Dr. Michael George Michalopulos, 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.

Heart disease is the leading cause of death in the United States for both men and women. This includes coronary artery disease, heart attacks, congestive heart failure, and congenital heart disease. Some conditions, such as genetics, cannot be controlled. But there are many other things one can do to lower their risk for heart disease. Controlling high blood pressure and cholesterol levels, reducing or stopping smoking, exercising more and losing weight if needed, and eating a diet low in sodium can all protect the heart.

Angina is a squeezing type of chest pain that happens when the muscles around the heart don't get enough oxygen. It can be regular or infrequent. Usually, angina is caused by coronary heart disease. However, not all chest pain is angina. Chest pain can also be caused by a lung infection or panic attack, for example, so it is important to have any sudden pain checked.

Arrhythmia is the word for when the heart beats too fast, too slow, or irregularly with skipped beats. It can feel frightening, and depending on the type it can be dangerous, but in most cases arrhythmia is not serious and can be treated. It is very common, especially in older adults.

Heart valve problems can happen in any one of the the heart's four valves that keep blood flowing where it needs to go. Babies can be born with problems in their heart valves, or valves can be damaged by infections. The valves can stiffen and become less mobile, or they can stop closing properly and 'leak' when the heart beats. Valve problems can usually be repaired surgically.