Clinical Narratives


In my earlieryears as a medical practitioner, I was posted to the chronic kidneyinfection sections of a health facility. I was tasked withinteracting daily with the patients and ensuring that they underwentthe dialysis process without fail. As a result, my primaryresponsibility was to monitor the progress of all the patients andinforming the head of the section on any developing issues. I canconclusively state that this was one of the most eye-openingexperiences I have ever had in my life as a medical student andpractitioner. The opportunity provided me with a new learning curvesince I was required to make life and death decisions within a shorttime. In such instances, making the wrong decision would bedetrimental to the life of a patient. The margin of error was solimited that I had to put my best foot forward when undertaking myresponsibilities at the health facility and particularly the dialysissection.

Despite havingspent several years learning about the use of advanced technologywith regards to the dialysis process, the first real-life practicewas unbelievable. The complete preparations before the actual processwere as important as the procedure involved in dialysis. Moreover, Ibecame conversant with the various types of dialysis. The ability todifferentiate between pediatric and peritoneal dialysis wasconsidered to be an essential element in the management of chronicinfections and kidney failures. Other concepts that were similarlyimportant included hemofiltration, hemodiafiltration, and intestinaldialysis.

Even though eachof the processes involved the exchange of waste from the body’sblood, there are various instances in which it is not advisable. Themain purpose of this process is to replace kidneys that areconsidered to be defective artificially. The entire process isnecessitated by the need to ensure sufficient circulation of freshblood in the body. Failure of the kidney to purify the blood is oneof the major reasons for dialysis. Acute kidney injury, which isreversible is also considered to lead to dialysis.

My clinicalexperiences in the chronic kidney section enabled me to identify thethree primary types of dialysis namely hemodialysis, peritonealdialysis, and hemofiltration. On the other hand, there are two typesof secondary dialysis, and they include hemodiafiltration andintestinal dialysis. Pediatric dialysis relates to the treatment ofchildren. Over the past years, there has been a substantial declinein morbidity rates among children undergoing dialysis. The onlyexceptions to such instances have been in the form of seizures andhypotensive episodes. This process advocates for the personalizationof the dialysis of children to facilitate the long-term exposure torenal failure treatment that they are likely to be subjected to inthe long run.

Peritoneal dialysis, on the other hand, revolves around the use ofthe glucose-containing solution. The fluid, known as dialysate ispassed through various parts of the body. They include the peritonealcavity, abdominal body cavity, and cavity around the intestine. Afterthe completion of the process, the fluid is drained from the bodybefore being replaced with fresh dialysate. The process is repeatedbetween four and five times a day. Even though hemodialysis issimilar to hemofiltration, the latter is based on the pumping ofblood through a dialyzer without a dialysate. My clinical experiencesat the health facility were therefore beneficial.