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Diabetic nephropathy hemodialysis or peritoneal dialysis

2017-01-24 15:15
Diabetic nephropathy hemodialysis or peritoneal dialysis
Kidney disease is a common complication of diabetes, and is also one of the main causes of death in patients with diabetes mellitus. In recent years, the incidence of diabetic nephropathy in China has increased significantly. According to statistics, China's hemodialysis patients with diabetic nephropathy has accounted for second, second only to glomerulonephritis. For patients with end-stage renal disease, a general practitioner may recommend kidney replacement therapy, including hemodialysis and peritoneal dialysis. Here is a brief introduction and comparison of these two renal replacement therapies.
Suffering from uremia patients, the renal function deterioration or loss, to human body metabolic waste and water body, must rely on artificial methods to dialysis, toxins, water body, to relieve the symptoms of uremia. This is hemodialysis.
The long-term hemodialysis patients should accept the "pre arteriovenous fistula" (the use of surgery will arm the arteries and veins are joined together). Patients need to play two needle, a needle is the blood draining out through the "artificial kidney device", the other is a needle will dialysed blood flow to the body, so that continuous cycle takes about 4 to 5 hours, the completion of a hemodialysis.
Hemodialysis is the protagonist of "artificial kidney device", it is the use of artificial membrane made of envelope or tiny hollow fiber, usually made of tiny hollow fiber 6000 to more than 15000. After the blood draining out through these tiny hollow tube inner layer, from the top down flow, and dialysis (dialysis treatment potion + water) flowing through the outer hollow tube, from the bottom to the top through the blood and dialysate flow in the opposite direction, using the "diffusion principle" can remove toxin, and the use of venous pressure and the negative pressure, the excess water in the body can be removed.
peritoneal dialysis
Peritoneal dialysis is a use of the natural human peritoneal blood purification method of semi permeable membrane, for in vivo. Using a simple surgery called peritoneal dialysis catheter "hose through the abdominal wall into the abdominal cavity, the catheter is provided the peritoneal dialysate import pathway, general adult peritoneal dialysate can accommodate about 4 liters. Stranded in the dialysis fluid in the waste in the blood will enter the peritoneal dialysate through the tiny blood vessels in the interval of the containing waste dialysate in peritoneal drainage by law is out, and then into another bag of fresh dialysate, so the cycle, every day according to the prescribed dialysis fluid replacement new that should be excluded The new supersedes the old. wastes.
Choice of dialysis mode
For diabetic patients, the two choice of dialysis modality and other similar patients with renal failure, but in view of metabolic disorders, diabetes patients should be according to their own condition and physical condition, choose under the guidance of a doctor. Hemodialysis and peritoneal dialysis have their pros and cons:
Compared with peritoneal dialysis, hemodialysis is closer to physiological state and can be carried out under the guidance of medical staff. However, patients with diabetes often complicated with coronary heart disease, hemodialysis will increase the burden on the patient's heart. In addition, long-term hemodialysis patients need to do arteriovenous fistula, and diabetes patients with atherosclerosis, arteriovenous fistula is not easy to succeed.
Peritoneal dialysis at home, which is convenient and can avoid the pain of puncture, but peritoneal dialysis will lose part of the protein, protein and plasma of patients with diabetes mellitus complicated with nephrotic syndrome is low, easy to aggravate malnutrition in peritoneal dialysis. In addition, the resistance of diabetic patients is low, and the probability of peritoneal infection during peritoneal dialysis is higher.
Because diabetes patients often complicated with cardiovascular disease, so many doctors advocate for patients with advanced diabetic nephropathy should be selected peritoneal dialysis. However, due to peritoneal dialysis fluid usually contains glucose, if in the process of dialysis is absorbed into the blood, can make blood sugar rise. The patients in peritoneal dialysis at the same time, insulin dosage should be adjusted under the guidance of a doctor (the subcutaneous or intraperitoneal administration), the blood glucose.
Another point to note, because it is easy to diabetic patients complicated with severe heart and brain blood vessels and nerve lesions, will affect the quality of life in patients with late dialysis and survival rate. Therefore, the onset of dialysis in patients with end-stage renal failure caused by diabetic nephropathy is earlier than that of other nephropathy. It is generally believed that when serum creatinine >530 micrograms / liter, creatinine clearance rate of <15 to 20 ml / min should begin dialysis.
The above for diabetic nephropathy hemodialysis or peritoneal dialysis do scientific analysis and give suggestions for the treatment of diabetic nephropathy, must find a professional hospital.

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