
Nice explanation
V nicely expained 🥇🙏
شكرا
Well explained
This is a really great video! Helped me alot for my upcoming exam
Glad it helped! best of luck!
Thank you very much
Nice explanation
Pls explain VUCG
thank you so much, a very informative video!
You're very welcome!
thanks a lot for this video
You are most welcome
Thank you!
Welcome!
Thank you
Very useful vid ❤
We know, that veins carry deoxygenated blood .
But in haemodialysis it carry oxygenated blood to all parts of the body.
Plz clear my confusion!!
By the way nice video 👍
This is true but there are some exceptions e.g. the pulmonary veins carry oxygenated blood from the lungs to the left atrium of the heart. In haemodialysis you create a connection between an artery and vein (arteriovenous fistula) and because the blood in the artery is at higher pressure it will flow to the area of lower pressure (i.e. to the vein). So you'll have oxygenated blood from the artery going directly into the vein, meaning the vein will be carrying some oxygenated blood.
@@fallikedominoes Thank you
Vacide hocaya selamlar 🙃😊
Does hemodialysis take away heavy metals from the blood too?
Idk about metals, but I know it takes away electrolytes or something, which means you’ll just need take a dialyavite pill once a day to compensate
Very useful
wow. very understandable. tnx u.
The best ❤
Very nice video
Thanks sir 🙏🙏
Nice
Great 👍🏻 👌
AV fistula.. fistulectomy... Atrioventricular.. SA node... Graft..ing...
which process is best..?
hemodialysis
@@varnam6646 😔
Why the sad face
@@vm2113 my brother passed away...
I'm so sorry that happened. Very unfortunate. RIP. Take care of yourself Abdul.
Was this what I thought I could smell by my bed?,or was that the Huge chalk coloured feed bag I was attached to?
Im scared cause I have a kidney disorder and covid 19 is growing in my state like crazy and my family is making no effort to even care and covid 19 causes kidney failure and i already have my kidneys not working as they are supposed to so like if I get covid 19 I will either die or have my kidneys shut down and im 16 so like this is my entire life gone. I don't want this im scared but its out of my control. Idk if I want to go through with dialysis I may just want to die idk
don't worry everything's gonna be alright. have faith in God ❤️❤️
Everything will be fine dear!😊💫😇
You take precautionary measures. Follow the instructions for Covid 19
Separate your water cup, plates etc with your family of they are not following the rules. Stay safe 💕
Dont worry. This isn't painful. Unless you overthink about it.
Just chill.
May you get 100% perfect.
Just in case if you have to go through this, just make sure to follow diet as instructed and you'll be a chilling kid 😎
Have you got your vaccine yet? 🤞 for you. Stay strong. Don’t let your fear take over your life. Whatever happens you’ll be ok, I know it.
Hi friend! May I ask you if your company needs pharmaceutical packaging materials and tubes(such as disposable peritoneal dialysis drainage bag system,disposable drainage bag etc.).We are a company with 20 years experience in manufacturing medical items from China.😀
Why fistula is needed in hemodialysis?
Artery or vein ka blood mix ho jaa hai or more volume or with pressure ke sath dialyzer machine k pass jata hai jisse jayda effective way m dialysis hoga ,or tejii se hoga
The blood from the artery and vein gets mixed and goes to the dialyzer machine with more volume and pressure, so that dialysis will happen in a more effective way and faster.
Small molecules.. diffusion.. higher lower concentration..
PD is double the cost of HD
👌
prob more infections because its done at home and its the person getting it infected. If it was done by a nurse than it prob be less.
Are the any anti - uremia drugs?
can patients taking warfarin go on dialysis? what is plasmapheresis?
Warfarin increases risks of bleeding, doctors will need to evaluate individual cases to decide if the pros outweigh cons. Plasmapheresis is when the liquid portion of the blood (plasma) is separated from your blood and replaced with a new one.
👏
Catalyst... Equilibrium... Equalizers..n
Kidney and lungs...
Heart buffer system
Hendro prasetyo 202202193 hadir
La série B manifestez vous
a man-made machine I tell you that
“Less expensive”
Do americans have to pay for this?
Anyone here who goes on dialysis automatically receives govt health insurance called Medicare, which pays 80% of the cost. If you are poor, you also can get Medicaid, which will cover the rest of the cost. If not poor, it's best to have private insurance to cover what Medicare doesn't pay for.
x
🎮👜
3:08 is wrong- peritoneal dialysis is not less effective than hemodialysis
PD filters a smaller volume of blood/removes less waste PER MINUTE than HD, so yes, it is less effective - PD has to be performed for a longer time than HD for the same effect!
@@Alilamedicalmedia faster doesn't make it better.... only makes more convenient to the nurse..... your kidney's have to do it 24/7 for your body so by your logic your kidney's are less effective than HD
"Better" compared to the other method in term of time - is it not more convenient for the patient as well? We don't compare apples to oranges, but if you insist: your kidneys are definitely less effective, doing more or less the same job for a longer time (that's the definition of efficiency), but you don't have to sit and wait for them to do their job, you don't have to pay them, don't have to worry about infection, etc.
your pronounciation of the words and speed you speak makes it hard to understand what you are saying and it is difficult to read the text at the same time - you need to re-do this video with a new person who can speak and pronounce the words CLEARLY so that the listner and watcher could understand what you are saying.
😂😂go learn some good English please
she knows English thats why the comment is also in English 😂@@wambuim8767
Thanks