By Roger Gabriel (auth.)
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Additional resources for A Patient’s Guide to Dialysis and Transplantation
Even for patients who have had warning this period may prove to be a worrying and stressful time. 51 PREPARATION FOR DIALYSIS Technical Procedures needed before Haemodialysis can be Started In order to perform haemodialysis a way must be made to connect the dialysis machine to the patient' s bloodstream so that blood can flow to the machine and back to the patient. This is called obtaining 'vascular access'. The word vascular is a word meaning to do with blood vessels. If time allows, a fistula is made when the patient' s kidney function has fallen to about one tenth of normal.
Peritoneal dia lysis depends upon water and 45 PRINCIPLES OF DIALYSIS waste products crossing a naturally occurring semipermeable membrane - the peritoneum. Here are so me definitions to help make this section clear: Abdominal Cavity This is in the belly. It contains the liver, stornach and intestines. The kidneys and large blood vessels lie behind this cavity and in front of the spine. Peritoneum The whole of the body cavity is lined by the peritoneum. This is a thin and stretchable membrane which moves with the stornach and intestines.
When the vein has enlarged it is then possible to put wide bore needles through the skin into the fistula to carry blood to and from the dialyser each time the dialysis is needed. In a right-handed person the fistula is made in the left forearm and vice versa. This allows the patient to use his 'better' hand to insert needles for hirnself. Fistulae are used all over the world for vascular access for dialysis. 5 A Cimino fistula. 6 A shunt inserted into a leg. The shunt is on the outside of the leg and of the type developed by Quinton and Scribner The shunt For the person who requires urgent dialysis there is not time to develop a fistula.
A Patient’s Guide to Dialysis and Transplantation by Roger Gabriel (auth.)