Although chronic kidney disease in its end-stage is serious, there are effective treatments for it. Kidney transplant is one of the best options. This treatment allows the patient to almost fully recover. In case there are contraindications for transplantation or when the patient does not consent to such treatment, dialysis is used. Our qualified, empathetic and caring team will help you understand your disease and choose the right treatment. If dialysis is chosen, here are the options at DaVita.

Hemodialysis

It is a procedure of cleansing the blood of toxins and unnecessary metabolic elements, and removing excess water accumulated in the body as a result of abnormal kidney function.

During hemodialysis, the patient's blood is repeatedly passed through the dialyzer (which is a key element of the device, the so-called artificial kidney), filtered inside it and pumped back into the circulatory system. The human body has an average of 4 to 5 litres of blood. About 300-400 ml is outside the patient's body during hemodialysis.

In order for the blood to be purified in the dialyzer and to return to the body in this form, the patient must first have an appropriate vascular access. It can be an arteriovenous fistula, a fistula with a vascular prosthesis or a vascular catheter placed in one of the central veins. The best access is an arteriovenous fistula from own vessels, because it is the safest and most durable.

Before each hemodialysis treatment, the nurse checks the basic vital parameters (blood pressure and heart rate) and weighs the patient to assess the change in water accumulation since the last treatment. Then the patient is connected to an artificial kidney apparatus programmed appropriately for him. The procedure usually takes about 4 hours. It is usually performed 3 times a week.

Hemodiafiltration

This is the type of hemodialysis that is recommended for patients with cardiovascular disease. Its use is especially important in patients with concomitant heart insufficiency. Research has shown that this form of therapy has greater potential than regular hemodialysis to remove some uremic toxins.

Peritoneal dialysis

Peritoneal dialysis is a process of removal of uremic toxins through the peritoneal membrane that lines the abdominal (peritoneal) cavity and the organs inside it. A special fluid called dialysate is introduced into the abdominal cavity (through a small catheter previously implanted by a surgeon).

The chemical composition of the fluid is such that allows the substances that should be removed from the blood (e.g. urea, potassium, phosphates) penetrate into it and at the same time the substances needed to compensate for metabolic acidosis are absorbed from the fluid into the blood. The dialysate also contains substances that help dehydrate the patient properly.

The patient injects and discharges the fluid on their own 3-5 times a day or uses a special device, the so-called cycler. The cycler is programmed to change the dialysis fluid 4-8 times a night while sleeping, which takes 8 to 10 hours. In the morning, the patient disconnects the apparatus, closes the catheter with a stopper and functions without additional obligations.

Peritoneal dialysis is performed daily—manually during the day or at night with a cycler.

The doctor together with the patient decide which method of treatment is most appropriate, after discussing all the pros and cons of each method for a particular patient.