For Pet Owners:
Hemodialysis is a method of treating kidney failure that involves using a machine to clear the blood of substances that the kidney is failing to clear out. One of the many jobs of the kidneys is to clear the blood of certain substances, which include normal waste products as well as certain drugs or even toxins, by extracting those substances from the blood and putting them in the urine. The urine is then eliminated from the body. Hemodialysis does not make the kidneys get better; it does the job of the kidneys so the patient can live long enough for the kidneys to heal if the kidneys failed because of a problem that can be reversed. Hemodialysis reliably makes the blood values better.
Hemodialysis is frequently referred to as intermittent or continuous therapy, depending on whether the treatment is provided for several hours a day every day to every other day, or whether the treatment continues around the clock (24 hours a day) for days on end until the patient recovers. There is no convincing evidence that one form is always better than the other. In most cases, the most readily available form is chosen, although there are certain circumstances that make one preferred to the other.
Peritoneal dialysis is a different form of dialysis that cleans the blood by putting a saline solution in the belly using a special catheter, and then draining it out and repeating the process. I have not been tracking veterinary hospitals that provide this therapy.
There are about 35 veterinary hemodialysis units in the world (that I know about). I try to keep this list current, even if I don’t know the unit or the doctors performing the treatments.
Veterinary Publications of Interest:
Acierno MJ, Labato MA (eds): Veterinary Clinics of North America: Small Animal Practice 41(1):2011. Entire issue devoted to Dialysis and nephrology
Acierno MJ. Continuous Renal Replacement Therapy. In Polzin D, Bartges J (eds) Nephrology and Urology of Small Animals, Wiley-Blackwell, Ames, 2011.
Acierno MJ, Labato MA. Continuous Renal Replacement Therapy, In: Ettinger SJ, Feldman EC (eds): Textbook of Veterinary Internal Medicine, Seventh Edition. Philadelphia, W.B. Saunders Company 2010.
Acierno MJ. Maeckelbergh V. Continuous Renal Replacement Therapy. Compendium Cont Ed Pract Vet. 2008;30(5):264-272
Langston CE. Hemodialysis. In Polzin D, Bartges J (eds) Nephrology and Urology of Small Animals, Wiley-Blackwell, Ames, 2011.
Poeppel K, Langston CE. Technical Management of Hemodialysis Patients. In Burkitt JM (ed): Advanced Nursing and Monitoring Techniques for Small Animal Emergency and Critical Care, Wiley-Blackwell, Ames, 2012, in press.
www.vetcrrt.net This is the home page of the Veterinary CRRT Society
www.renalpharmacyconsultants.com This website has a pdf file of the Dialysis of Drugs handbook, to help determine if a particular drug is dialyzable.
www.facebook.com/pages/Nephrovet/300014800104518?ref=tn_tnmn This website is managed by Miguel Malheiro, and has topics related to veterinary nephrology and dialysis.
2010, 2008, 2006, and 2004 Proceedings of The Advanced Renal Therapies Symposium
These cover a variety of topics related to ERRT by various authors. They are available to veterinarians in pdf format (slightly revised from initial printing) from email@example.com