Jacqueline K. Dake, APNP, NP

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.

Urinary tract infections are extremely common: 12% of all men and 40-50% of all women will have a urinary tract infection during their lifetime. They are more common in women because women have shorter urethras, so bacteria have a shorter distance to travel from the outside of the body to the bladder and cause an infection. Some people also have urethras that are an unusual shape or have an obstruction in the urethra that makes getting a UTI more likely. Also, certain chronic illnesses like diabetes weaken the immune system, so any bacteria in the body are more likely to cause an infection.

A urinary tract infection can be diagnosed very quickly by a doctor. A sample of urine can be examined under a microscope for the presence of bacteria or white blood cells. There are also diagnostic strips that can be used to test a urine sample without the need for a microscope. Once a diagnosis is made, treatment is a course of oral antibiotics, and most patients feel better within just a few days. There are some things that patients can do themselves to help reduce the risk of getting a urinary tract infection in the future. Stay well hydrated, wipe from front to back after going to the bathroom, wear breathable cotton undergarments, and don't hold it in when patients feel the urge to go.