What is dialysis?
Dialysis is a procedure that is done routinely on people who have acute or chronic
kidney (renal) failure. It filters waste and extra fluid from the blood, something
that would normally be done by the kidneys. Dialysis may also be used to prevent kidney
failure if someone has been exposed to or swallowed toxic substances. There are 2
types of dialysis that may be done on your child: peritoneal or hemodialysis.
Peritoneal dialysis can be done at home. But you must be trained first. This method
uses the lining of the belly (abdominal) cavity to filter the blood. This cavity is
the space that holds organs such as the stomach, intestines, and liver. The lining
is called the peritoneum. First, a surgeon places a thin, flexible tube (catheter)
into your child’s belly. After the tube is placed, a sterile cleansing fluid (dialysate)
is put through the catheter into the peritoneal cavity. The fluid is left in the belly
for a certain period of time. This fluid absorbs the waste products and toxins through
the peritoneum. The fluid is then drained from the belly, measured, and discarded.
This process of filling and draining fluid is called an exchange.
There are 2 different types of peritoneal dialysis:
Continuous ambulatory peritoneal dialysis (CAPD). CAPD does not require a machine. The exchanges can be done 3 to 5 times a day, during
Continuous cyclic peritoneal dialysis (CCPD). CCPD requires the use of a special dialysis machine that can be used in the home.
This type of dialysis is done automatically, even while your child is asleep.
Hemodialysis is done in a dialysis center or hospital by trained healthcare professionals.
A special type of access, called an arteriovenous (AV) fistula, is placed surgically.
It is usually done in your child's arm. This involves joining an artery and a vein
together. An external, central, IV (intravenous) catheter may also be inserted. But
this is less common for long-term dialysis. Your child will then be connected to a
large hemodialysis machine. Blood is pumped through a tube into the machine to filter
out the wastes and extra fluid. The filtered blood then flows through another tube
back into your child's body. Hemodialysis is usually done several times a week. Each
session lasts for 4 to 5 hours. It may be helpful to bring games or reading materials
for your child to keep him or her busy during this procedure.