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Principle Diffusion removes urea, creatinine, potassium Ultrafiltration removes excess fluid Blood flows on one side of a semipermeable membrane, dialysate on the other Access Sites Arteriovenous fistula (preferred) Arteriovenous graft Central venous catheter (temporary) Indications End-stage renal disease Acute kidney injury with: Severe hyperkalemia Metabolic acidosis Pulmonary edema Uremic symptoms Frequency Usually 3 times per week Each session lasts 35 hours Advantages Rapid removal of toxins Effective fluid control Suitable for unstable biochemical states Complications Hypotension Muscle cramps Disequilibrium syndrome Infection at access site Thrombosis of fistula Peritoneal Dialysis (PD) Definition Peritoneal dialysis uses the peritoneal membrane as a natural semipermeable membrane to remove waste products and excess fluid