The renal functional capacity can be assessed by measuring serum creatinine/blood urea nitrogen (BUN) or by urea and creatinine clearance. There are two types of dialysis procedures; it may be hemodialysis (using a machine/artificial kidney-like apparatus) or peritoneal dialysis (using a peritoneal membrane as a filter). Peritoneal dialysis is recommended for younger patients because of its flexibility and can be performed at home. Hemodialysis is done for patients with no residual renal function. Dr. Willem Kolff is considered the father of dialysis. This young Dutch physician constructed the first dialyzer (artificial kidney) in 1943.
The mechanism of hemodialysis:
In hemodialysis, the wastes and excess water are removed by using an external filter called a dialyzer, which contains a semipermeable membrane. The separation of wastes is done by creating a counter-current flow gradient, where blood flow is in one direction and the fluid of the dialyzer is in the opposite direction. Peritoneal dialysis uses the peritoneum as a natural semipermeable membrane and removes waste and water into the dialysate (the material or fluid that passes through the membrane of the dialysis).
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