dialysis

Blood enters the kidney through the renal artery. The blood is filtered through the glomeruli to extract the nitrogenous waste products and excess water that make up urine. The urine flows through the ureter to the bladder; the cleaned blood then leaves the kidney via the renal vein.

Technique for removing waste products from the blood suffering chronic or acute kidney failure. There are two main methods, haemodialysis and peritoneal dialysis.

In haemodialysis, the patient's blood is passed through a pump, where it is separated from sterile dialysis fluid by a semipermeable membrane. This allows any toxic substances which have built up in the bloodstream, and which would normally be filtered out by the kidneys, to diffuse out of the blood into the dialysis fluid. Haemodialysis is very expensive and usually requires the patient to attend a specialized unit.

Peritoneal dialysis uses one of the body's natural semipermeable membranes for the same purpose. About two litres of dialysis fluid is slowly instilled into the peritoneal cavity of the abdomen, and drained out again, over about two hours. During that time toxins from the blood diffuse into the peritoneal cavity across the peritoneal membrane. The advantage of peritoneal dialysis is that the patient can remain active while the dialysis is proceeding. This is known as continuous ambulatory peritoneal dialysis (CAPD).

In the long term, dialysis is expensive and debilitating, and transplants are now the treatment of choice for patients in chronic kidney failure.