透析

Acute renal failure occurs when the glomerular filtration rate suddenly drops below 15 mL/min or stops entirely, often caused by trauma, obstruction, or nephrotoxic chemicals. Chronic renal failure develops gradually, with the glomerular filtration rate declining below 60 mL/min over time, typically resulting from diabetes mellitus or hypertension.

Hemodialysis circulates heparin-enriched patient blood through a hemodialyzer containing selectively permeable membranes. Small solutes like urea and excess ions such as potassium diffuse from the blood into a dialysate solution, while larger components like proteins remain in the blood. The cleansed blood is then returned to the body.

In peritoneal dialysis, the peritoneum, the abdominal lining, functions as the dialysis membrane. A catheter introduces dialysate fluid into the peritoneal cavity, allowing waste products to diffuse from the blood into the solution. After a set period, the used dialysate is drained and replaced with fresh solution to continue the filtration process.

Heparin is an anticoagulant added to patient blood during hemodialysis to prevent blood clots from forming in the apparatus and tubing. This ensures uninterrupted blood flow through the hemodialyzer and maintains the effectiveness of the filtration process throughout the procedure.

Peritoneal dialysis can be performed at home, providing greater flexibility and independence for patients. It requires patient training and strict hygiene practices but eliminates the need for frequent visits to a medical facility, making it suitable for patients who prefer home-based treatment options.

Small solutes including urea and excess ions like potassium diffuse through the selectively permeable membrane into the dialysate solution. Larger molecules such as proteins and blood cells are retained in the blood because they cannot pass through the membrane's pores, ensuring these vital components remain in circulation.

The choice between hemodialysis and peritoneal dialysis depends on the patient's overall health status, the stage of renal failure, and lifestyle considerations. Hemodialysis suits patients preferring professional monitoring at a facility, while peritoneal dialysis benefits those seeking home-based flexibility and independence in managing their condition.