Nephrology and Urology



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Overview

 


When your kidneys are healthy, they clean your blood. They also make hormones that keep your bones strong and your blood healthy. When your kidneys fail, you need treatment to replace the work your kidneys used to do. Unless you have a kidney transplant, you will need a treatment called dialysis.

There are two main types of dialysis: hemodialysis and peritoneal dialysis. Both types filter your blood to rid your body of harmful wastes, extra salt and water. Hemodialysis does that with a machine. Peritoneal dialysis uses the lining of your abdomen, called the peritoneal membrane, to filter your blood. Each type has both risks and benefits. They also require that you follow a special diet. Your doctor can help you decide the best type of dialysis for you.


When Kidneys Don't Work Right ?

In addition to removing wastes from your bloodstream, the kidneys also make and regulate hormones and other chemicals in your body. When the kidneys aren't working correctly, your body can develop several problems, including:

  • Joint problems
  • Body aches and pains
  • Fatigue
  • Bone problems
  • Itchy skin
  • Sleep problems
  • Anemia a problem in which the number of red blood cells or hemoglobin in the blood is too low


What Is Dialysis ?

When someone's kidneys can no longer do their job and can't get better, a person has chronic kidney disease. A doctor might say the kidneys are failing. This means they are not working well and the person may need help. The person may be losing weight or feeling tired and sick.

A medical treatment called dialysis can take over the job of filtering your blood. Through dialysis, a person is hooked up to an artificial filtering system that removes waste from the blood. Not that many people younger than 19 receive dialysis — about 2,300 young people in the United States do.


Other Options


In some cases, a kid can get a new kidney. This is called a transplant, which means receiving an organ from another person's body. This operation can be a big help to kids with kidney disease because after the surgery they may no longer need dialysis treatments.

But kids who need dialysis can benefit from improving technology. Improvements to dialysis machines mean that the machines are smaller and that receiving dialysis is getting easier. This makes it easier for kids with kidney failure to do everyday things and enjoy activities, just like other kids. One doctor puts it this way to kids who need dialysis: Dialysis is part of your life, but it isn't your life or who you are.


What types of Dialysis are there ?

There are two main types of dialysis: "hemodialysis" and "peritoneal dialysis." Hemodialysis uses a special type of filter to remove excess waste products and water from the body. Peritoneal dialysis uses a fluid that is placed into the patient's stomach cavity through a special plastic tube to remove excess waste products and fluid from the body.

During hemodialysis, blood passes from the patient's body through a filter in the dialysis machine, called a "dialysis membrane." For this procedure, the patient has a specialized plastic tube placed between an artery and a vein in the arm or leg (called a "gortex graft"). Sometimes, a direct connection is made between an artery and a vein in the arm. This procedure is called a "Cimino fistula." Needles are then placed in the graft or fistula, and blood passes to the dialysis machine, through the filter, and back to the patient. In the dialysis machine, a solution on the other side of the filter receives the waste products from the patient.

Peritoneal dialysis uses the patients own body tissues inside of the belly (abdominal cavity) to act as the filter. The intestines lie in the abdominal cavity, the space between the abdominal wall and the spine. A plastic tube called a "dialysis catheter" is placed through the abdominal wall into the abdominal cavity. A special fluid is then flushed into the abdominal cavity and washes around the intestines. The intestinal walls act as a filter between this fluid and the blood stream. By using different types of solutions, waste products and excess water can be removed from the body through this process.















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