Kidney Dialysis

Kidney Dialysis is done to perform the functions done by healthy kidneys such as removing waste, salt and extra water, keeping a safe level of potassium, sodium and bicarbonate in your blood and help control blood pressure.

Some facts about Kidney Dialysis:

• Kidney dialysis is required in end stage renal disease (ESRD), where kidneys become damaged and can no longer function properly.
• Kidneys are the most vital organ of human body which help remove waste fluid from your body, maintain your blood pressure and keep your bones strong. The right amount of potassium and sodium in your blood can also be ensured by kidneys.
• The hormone that causes your body to create red blood cells can be produced by kidneys.
• Prolonged high sugar is the most common cause of chronic kidney disease which requires kidney dialysis.
• The process of filtering and purifying the blood using a machine is known as Dialysis.
• Although kidney failure permanent in most of the cases, dialysis may only be needed for a short time in some cases of acute kidney failure, until the kidneys get better.
• Your kidneys do not get better and you will need dialysis for the rest of your life in chronic or end stage kidney failure.
• Dialysis can be done in a dialysis unit, in a hospital or at home based on your medical condition and your need.
• The time needed for your dialysis depends on how well your kidneys work, the amount of waste you have in your body, the amount of fluid weight you gain between treatments, your size and the type of artificial kidney used.
• You will need to have dialysis treatments for the rest of your life unless you get a kidney transplant as it does not cure your kidney disease.
• Although, the dialysis treatment is painless, some patients may have a drop in their blood pressure. You may feel sick to your stomach, vomit, have a headache or cramps if your blood pressure drops. However, these problems usually go away with frequent treatments.
• Life expectancy on dialysis can vary depending on how well you follow your treatment plan and your other medical conditions.
• Usually 5 to 10 years is the average life expectancy on dialysis. However, many patients have lived well for 20 or even 30 years on dialysis.

Types of Kidney Dialysis:

Hemodialysis and Peritoneal dialysis are two types of kidney dialysis.

Hemodialysis:

• Hemodialysis is the most common type of dialysis in which an artificial kidney called as hemodialyzer is used to remove the waste fluid and chemicals from your blood.
• A vascular access or an entrance point is created surgically to get the blood to flow to the artificial kidney, into your blood vessels.
• A larger amount of blood is allowed by this vascular access to flow through your body during hemodialysis treatment in order to filter and purify the blood.
• There are two kinds of vascular access designed for long term dialysis treatments .
• An artery is joined to a vein under your skin to make a bigger blood vessel called a fistula and an access is made.
• The doctor may use a soft plastic tube to join an artery and a vein under your skin, called a graft if your blood vessels are not adequate for a fistula.
• A catheter may be inserted into the large vein in your neck for short term use.
• Hemodialysis is required 3 times per week and usually last 3 to 5 hours.The amount of time for treatment depends on your body size and the amount of waste in your body.

The peritoneum is a membrane which lines your abdomen and is capable of filtering waste products out of the blood in a similar way to kidneys, as it has large quantity of small blood vessels.
There are two types of peritoneal dialysis.

Continuous Ambulatory Peritoneal Dialysis (CAPD):

Dialysis fluid flows into your abdominal cavity through a catheter in this process and remains in the abdominal cavity for several hours. The waste products can be filtered out of the blood into the dialysis fluid by the peritoneum. Usually, it takes about 30 to 40 minutes to drain the fluid into the peritoneal cavity. Your abdomen is filled and drained multiple times every day in this process.

Automated Peritoneal Dialysis (APD):

In this process an APD machine controls the drainage of fluid. The machine will be connected to your abdomen for 8 to 10 hours. You will keep dialysis fluid in your peritoneal cavity during the day which will be drained away in the evening. Therefore, this process will be done overnight as you sleep.

Advantages and disadvantages of Types of kidney dialysis:

Advantages of haemodialysis :

You can plan haemodialysis as your convenience as daily dialysis is not required.

Disadvantages of haemodialysis :

• Diet and fluid intake are restricted.
• You will need to ensure the access to the dialysis machine on that place if you travel for several days.
• Low blood pressure, anemia, lack of red blood cells, muscle cramping, difficulty sleeping, itching, high blood potassium levels, depression, pericarditis are the most common side effects of haemodialysis.

Advantages of peritoneal dialysis:

Traveling is easier with CAPD as it fit in with work and other activities.
Restrictions on diet and fluid intake is less.

Disadvantages of peritoneal dialysis:

• Peritoneal dialysis is required on daily basis and CAPD will be done through out the day.
• Peritonitis, an infection of the peritoneum can be a cause of Peritoneal dialysis. Symptoms of Peritonitis include severe abdominal pain, episodes of shivering, fever and vomiting.
• Peritoneal dialysis can result in lethargy or malnutrition because of protein loss.
• Weight gain, high blood sugar due to the dextrose in the dialysate and abdominal muscle weakening are the possible side effects.
• Long-term dialysis treatments may develop amyloidosis which will have symptoms of joint pain, stiffness, and swelling. This disease can occur when amyloid proteins produced in bone marrow build up in the kidneys, liver, heart, and other organs.
• Depression may be developed in some people after being diagnosed with long-term kidney failure.