Definition

• Dialysis
  • Process of diffusing blood across a semipermeable membrane to:
    • Remove toxic materials
    • Maintain fluid, electrolyte, and acid–base balance
  • Used in cases of acute renal failure, some acute poisonings, and end-stage renal disease (ESRD)
    • ~450,000 patients in the U.S are currently receiving dialysis for ESRD.
    • Leading causes of ESRD are diabetes (45%) and hypertension (27%).
• Hemodialysis
  • Toxic materials are removed from blood as it is passed through a dialyzer.
  • Most common therapeutic technique for ESRD (>90% of U.S. patients)
  • Intermittent hemodialysis: typically performed for 3–4 hours per session, 3–4 times per week
  • Slow, low-efficiency dialysis (SLED)
    • Hemodialysis performed over 6–12 hours per session, 3–6 times per week
  • Continuous renal replacement therapy (CRRT)
    • Hemodialysis performed on a continuous rather than intermittent basis
      • Continuous arteriovenous modalities
        • Continuous arteriovenous hemofiltration (CAVH)
        • Continuous arteriovenous hemodialysis (CAVHD)
        • Continuous arteriovenous hemodiafiltration (CAVHDF)
      • Continuous venovenous modalities
        • Continuous venovenous hemofiltration (CVVH)
        • Continuous venovenous hemodialysis (CVVHD)
        • Continuous venovenous hemodiafiltration (CVVHDF)
• Peritoneal dialysis
  • Toxic materials are removed without direct access to the bloodstream by exchanging dialysate in the peritoneal cavity.
  • Types
    • Continuous ambulatory peritoneal dialysis (CAPD)
    • Continuous cyclic peritoneal dialysis (CCPD)
    • Nocturnal intermittent peritoneal dialysis (NIPD)

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