Dr. Amara Sarwal, MD, MSCI is a nephrologist in Salt Lake City, UT specializing in adult nephrology. She graduated from St. George's University School of Medicine. Dr. Amara Sarwal, MD, MSCI is affiliated with University of Utah Health and UNIVERSITY OF UTAH ADULT SERVICES.
Dialysis
Dialysis is a procedure that replicates renal (kidney) function by filtering patients' blood. When kidneys do not work properly, waste can accumulate in the blood and unbalanced chemicals can impair the body's critical functions. In order to stay healthy, a person without proper kidney function must receive dialysis. There are two forms of dialysis treatment: hemodialysis and peritoneal dialysis. Both forms of dialysis are recurring treatments that in many cases last throughout the lifetime of the affected patient. Patients who briefly lose renal function may slowly reduce the frequency of dialysis sessions until their kidneys recover. However, most patients who start on dialysis remain on dialysis for the rest of their lives or until they receive a kidney transplant.
A number of conditions can worsen renal function and lead to end-stage or acute kidney failure. When kidneys fail (i.e. nearly 90 percent of their function is lost), dialysis is typically prescribed. Conditions that cause chronic kidney failure (eventually requiring dialysis) include:
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.
Dr. Amara Sarwal, MD, MSCI graduated from St. George's University School of Medicine. She completed residency at Internal Medicine - Lincoln Hospital. She has a state license in Utah.
Medical School: St. George's University School of Medicine
Residency: Internal Medicine - Lincoln Hospital
Licensed In: Utah
Dr. Amara Sarwal, MD, MSCI is associated with these hospitals and organizations:
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Dr. Amara Sarwal specializes in adult nephrology. She obtained her medical school training at St. George's University School of Medicine and performed her residency at Lincoln Medical and Mental Health Center. These areas are among her clinical interests: polycystic kidney disease, hypertension (high blood pressure), and dialysis. Dr. Sarwal's hospital/clinic affiliations include CommonSpirit Health - Mountain Region and the University of Utah Health.