Explain in detail the role of dialysis in managing Robert’s condition.
As mentioned in the case study, Robert has large concentrations of protein in his urine, which indicates the presence of proteinuria and a sign of kidney damage. As proteins are reabsorbed from urine, presence of large concentrations of protein indicates insufficient absorption or decreased filtration. Accumulation of harmful waste materials could raise blood pressure and excessive fluid collection may lead to swelling or oedema. This shows a need to commence dialysis for Robert on an immediate basis. Dialysis helps in filtering salt, harmful waste and excessive fluid from the blood and restores blood to a healthy and normal balance. Thus, dialysis replaces the kidneys’ certain important functions. In case of ESRD, various uremic toxins build up takes place, which could be cleaned by dialysis. During haemodialysis, the blood flow through a specific filter inside the dialysis machine, where the filter eliminates waste products and excess fluids from the system but maintains adequate balance of various minerals like sodium and potassium (Puljak, Burilovic, & Brkovic, 2016). After the cleaning of blood, it is returned into the system. However, Kwiatkowska, Domanski, & Pawlik, (2015) in this regard stated that the uremic toxic levels do not reduce to a normal range merely by dialysis and even in case of a transplant, the transplanted kidney may not be effective enough to clean 100% waste materials, which could be monitored by creatinine level. Toxins demonstrate various cytotoxic activities and contain various molecular weights, in certain cases those toxins may bound to proteins like albumin. Such complicated toxic complexes are presently matter of attraction of numerous scientist working to develop the standard of contemporary dialysis procedures.
References
Adejumo, O., Okaka, E., Madumezia, G., Okwuonu, C., & Ojogwu, L. (2015). Assessment of some cardiovascular risk factors in predialysis chronic kidney disease patients in Southern Nigeria.Nigerian Medical Journal, 56(6), 394. http://dx.doi.org/10.4103/0300-1652.171616
Koning, S., Gansevoort, R., Mukamal, K., Rimm, E., Bakker, S., & Joosten, M. (2015). Alcohol consumption is inversely associated with the risk of developing chronic kidney disease. Kidney International, 87(5), 1009-1016. http://dx.doi.org/10.1038/ki.2014.414