Recent Evidence-based Understanding About Dialysis Techniques

What is dialysis?

Dialysis is a treatment provided to filter and purify the blood using a machine. This helps to keep your body in balance when the kidneys are not able do their job as they should do. Our kidneys are a pair of organs, each about the size of a fist, that are located on either side of the body. They’re responsible for purifying the blood by removing waste from the body. You can read about kidney here – Kidney Anatomy.

Recent advancements in the dialysis technologies and procedures

The article discusses recent research and improvements in the dialysis techniques. These are described herein below.

Dialysis Adequacy

According to research published in the Journal of the Canadian Association of Nephrology Nurses and Technicians, improvement in the adequacy of dialysis has been linked to a decrease in mortality among hemodialysis patients. Adequacy of dialysis is measured by urea kinetic modelling (UKM) and is considered an extremely important clinical outcome for all dialysis programs.
However, the relationship between adequacy and quality of life of patients undergoing dialysis is not very less clear in these studies. It can be demonstrated that patients with higher Kt/Vs live longer, but do they live better? It is not yet known.
The research shows that both adequacy and quality of life improved from one to three months of dialysis. However, too many variables were involved to give a conclusive explanation to assume that a relationship exist between them. An analysis with a larger sample may establish for the relationships better or reject it completely.

Choice of dialysis technique

In a study published in Nephrology Dialysis Transplantation, Volume 30, members of the ERBP Diabetes Guideline Development Group have performed a comprehensive review on research papers comparing haemodialysis and peritoneal dialysis in patients with diabetes. A crude but quick way to summarize the research is that no strong scientific data is found to support the use of either PD or HD in diabetics.
If a patient has to be moved from peritoneal dialysis to haemodialysis due to a lack of efficiency of peritoneal dialysis, he will be examined in the peritoneal dialysis group, despite the failure of peritoneal dialysis. If the patient dies just after the switch to haemodialysis, in the analysis, his death will be attributed to the haemodialysis group, although the initial failure was linked to the peritoneal dialysis technique.
When patients were not satisfied with their harmodialysis treatment, their mortality risk was higher. The probability of them withdrawing from dialysis is also higher. Patients’ involvement in dialysis choices, patients’ satisfaction, and quality of life need to be evaluated in future studies.

Opioids are common for people on dialysis

Pain is common in dialysis patients. But dialysis patients can’t take certain drugs because their kidneys can’t process them. This makes pain controlling difficult.
A group of researchers reviewed Medicare data. They found that about two-thirds of dialysis patients received at least one opioid prescription every year. More than 20 percent received repeated prescriptions. More than 25% of these patients were given opioid prescriptions higher-than-their recommended doses.
The use of opioids during dialysis was associated with increased risks of early death and withdrawing from dialysis. Learn about how ‘how does dialysis work’ and ‘side effects of dialysis’.
Mohd Salman, is a medical doctor and is associated with DiseaseFix as a researcher. DiseaseFix develops health information modules for patients and provides a unique platform to allow access of reliable information of a variety of types for diseases.

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