Dear Shihana,

Dialysis is a medical process through which a person''s blood is cleansed of the toxins the kidneys normally would flush out. It is generally used when a person''s kidneys no longer function properly. This can be a result of congenital kidney disease, long-term diabetes, highblood pressure or other conditions.

Dialysis may be either temporary or permanent, depending on the person. If a dialysis patient is waiting on a kidney transplant, the procedure may be temporary. However, if the patient is not a good transplant candidate, or a transplant would not alleviate the condition, dialysis may be a life-long routine.

There are two main kinds of dialysis used: peritoneal and hemodialysis. Peritoneal dialysis can be done in the home, by the patient, either alone or with a helper. Peritoneal dialysis uses the body''s peritoneal membrane, inside the abdomen, to infuse a glucose-based solution into the abdominal cavity. The solution remains in the abdomen for about two hours, and is then drained out.

A surgeon must place a tube with a titanium plug inside the patient''s abdomen for this procedure. The patient must also be trained to perform the procedure. Absolute attention to sterile procedures is required, or peritonitis could result. This is especially dangerous in patients whose immune systems may already be compromised or suppressed.

Hemodialysis is probably the procedure that most people are familiar with. This procedure is performed at a hospital or dialysis center. The patient is hooked up, via a tube in the veins, to a machine that circulates his blood through a machine, through semi-permeable filters that take out the toxins in the blood. The procedure usually takes three to four hours.

While dialysis may be a life-saving procedure, it is not perfect. Patients must follow a specialized diet that is higher in protein and lower in phosphorus and potassium, since these minerals tend to build up quickly in the blood. They must also limit their fluid intake, since dialysis only removes so much water from the patient''s body. Infection is also an ever-present specter, since a permanent access point must be created in the body for either dialysis procedure.

There are stories of people who have survived many years on dialysis, but the long-term outlook is not good without a transplant. Researchers are working to improve dialysis procedures and survival rates. Most doctors will tell a patient that the best treatment is to prevent kidney damage.

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