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Skip to 0 minutes and 11 seconds In addition to office hemodialysis, nowadays we also have home hemodialysis. Which looks like this. And it has shorter treatment period of about two to three hours, but it’s done more often about four to five days per week at home. The more frequent dialysis keep the amount of toxin and water to a minimum. It also reduces side effect which is disequilibrium syndrome. And the patient needs training for using a home hemodialysis unit. Complication of hemodialysis. Infection and clotting are the main problems. Low blood pressure, nausea, muscle cramp and headache near the end of dialysis session, fatigue after treatment. And all this are called disequilibrium syndrome due to the removal of uremic toxin and water. Peritoneal dialysis, on the other hand.

Skip to 1 minute and 29 seconds Uses patients own peritoneal membrane as a filter. It needs replacement of the catheter and therefore the potential for complication of infection. It is a slow process and therefore it has less physiological complications. However, it does have the convenience of dialysis at home or at work. Here look. Let’s look at the process. The catheter is in the peritoneum that dialysate is in the peritoneal cavity. The dialysis in from the bag and then drain out into the waste bag. And therefore the solute are diffused from the capillary into the peritoneal space. And the dialysate is removed or drained from the peritoneal cavity. The two types of peritoneal dialysis. Continuous ambulatory peritoneal dialysis or CAPD. There are three steps for CAPD. Fill.

Skip to 2 minutes and 54 seconds Fill the peritoneal cavity with dialysis. Dwell. Let the fluids sit there or dialysis sit there. And then drain after a few hours. And typically it takes four to six exchanges per day. It can be done at work or in the office. That’s why it’s ambulatory. It requires manual exchange and of course the patient needs training for doing this. And this is the setup. This is the permanent catheter. The transfer set. The disposable cap. And this is a disposable tubing. Dialysate is let in and dialysate is let out to the drain bag. So if you look at this patient were on peritoneal dialysis. He can read books and still carry on his normal office duty or activity.

Skip to 4 minutes and 9 seconds The other setup for peritoneal dialysis is called continues cycling peritoneal dialysis or CCPD. It sets up automatically for filling and draining the dialysate. It carries out 10 to 12 hours per day and it can be done at night during sleep. And of course patient needs training for this. And if you look at this depiction, the patient is asleep while the CCPD is going on.

Hemodialysis & Peritoneal Dialysis

In this step, Prof. Lee clarifies the hemodialysis and peritoneal dialysis.

First, for patients who need hemodialysis at home, they need training.

Prof. Lee will then explain several complications of hemodialysis, including infection, nausea, headaches, and fatigue after treatment. He also mentions peritoneal dialysis is more convenient since the patient can take it at work or at home.

The final part of the video, He will talk about Continuous Ambulatory Peritoneal Dialysis (CAPD). It is a sort of peritoneal dialysis, including three steps: fill, dwell, and drain. Continuous cycling peritoneal dialysis (CCPD), is another kind of peritoneal dialysis, which is usually done at night during sleep.

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Pharmacokinetics: Drug Dosing in Renal Disease

Taipei Medical University