WEBVTT

00:00:08.929 --> 00:00:11.950
Dialysis is used to replace functions of the kidneys

00:00:11.953 --> 00:00:15.437
when they can no longer work sufficiently on their own.

00:00:15.953 --> 00:00:18.585
In this case, the kidneys are said to have failed.

00:00:19.757 --> 00:00:22.000
The main task of the kidneys is

00:00:22.000 --> 00:00:25.097
to filter toxins and waste products from the blood

00:00:25.100 --> 00:00:27.513
and excrete these in the urine.

00:00:28.482 --> 00:00:29.908
If the kidneys fail,

00:00:29.911 --> 00:00:32.696
dialysis takes over the role of cleaning the blood.

00:00:33.446 --> 00:00:36.767
The main techniques used are hemodialysis

00:00:36.770 --> 00:00:40.204
and peritoneal dialysis.

00:00:41.228 --> 00:00:45.770
With hemodialysis, the blood is cleaned outside of the body.

00:00:46.302 --> 00:00:49.849
For this purpose, the doctor creates a vascular access,

00:00:49.852 --> 00:00:51.804
usually on a forearm.

00:00:52.489 --> 00:00:55.267
Via narrow tubes and a pump, the blood

00:00:55.270 --> 00:00:59.226
flows into a special filter, the dialyzer.

00:00:59.724 --> 00:01:01.902
There, the blood is guided along one side

00:01:01.905 --> 00:01:07.369
of a dialysis membrane, which contains small pores

00:01:07.372 --> 00:01:09.836
and only allows certain substances to flow through.

00:01:10.195 --> 00:01:12.437
On the other side of the membrane,

00:01:12.440 --> 00:01:16.000
the dialysate flows in the opposite direction to the blood.

00:01:16.943 --> 00:01:19.828
The dialysate is a water-based solution

00:01:19.831 --> 00:01:22.852
with a lower concentration than the blood.

00:01:23.891 --> 00:01:27.000
This difference in concentration ensures that

00:01:27.000 --> 00:01:29.022
the toxins and waste products pass

00:01:29.025 --> 00:01:31.661
from the blood into the dialysate.

00:01:31.757 --> 00:01:36.203
The blood components are held back by the membrane.

00:01:36.930 --> 00:01:38.649
When the blood has been purified,

00:01:38.652 --> 00:01:40.966
it flows back into the body.

00:01:40.969 --> 00:01:46.000
Used dialysate is continuously drained out of the filter,

00:01:46.000 --> 00:01:49.206
while fresh dialysate is replenished.

00:01:49.550 --> 00:01:51.000
In this way, the blood is pumped

00:01:51.000 --> 00:01:55.839
through the dialysis machine and cleaned multiple times.

00:01:56.386 --> 00:01:59.456
Hemodialysis lasts 4 to 5 hours.

00:01:59.815 --> 00:02:02.089
It is carried out at most 3 times a week

00:02:02.092 --> 00:02:04.890
at a dialysis center.

00:02:05.311 --> 00:02:07.388
With peritoneal dialysis,

00:02:07.391 --> 00:02:10.405
the blood is cleaned directly in the abdominal cavity.

00:02:11.038 --> 00:02:15.250
The abdominal cavity is lined with a membrane of tissue

00:02:15.253 --> 00:02:19.042
called the peritoneum, which is very rich in blood vessels.

00:02:19.971 --> 00:02:22.668
A catheter is used to infuse the dialysate

00:02:22.671 --> 00:02:24.417
directly into the abdominal cavity.

00:02:25.000 --> 00:02:29.134
The peritoneum then acts as a dialysis membrane,

00:02:29.137 --> 00:02:31.689
with toxins and waste products from the

00:02:31.692 --> 00:02:35.396
peritoneal blood vessels passing into the dialysate.

00:02:36.427 --> 00:02:37.668
After a certain period,

00:02:37.692 --> 00:02:41.000
the dialysate is drained via a catheter

00:02:41.000 --> 00:02:42.602
and replenished.

00:02:43.250 --> 00:02:46.500
This enables continuous cleaning of the blood.

00:02:46.852 --> 00:02:49.529
Peritoneal dialysis can be performed

00:02:49.532 --> 00:02:51.899
on an ambulatory basis, that is, in the patient’s home.

00:02:52.123 --> 00:02:54.049
The dialysate is changed manually

00:02:54.052 --> 00:02:57.011
three to four times per day.

00:02:57.014 --> 00:02:58.649
If the patient doesn’t want to exchange

00:02:58.652 --> 00:03:00.120
dialysate bags during the day,

00:03:00.123 --> 00:03:03.000
they can use a special machine at night,

00:03:03.000 --> 00:03:05.943
which performs several automatic exchanges while they sleep.

00:03:07.779 --> 00:03:09.531
To recap:

00:03:09.880 --> 00:03:14.138
Dialysis takes over functions of the kidneys if they fail.

00:03:14.607 --> 00:03:16.089
The main task is

00:03:16.092 --> 00:03:19.000
to filter toxins and waste products from the blood.

00:03:19.586 --> 00:03:25.000
Doctors mostly use hemodialysis or peritoneal dialysis.

00:03:25.656 --> 00:03:29.942
With hemodialysis, the blood is cleaned outside of the body.

00:03:29.945 --> 00:03:31.822
With peritoneal dialysis,

00:03:31.825 --> 00:03:33.380
it is cleaned in the abdominal cavity.

00:03:33.777 --> 00:03:36.140
The basic principle is that dialysis fluid pulls

00:03:36.143 --> 00:03:41.223
toxins and waste out of the blood through a membrane.

00:03:42.074 --> 00:03:46.272
This dialysate is drained and replenished regularly.

00:03:47.077 --> 00:03:51.676
While hemodialysis uses an artificial membrane,

00:03:51.679 --> 00:03:54.049
peritoneal dialysis uses

00:03:54.052 --> 00:03:56.097
the lining of the abdominal cavity the same way.

00:03:56.664 --> 00:03:59.898
Depending on which type is used, it may be possible

00:03:59.901 --> 00:04:02.292
to perform dialysis in the patient’s home.