00:01
Let's look at these
a little bit more closely.
00:03
Again, I'm going to say
that we've got hemodialysis
that's blood dialysis.
00:07
So that means that we are hooking
our patient up to a machine.
00:11
We are actually taking their blood,
and we are running it through
an extracorporeal circuit
through a dialyzer,
cleaning that blood
and essentially returning that
cleaned blood back to the patient.
00:23
We've got peritoneal dialysis.
00:26
So this is actually really cool
where we use the peritoneum
as a dialyzer.
00:31
So we can take advantage of that
and do dialysis through
having fluid instilled
into that peritoneal cavity
and then removing that fluid.
00:40
And then finally,
that golden opportunity
transplant,
which is what most of us strive
to have each patient
have available to them.
00:47
So under hemodialysis,
there's a couple
of different variants
that we have available
to our patients.
00:52
They can do what we call
in-center dialysis.
00:54
Meaning that a patient is
coming from home to a center
where there are
nurses and technicians
that can do the dialysis
for the patient.
01:02
And this comes in a few
different varieties.
01:05
You can do thrice weekly dialysis,
where they're going to a center
and they're spending maybe
four hours at a time
three times a week
at that center,
or my very favorite,
which is nocturnal dialysis
in-center.
01:18
So that means patients come to
dialysis at 9 o'clock at night.
01:22
They sleep through their dialysis,
they wake up at five o'clock
in the morning
and they're on
for the rest of their day
to go to work, or go to school,
or do whatever they want.
01:30
It's a longer dialysis
period of time,
but the dialysis is slower,
and oftentimes
patients will feel better.
01:37
There's also
home dialysis or home hemodialysis
that our patients can do.
01:42
This includes short daily dialysis,
that means that patients
are actually dialyzing
six times per week
about two to three hours
at a time.
01:50
They get to do this within the
comfort of their homes.
01:52
They could be reading a book,
they could be reading the paper,
they can be studying.
01:56
They can do
nocturnal home dialysis,
so they're sleeping
in their own bed
and doing dialysis overnight
anywhere from six to eight hours.
02:03
And they can do
conventional dialysis
where they have more of a
conventional machine
and they're doing
four hour dialysis, thrice weekly.
02:10
We also have peritoneal dialysis
that we talked about.
02:13
And again, this is really kind of a
neat phenomena,
If you think about our own body,
our peritoneal cavity,
actually can be used as
the dialyzer.
02:21
So we instill fluid
into the abdomen,
and then we take that fluid out.
02:25
And people can do this
in an ambulatory setting,
meaning that they're manually
putting that fluid in.
02:30
So they might put some fluid
into their belly,
leave that in for four hours,
they drain that manually,
and they put more fluid in
and they do that
throughout the day.
02:38
That's referred to as
continuous ambulatory
peritoneal dialysis.
02:43
And they can also have an
automated peritoneal dialysis.
02:46
That means that patients might work
during the day
they come home at night,
they hook up to a machine
and the machine actually
is what instills the fluid
in the peritoneal cavity.
02:57
And then releases the fluid,
instills and releases
and do their dialysis
overnight.
03:02
They wake up the next morning,
ready to go.
03:04
And then finally,
we have transplant.
03:07
Transplant again,
is that golden opportunity
that I think most nephrologists
will strive to have their patients
have available to them.
03:15
We'll talk a little bit more
about that
in the next coming slides.