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    Dialysis vs CRRT: Understanding the Different Types of Dialysis

    Are you dealing with the early stages of Chronic Kidney Disease (CKD)? CKD expresses itself differently in patients, with some experiencing the onset of the condition over several years. However, patients with CKD are always at risk of entering renal (kidney) failure, requiring dialysis treatment.

    According to guidelines set by the National Kidney Foundation, you'll start dialysis treatment when your kidney function drops below 15%. The patient may also require dialysis when dealing with extenuating symptoms caused by the disease, such as shortness of breath, muscle cramps, fatigue, vomiting, or nausea.

    Your doctor will decide when it's time to start your dialysis treatment. They'll schedule your treatment and advise you on what to expect from the procedure and treatment frequency. They'll also make recommendations on other issues like wearing comfortable dialysis clothing during your treatment.

     

    What are the Different Types of Dialysis?

    Dialysis Equipment

    Dialysis is a treatment developed in the 1940s for use in patients experiencing kidney disease. The kidneys are the body's primary filter for the blood, removing toxins and waste from the body through producing urine.

    If your kidneys fail, dialysis works to perform the function of the kidneys. According to data from the National Kidney Foundation, end-stage renal failure only occurs when the patient has between 10% to 15% of their remaining normal kidney function.

    Dialysis helps to stabilize your mineral and electrolyte levels when your kidneys are failing. It's an essential, life-saving treatment for many people with advanced CKD.

    There are two types of dialysis performed in the hospital on patients with CKD.

     

    #1 Hemodialysis

    This type is the most common form of dialysis. This procedure involves the use of an artificial kidney, otherwise known as a "hemodialyzer," for removing extra fluids and waste from the patients' blood. After filtering, the dialysis machine returns the clean blood to the patient.

     

    #2 Peritoneal Dialysis

    This dialysis involves a surgical procedure to insert peritoneal dialysis (PD) catheter into the patient's abdomen. The catheter functions by filtering the blood through the peritoneum membrane in the abdomen.

    During your treatment, a specialized fluid, "dialysate," absorbs waste as it flows into the peritoneum. The dialysate drains from the abdomen after drawing the waste out of the patient's blood. This process can take hours, and the patient needs to ensure they have comfortable dialysis clothing for their treatment.

    Since patients require this process three to six times daily, they may also need the fluid exchange performed while they sleep in a controlled setting.

    There are several types of Peritoneal Dialysis.

     

    Continuous Ambulatory Peritoneal Dialysis (CAPD)

    This method occurs while the patient is conscious. The patient's abdomen fills and drains several times a day.

     

    Continuous Cycling Peritoneal Dialysis (CCPD)

    The CCPD method requires the use of a machine for cycling fluids in and out of your abdomen. Typically, this procedure happens while the patient is sleeping.

     

    Intermittent Peritoneal Dialysis (IPD)

    This dialysis treatment occurs in hospitals and nursing homes. The process requires using the same machine as CCPD, but the procedure takes a great deal longer.

     

    What Is Continuous Renal Replacement Therapy (CRRT)?

    CRRT is a third type of dialysis used for advanced CKD patients who cannot tolerate dialysis's harsh effect on the body. Unlike the regular dialysis procedure, which can take up to four hours, CRRT is operational 24-hours a day.

    CRRT is increasingly used in ICUs to treat patients with acute kidney failure. The process is far gentler on the body than standard dialysis. As a result, it reduces the strain on the patient's physiology. CRRT requires administration by a specially trained and skilled staff

    The standard hemodialysis dialysis treatment is harsh on the body. This outpatient procedure occurs around three times per week for up to four hours per session. The flow rates used in the treatment are high, allowing the patient to clear their blood as fast as possible.

    CRRT Equipment

    However, the treatment places severe physiological demands on the body, and it's not suitable for round-the-clock use.

    Patients who already have cardiovascular health issues and high blood pressure may not tolerate the effects of standard dialysis procedures.

    CRRT presents a solution to this problem. This slower type of dialysis places less strain on the heart. Instead of the process occurring for a four-hour session, it runs 24-hours per day. To keep the dialysis circuit from clotting, doctors administer anticoagulation drugs to the patient.

    Continuous Renal Replacement Therapy (CRRT) offers the patient a slow and continual extracorporeal blood treatment therapy. The process mimics optimal kidney function in a healthy individual. It regulates water, minerals, and electrolytes, ensuring the patient receives the removal of waste products from the blood.

     

    What are the Features of CRRT?

    CRRT has some significant features that differentiate it from standard hemodialysis. Some of the interesting differences and advantages of CRRT vs. hemodialysis include the following.

     

    Minimal Adverse Health Impact on Patients Hemodynamic Stability

    Doctors notice a significant lowering of circulating blood volume in patients undergoing IHD. This situation occurs due to the fast removal of fluids and the potential for hypotension risk (lowered blood pressure).

    The continuous, slow removal of fluids and waste products using CRRT enhances intravascular water refilling from the patient's tissues. As a result, it mitigates the adverse impact on hemodynamic stability.

     

    Enables the Removal of Solutes from Blood and Tissues

    The continual slow removal of solutes from blood facilitates its transfer from the tissue, enabling the removal of uremic toxins.

    CRRT conducted with high-permeable hemofilters removes solutes with high molecular weights up to 30,000 Daltons. This action also includes humoral mediators in the patient's clinical status.

     

    Doctor with Clipboard

    Should I Worry About Getting Dialysis Treatment?

    Your doctor monitors your condition, and when they feel your kidney function is at dangerously low levels, they'll start you on dialysis. You'll have to rely on the trust you build with your doctor to ensure they're looking out for your best interests.

    Going into the hospital for dialysis treatment can be a scary experience. If it's your first procedure, make sure you wear loose, comfortable dialysis clothing. Staying relaxed and comfortable during your treatment is paramount since you will be lying down or sitting in a chair for at least a few hours.