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Kidney Failure Treatment
In determining kidney failure treatment, it is necessary to first diagnose and determine the cause of kidney failure. Kidney failure treatment is usually determined by the severity and type of kidney failure.
Kidney (or renal) failure is typically diagnosed and treated by a nephrologist (a doctor who specializes in treating the kidneys). A person who is suspected of having kidney failure will undergo extensive blood tests. These tests will assess the levels of creatinine, blood urea nitrogen, uric acid, phosphate, sodium, and potassium in the blood.
A full assessment of the kidneys is necessary to determine if the underlying kidney disease can be treated and whether the kidney failure is chronic or acute. This is normally determined by the use of magnetic resonance imaging (MRI), computed tomography (CT) scan, ultrasound, X rays, renal biopsy, and arteriogram (the recording of an arterial pulse) of the kidneys. These help to determine the cause of kidney failure and the level of remaining kidney function.
Kidney Failure Treatment
The treatment of kidney failure varies. For instance, the treatment of acute kidney failure is directed to the underlying condition or disease that has caused the kidneys to fail. Pre-renal conditions (conditions which do not cause kidney damage, but affect kidney function) may be treated with replacement fluids given through a vein, blood transfusion, diuretics (substance that increases urine formation and excretion), or other medications.
Post-renal conditions (conditions which causes obstruction of the urinary tract) and intra-renal conditions (causes direct injury to the kidneys) may require surgery and/ or medication. Outside of a kidney transplant, the primarily kidney failure treatment includes: hemodialysis (or haemodialysis), hemofiltration (or haemofiltration), and peritoneal dialysis.
HEMODIALYSIS
Hemodialysis (commonly referred to as dialysis) is a primary type of kidney failure treatment. It is administered in both acute and chronic kidney failure cases. Dialysis involves circulating the blood outside of the body through an extra corporeal circuit (ECC) or dialysis circuit. This circuit is made up of plastic tubing, a filter known as a dialyzer (or artificial kidney), and a dialysis machine.
The machine monitors and maintains blood flow and administers dialysate. Dialysate is a sterile chemical solution that is used to draw waste products out of the blood. Fluid removal takes place after the blood leaves the body and passes through the dialysis circuit (ECC) and the dialyzer (filter).
The duration of one course of dialysis (called a "run") may last for three to four hours, depending on the dialyzer used and the condition of the patient. During a "run", waste products are carried from the bloodstream out of the body. At the same time, electrolytes and other chemicals are added to the blood. The purified and chemically balanced blood is then returned to the body.
HEMOFILTRATION
Another type of kidney failure treatment is hemofiltration. It is also known as continuous renal replacement therapy (CRRT). This procedure is a slow continuous blood filtration therapy. This kidney failure treatment is used mainly to control acute kidney failure, in critically ill patients.
These patients are typically very sick and may have heart problems or circulatory problems. Consequently, they cannot handle the rapid filtration rates of hemodialysis. They frequently need antibiotics, nutrition, and other fluids administered through a vein, to treat their primary condition. Since hemofiltration is a slow continuous process, it is easier to give the required fluids to patients with kidney failure, without the risk of fluid overdose.
Hemofiltration also uses a dialysis circuit (ECC). A hollow fiber filter (hemofilter) is used instead of a dialyzer. This is responsible for removing excess fluids and toxins from the blood. Instead of a dialysis machine, hemofiltration uses a blood pump which causes the blood to circulate through the ECC.
The volume of blood which flows through the ECC is much lower than in hemodialysis. The rates of filtration are slower and gentler on the circulatory system. This kidney failure treatment is generally used until kidney failure is reversed, in patients with acute kidney failure.
PERITONEAL DIALYSIS
This kidney failure treatment is generally administered to patients with chronic kidney failure. It can also be uses by patients with acute kidney failure, once they are stable and not in immediate crisis.
This procedure uses the patient's peritoneum as a blood filter. The peritoneum is the membrane (thin flexible skin-like tissue) that lines the abdominal cavity. A flexible tube-like instrument (called a catheter) is surgically inserted into the patient's abdomen.
During this unique kidney failure treatment, the catheter is used to fill the abdominal cavity with dialysate. Dialysate is a sterile chemical solution that is used to draw waste products out of the blood. Waste products and excess fluids move from the patient’s blood into the dialysate. After a period of time the waste-filled dialysate is drained from the patient's abdomen, and replaced with clean dialysate.
A qualified and competent physician will recommend the treatment most appropriate to the patient's condition. He or she will assess the condition of the patient and the severity of renal (or kidney) failure, before prescribing a course of treatment.
Each kidney failure treatment described above is designed to supplement or substitute the function of the kidneys.
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