Dr Rezwanur Rahman is giving his utmost services to dialysis patients. He believes that dialysis is not the end of life rather with proper care a dialysis patient can live a long healthy near normal life. At present almost 1200 session of hemodialysis is undergoing per month under his care in two reputed hospitals at Dhaka.

He regularly performs CAPD catheter insertion in those patients with ESRD, for whom hemodialysis is not suitable. At least 50 CAPD patients are getting dialysis under his care.

Dialysis is a procedure to remove waste products and excess fluid from the blood when the kidneys stop working properly.

Types:

·      Hemodialysis

·      Peritoneal dialysis

Choice of suitable dialysis methods for a patient is individualized. Usually 90% patients choose hemodialysis.

How hemodialysis works:

The technique involves pumping the patient’s blood through an array of semi permeable membranes (an “artificial kidney”) which separates the blood from the dialysate, a solution of crystalloids including sodium, calcium, and a bicarbonate buffer. Osmotic exchange across the membrane allows for the removal of urea, creatinine, phosphate and other uraemic metabolites and for correction of acidosis and electrolyte abnormalities. Adjustment of the pressure difference across the membrane allows for convective loss of water and its dissolved solutes from the blood compartment, allowing correction of volume overload

How many times  dialysis is required in a weeks

12 to 16 hours per week

Usually 4 hours session/ 3 to 4 session per week

Things to be taken care in hemodialysis patient

·      Correction of fluid over load

·      Hypertension

·      Anemia

·      Vitamin deficiency

·      Bone disease

·      Joint disease

·      Vascular and extra vascular calcification

·      Cardiac disease

·      Neuropathy

·      Pruritis

·      Proper vaccinations

CAPD is more convenient for patients with

·      Hemodynamically unstable patients

·      Hemorrhagic condition

·      Repeated vascular failure

·      Heart failure

·      Removal of high molecular weight toxin

Advantages of CAPD

·      Preservation of residual renal function

·      No need of vascular access

·      No need to go to dialysis center

·      Chance of blood borne infection is less

Conditions where CAPD is not a suitable option

·      Inguinal , umbilical or diaphragmatic hernia

·      Ileostomy or colostomy

·      Abdominal wall or intra-abdominal sepsis

·      Extensive abdominal adhesion due to previous surgery

·      Morbid obesity

·      Huge polycystic kidney disease

·      Severe gastroparesis or lung disease