Dr. Adeola Titilayo Odugbesi, MD

For hemodialysis (the more common form of dialysis), a patient will visit a hospital or clinic and be connected to a dialysis machine by a needle attached to a tube that draws blood from the arm. The drawn blood is transferred to the dialysis machine, where it is filtered and separated until clean. Waste products from the blood pass into a fluid called dialysate, which is pumped out of the machine into a waste receptacle. The machine also measures and helps ensure the blood has the appropriate level of fluid, electrolytes, and pH. A tube delivers the cleaned blood back into the patient's body. A dialysis session like this will typically last for three to four hours, with a patient undergoing dialysis around three times per week.

A second method of dialysis is known as peritoneal dialysis. Unlike hemodialysis, peritoneal dialysis can be performed at home by oneself after an initial surgery. To start, a physician (generally a surgeon) will make a small incision in the lower abdomen and insert and surgically attach a catheter (thin tube). At home, the patient connects a pump to the abdomen catheter, delivering dialysate (dialysis fluid) from a bag hanging on a wheeled stand. This fluid enters the peritoneal cavity (greater abdomen area containing the stomach, liver, and intestines) and collects waste through osmosis, where waste in the blood moves across a membrane and into the dialysate. This process continues for several hours until the fluid concentration is equal between the blood and dialysate, at which point the fluid can be drained. The fluid can then be passed through a machine called a cycler, which removes waste and allows for the dialysate to be reused. This process is repeated about four times per day. Dialysis patients must limit the amount of fluid they consume prior to receiving dialysis and should also avoid eating salty foods. The cycler cannot filter more than a certain amount of waste products from the blood.

Kidneys are important organs, and dialysis treatments are vital for those with renal dysfunction. For many, dialysis is not so much a medical procedure but a part of their normal life.

During surgery, the blockage is identified, and an incision is made to expose the artery. The surgeon prepares a tube, called a graft, to be used as the bypass. Sometimes this tube is synthetic, and sometimes a piece of the patient's own vein or artery is used. The ends of the bypass graft are attached to the artery above and below the blockage. Now blood can simply flow around and continue on its way.

After a peripheral bypass, patients may need to spend a couple of days in the hospital while doctors make sure the bypass is working and not leaking. If the bypass was done in the leg, doctors may check the pulse in the feet to make sure blood is flowing well. Patients may experience some swelling in the area where they had surgery. Raising an arm or leg will help. Patients will likely be back to normal activities within 2-3 weeks.