Explain the indications for dialysis as well as the differences in the forms of dialysis (intermittent hemodialysis, CRRT, peritoneal dialysis).

Explain the indications for dialysis as well as the differences in the forms of dialysis (intermittent hemodialysis, CRRT, peritoneal dialysis).

Explain the indications for dialysis as well as the differences in the forms of dialysis (intermittent hemodialysis, CRRT, peritoneal dialysis).

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Indications for Dialysis
Dialysis is a type of renal replacement therapy. It maintains normal homeostasis among people that experience rapid decline in the kidney function. The indications for dialysis are varied. They include acute kidney injury, pericarditis, uremic encephalopathy, refractory acidosis, and life-threatening hyperkalemia. The additional indications are hypervolemia that causes end-organ complications, failure to thrive, malnutrition, peripheral neuropathy, intractable gastrointestinal symptoms, toxic ingestion, and asymptomatic patients with glomerular filtration rate of 5-9 ml/min1.73 m (squared). These conditions cause considerable impairment in cytokines clearance, cardiac depression, vasodilation, and immunosuppression, which cause hemodynamic instability, end-organ failure, and delayed renal recovery (Murdeshwar & Anjum, 2023). Some of the contraindications for dialysis include coagulopathy, difficult vascular access, and cardiac failure.
Dialysis exists in different forms. They include intermittent hemodialysis, peritoneal dialysis, and continuous renal replacement therapy (CRRT). Intermittent hemodialysis is a dialysis approach that is done for a period of 3 to 5 times a week. It works by promoting homeostasis by removing solutes through diffusion and ultrafiltration. Intermittent hemodialysis has the benefit of rapid correction of fluid and electrolyte imbalances and elimination of drugs and other substances. Peritoneal dialysis is the other alternative that uses the peritoneum to remove solutes. There is the infusion of a highly concentrated dialysate solution to the peritoneal cavity that absorbs solutes through diffusion. Peritoneal dialysis has limitations such as catheter malfunction and leakage. The last dialysis method is continuous renal replacement therapy (CCRT). It is performed continuously over 24 hours daily to provide stable solute removal. CCRT reduces the risk of hemodynamic instabilities associated with intermittent hemodialysis that develops following the rapid solute removal. Solute removal in CRRT occurs through diffusion (Mollahosseini et al., 2020). There is also the reduced risk of volume overload with this dialysis approach.
References
Mollahosseini, A., Abdelrasoul, A., & Shoker, A. (2020). A critical review of recent advances in hemodialysis membranes hemocompatibility and guidelines for future development. Materials Chemistry and Physics, 248, 122911. https://doi.org/10.1016/j.matchemphys.2020.122911
Murdeshwar, H. N., & Anjum, F. (2023). Hemodialysis. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK563296/

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