Dijaliza

Krajnji stadij HBB zahtijeva nadomjestak funkcije zdravih bubrega tako da pacijent počinje liječenje dijalizom (hemodijaliza ili peritonealna dijaliza).

 

Hemodijaliza je proces kojim cirkulirajuća krv iz organizma prolazi kroz specijalne filtere aparata za dijalizu i izbacuje otpadne tvari iz krvi.

Aparat za dijalizu ima tri važne funkcije: da odstranjuje otpadne tvari iz krvi, da pumpa krv i prati njeno cirkulisanje i da kontroliše krvni pritisak i količinu tečnosti odstranjene iz organizma. Da bi hemodijaliza bila moguća potrebni su specijalni pristupi do krvnih sudova, koji mogu biti privremeni i trajni. Hemodijaliza se vrši u specijaliziranim ustanovama – dijaliznim centrima. Pacijenti najčešće imaju tri tretmana sedmično, a sam process hemodijalize traje 3-4 sata.

Kod peritonealne dijalize pacijentova krv se ne prečišćava van organizma – putem dijaliznog aparata, već unutar samog organizma. Membrana abdomena, tzv. peritoneum u organizmu ima ulogu prirodnog filtera. U peritonealnoj dijalizi se putem mekanog katetera ubaci u stomak dijalizna otopina, tzv. dijalizat.

Otpadne tvari i tekućine iz krvi prolaze kroz dijalizat i peritonealnu membranu, koja ih odstaranjuje. Peritonealna membrana ima istu funkciju kao i membrana na aparatu za hemodijalizu. Ona zadržava u organizmu sve korisne tvari, a izbacuje van sve otrovne tvari i višak tečnosti. 
Nakon nekoliko sati korišteni dijalizat s otrovnim tvarima i viškom tečnosti se izvlači, a ubacuje se novi, da bi proces dijaliziranja mogao ponovo započeti. Tu aktivnost nazivamo promjena.

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