How does dialysis access work and what are the different methods used for dialysis access? [Dr. Spinowitz]

Q: How does dialysis access work and what are the different methods used for dialysis access?

A: The job of the kidney is to filter the blood, removing wastes, toxins, extra fluid, and maintaining the balance of electrolytes. When the kidney is not functioning normally, fluids can build up, toxins can build up, and electrolytes can be abnormal, which can be deadly. When the kidney, for whatever reason is not functioning normally, the body needs to remove those wastes, get rid of those fluids, and maintain electrolyte balance another way. Therefore, we need dialysis. There are different modalities for dialysis, including hemodialysis and peritoneal dialysis.

Hemodialysis can be performed through a fistula, a graft, or a catheter. The blood is removed from the body and brought through a machine. That machine acts like the kidney, removing the extra fluids and waste, maintaining electrolyte balance, and returning clean blood to the body.

Peritoneal dialysis is similar in that the body is able to be cleaned of those extra toxins, get rid of the extra fluid, and maintain electrolyte balance. However, with peritoneal dialysis, the blood is not removed from the body, cleaning the blood in the machine; rather the body is used as the machine. The peritoneal dialysis catheter is inserted into the abdomen, and the blood from the intestines–running through its normal path–is cleaned as dialysate, a fluid, and introduced into the abdomen through the peritoneal dialysis catheter.

More videos from the interview with Dr. Spinowitz of the Queens Endovascular Center as he explains the Dialysis Access Management process:

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