Hemodialysis :
Removal of nitrogenous and toxic products of metabolism from the blood. The exchange occurs between the patient’s plasma and dialysate across the semi-permeable membrane. dialysis occurs 3-4 times a week for 3-4 hours. radial artery and cephalic veins are taken classically for the process.Dialysis can cause growth alteration in young patients.
Peritoneal dialysis,access to the body via catheter into the peritoneal cavity. The advantage of it is no risk of air embolism and blood leaks. this procedure is safer and gives patients the freedom.
Oral considerations in acute/chronic renal failure and ESRD patients:
ARF patients are often young healthy adults and not for elective dental care. Peritoneal dialysis generally poses no contradiction to dental treatments.
Most patients of CRF with ESRD, are not aware of the complications of dental neglect while on hemodialysis.
Excessive bleeding and anemia are two major hematological conditions that most commonly patients with uremia and renal failure. Bleeding occurs in these patients due to platelet defects, increased prostacyclin activity, intrinsic coagulation defects and capillary fragility. Hemorrhagic tendency can be magnified in the presence of uremia.
Patients has hemorrhagic episodes in the gingival, ulceration, purpural or petechial lesions throughout the oral mucosa. Bruising after trauma, hematoma is observered after minor or major dental surgery. Haemostatic measures must be considered in such patients.
1-deamino-8-D-arginine vasopressin was seen effective in short-term therapy. The conjugated Oestrogen for long duration of treatment as hemostat. Administered in the form of oral rinses or cotton to reduce postoperative bleeding. meticulous surgical techniques, primary closure and local haemostatic agents are the part of standard care.
Dialysis causes hydration, serum electrolytes, urea and creatinine towards normal levels arguments have been made to treating patients in the day of dialysis contradicting this a statement can be raised that immediately after dialysis a patient is heparinized. Ideally, dental treatment should be done early to the day of dialysis. this facilitates healing in a uremic toxin free condition of the body. Dialysis patients require mort treatment time as they must be allowed to walk after every hour. Sitting in a cramped state or measuring the BP in the arm used for dialysis treatment must be avoided.
Susceptibility to infection is a serious concern for patients with uremia and ESRD due to the altered cellular immunity. These patients should have suitable oral health maintenance to remove the microorganisms, which causes septic conditions. Treatments for periodontitis, caries, root stumps or ulcers can become the entry point for microorganisms if not treated for such patients.
Proper treatment of the patients under dialysis can remove the cause and helps to maintain a good health of the patients.
For patients : Help your doctors to keep you healthy ..Always remember, “Your health is your wealth “
