Dialysis

"New dialysis techniques are being developed to serve as a support treatment for certain diseases while waiting for the efficacy of the definitive treatment".

DR. NURIA GARCÍA FERNÁNDEZ
PERSON IN CHARGE. DIALYSIS UNIT

The main function of dialysis will be to "clean" the blood of the toxins generated, excess water and electrolytes, such as sodium and potassium, which are produced by a defect in their elimination by the kidney.

In the Clinica Universidad de Navarra we have a Dialysis Unit composed of a team of multidisciplinary professionals specialized in this treatment: nephrologists, nurses, nutritionists, etc.

Upon your arrival for each session, a nurse and a nursing assistant will receive you and be responsible for your care. In addition, the Unit's nephrologist will be at your disposal for anything you need.

In recent years, important advances have been made in dialysis techniques that allow it to be an aid in the treatment of certain diseases such as heart failure, liver failure, multiple myeloma, etc.

During hemodialysis, the patient will be sitting in a reclining chair. During this time, besides being able to sleep, listen to the radio, read or talk, he or she can connect to the internet via wifi or watch television. You will also have breakfast, lunch or an afternoon snack, depending on the time.

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When is dialysis indicated?

The fundamental indication for dialysis is the treatment of chronic renal failure, which should always be integral, that is, with options for changing from one technique to another and the possibility of renal transplant in case there is no contraindication.

The diseases that lead to renal failure are multiple, but the main ones are: glomerulonephritis, pyelonephritis, interstitial nephritis, vascular nephropathies and diabetic nephropathy. Dialysis is also indicated in acute renal failure and in some intoxications.

Do you have any of these diseases?

It may be necessary to start dialysis

How is dialysis performed?

When the semi-permeable membrane is artificial. These can be of cellulosic or synthetic nature and by their structure they can be of capillary fiber or flat membrane. They vary by their permeability, surface, thickness, electrical charge and adsorption capacity. 

What is required and how is hemodialysis performed?

It is required a permanent access way to the intravascular torrent (preferably an internal arteriovenous fistula, possible a cannula, etc.), an artificial kidney (it consists of a blood extraction pump, a monitor and the dialyzer where the semipermeable membrane is located and where the exchange between the liquid or dialysis bath and the blood takes place).

Usually, the dialysis session in chronic patients is carried out three days a week (Monday, Wednesday and Friday; or Tuesday, Thursday and Saturday), with a duration of 4 hours per session, in morning, afternoon or evening shifts. It can take place in the hospital, in an outpatient dialysis unit or even at the patient's own home.

What complications can occur in hemodialysis?

The main complications are insufficient blood flow (the ideal is over 300 cm./min.), dialyzer breakage with blood loss, hypotension, dizziness, headaches, nausea or vomiting, itching, cramps, etc.

Currently, with modern automatic machines and various variants of bicarbonate dialysis, complications are minimal and largely curable.

When the semi-permeable membrane is natural, as in the case of the patient's peritoneum (layer that covers the internal organs of the abdomen and has multiple capillaries and a large surface area).

What is required for peritoneal dialysis?

Peritoneal dialysis requires the placement of a multi-perforated soft catheter in the abdomen, through which dialysis solution (similar to the liquid part of the blood but without waste products) is infused, of about two liters with refills every 4-6 hours during the day and about 8 hours at night, every day of the year.

This method of dialysis is called continuous ambulatory peritoneal dialysis and is performed by the patient himself after a period of hospital training. It can also be done with a machine or cycler that carries out the refills in a programmed way at night, allowing the patient to be free during the whole day and this is called automated peritoneal dialysis.
 
What complications can occur in peritoneal dialysis?

The main ones are the loss of fluid through the catheter access tunnel, infection of the tunnel or catheter, catheter obstruction, peritonitis, abdominal hernias, loss of protein, etc. All of them are solved with treatment.

The patient can and should choose, with the help of the nephrologist who treats him/her, the method of dialysis (peritoneal dialysis or hemodialysis and its multiple variants) that best suits him/her due to his/her characteristics (age, work, family circumstances, distance to the dialysis unit, type of renal disease and other concomitant diseases, possibility or not of access to the intravascular torrent, previous abdominal operations, etc.).

The doctor must inform you about all the differences between the different dialysis modalities and the advantages and disadvantages in general and in the specific case of the patient.

Furthermore, as the treatment of chronic end-stage renal failure is integrated, it is always possible to switch from one type of dialysis to another in case of intolerance or unsolvable problems.

Where do we do it?

IN NAVARRA AND MADRID

The Nephrology Service
of the Clínica Universidad de Navarra

The Nephrology Service of the Clínica Universidad de Navarra has more than five decades of experience, both in the diagnosis and treatment of all kidney pathologies and in the transplant of this organ. 

Our specialists have completed their training in centers of national and international reference.

We have the best facilities in the Dialysis Unit in order to offer the highest quality care to our patients.

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Why at the Clinica?

  • National reference in kidney transplantation, pioneer in living donor kidney transplantation.
  • Specialized nursing for the care and follow-up of our patients.
  • Cardiovascular and renal damage prevention program.

Safer than ever to continue taking care of you

We update safety protocols weekly with the latest scientific evidence and the knowledge of the best international centers with which we collaborate.