Dialysis is performed to remove harmful waste products and excess fluid from the blood when the kidney is not functioning properly. Please read the article to know more about this procedure.
The kidneys filter blood to remove the waste and excess fluid from the body. The waste products are sent to the bladder to eliminate during urination.
Dialysis is a procedure performed by a machine that functions the same as kidneys when they have failed. It filters and purifies the blood using a machine, and so it helps to keep the fluids and electrolytes in balance when the kidneys cannot do their job. It has been used since 1940 to treat people with kidney failure. End-stage kidney failure occurs when the kidneys perform only 10 to 15 percent of their normal function.
Dialysis is a procedure in which a machine performs and regulates the function that kidneys do and keeps the body running normally. Without dialysis, the organs will be damaged as the salts and other waste products start to accumulate in the blood and poison the body. But dialysis is not the only cure for kidney disease or injury; it needs different treatments in addition to address those concerns. The following are the uses of dialysis, that is, performing the functions of kidneys. They are:
Prevent excess water, waste, and other impurities from accumulating in the body.
Helps to control blood pressure.
Regulate the levels of chemical elements like sodium and potassium in the blood.
Activates a form of vitamin D, improving the absorption of calcium.
There are three types of dialysis; they are:
Continuous renal replacement therapy.
Hemodialysis is the most common type, and it uses an artificial kidney known as a hemodialyzer to remove the excess waste and extra fluid from the blood. Hemodialysis treatments last for three to five hours and are performed three times a week. Most hemodialysis treatments are performed in the hospital environment, doctor's office, or dialysis center. The treatment length depends on:
The amount of waste present in the body.
The current state of health.
Procedure - The blood removed from the body is filtered through the hemodialyzer, and the filtered blood is then returned to the body with the help of the dialysis machine. In order to get the blood flow to the artificial kidney, the doctor performs minor surgery to create an entry point (vascular access) into the blood vessels. The three types of entry points are:
Arteriovenous (AV) Fistula: It connects an artery and a vein. It is designed for long-term dialysis treatment and is the preferred option. People who receive this entry point are ready for hemodialysis after two to three months.
AV Graft: This type is also designed for long-term dialysis treatment, and it is a looped tube. People after AV grafts are ready for hemodialysis after two to three weeks.
Vascular Access Catheter: It is inserted into the neck's large vein and is designed for short-term or temporary use.
After being on hemodialysis for an extended period, the doctor will feel that you are ready to give yourself dialysis treatments at home. This is more common in people who need long-term treatment.
2. Peritoneal Dialysis:
A peritoneal dialysis catheter is inserted inside the abdomen, and the catheter filters the blood through the peritoneum. During treatment, dialysate, which is a special fluid, flows into the peritoneum. Dialysate absorbs waste out of the bloodstream, and it is drained from the abdomen. This procedure takes place for a few hours and is repeated four to six times a day. However, the fluid exchange can be performed when sleeping or awake. The different types of peritoneal dialysis are:
Continuous Ambulatory Peritoneal Dialysis (CAPD) - In continuous ambulatory peritoneal dialysis, the abdomen is filled and drained multiple times a day. This method is done when the patient is awake and does not require a machine.
Continuous Cycling Peritoneal Dialysis (CCPD) - Continuous cycling peritoneal dialysis cycles the fluid in and out of the abdomen and is usually done while sleeping.
Intermittent Peritoneal Dialysis (IPD) - Intermittent peritoneal dialysis is usually performed in the hospital and also performed at home. It uses the same machine as continuous cycling peritoneal dialysis, but the process takes a longer time.
3. Continuous Renal Replacement Therapy (CRRT):
Continuous renal replacement therapy is also known as hemofiltration and is used in acute kidney failure patients in intensive care units (ICU).
Procedure - The dialysis machine passes the blood through the tubing, and the filter removes waste products and water. The blood then returns to the body with the replacement fluid. This procedure is performed 24 hours a day.
All three forms of dialysis save our life, but they also carry some risks.
Risks Associated With Hemodialysis:
The risks associated with hemodialysis are,
Low blood pressure.
High blood potassium levels.
Sudden cardiac death - It is the leading cause of death for people undergoing dialysis.
Risks Associated With Peritoneal Dialysis:
The risks associated with peritoneal dialysis are,
Increased risk of infections in or around the catheter site in the abdominal cavity; that is, after the catheter is implanted, a person may experience peritonitis (infection or inflammation of the membrane lining the abdominal wall).
High blood sugar.
Abdominal muscle weakening.
Risks Associated With CRRT:
The risks associated with continuous renal replacement therapy are,
Delayed renal recovery.
Weakening of bones.
When people find it difficult to cope with dialysis treatment and its side effects, they consider stopping the treatment. In that case, the doctor checks your weight and blood pressure as it helps to determine whether the dialysis is adequate. Before stopping treatment, ask your concerns to know if there are any risks associated with stopping the treatment at any time. If the patient cannot cope up, then he or she is advised to visit a mental health professional before ending the life-saving treatment. When the underlying condition causing the kidney failure is not corrected, stopping the dialysis treatment will eventually lead to death.
The time taken for a dialysis procedure is around four hours and done thrice weekly in dialysis centers, whereas in the case of home dialysis, it is done four days a week.
The life expectancy of people who do not do dialysis even after end-stage kidney failure ranges from days to weeks, which depends on the overall medical condition of the patient, amount of kidney function, and the severity of kidney disorder.
Dialysis is needed in persons with end-stage kidney failure in whom the glomerular filtration rate drops to less than 15 ml/min/1.73 m², whereas the normal glomerular filtration rate is above 60 ml/min/1.73 m².
Creatine can be naturally reduced by:
- Reducing protein intake.
- Avoiding creatine supplements.
- Decreased salt intake.
- Avoiding NSAIDs.
- Intake of fiber-rich food.
- Reducing alcohol consumption.
- Avoiding smoking.
Dialysis tubing is the tubing made of cellulose, a semipermeable membrane used for separating small molecular weight substances from solution, in dialysis. It is also known as Visking tubing, which removes the unwanted toxins from the bloodstream.
An arterioventricular fistula is a permanent artificial connection between the artery and vein, which is created surgically on the non-dominant arm of the person. It is made under the skin and is the most preferred access route for hemodialysis because it lasts longer and has very few complications. For a fistula to be ready for dialysis, it usually takes a few weeks to months, after which it is ready for dialysis treatment.
Continuous ambulatory peritoneal dialysis can be done during the waking hours, even during movement, as it does not require any machine. It is usually done three to five times daily.
Limiting the occurrence of kidney failure or slowing down the progression of already present kidney failure helps in preventing dialysis. The following are the measures to be taken to prevent kidney disorders:
Avoiding smoking and alcohol.
- Maintaining ideal weight.
- Reduced salt intake.
- Healthy diet.
- Regular exercise.
- Adequate water intake.
Hemodialysis requires dialysis machines to filter the blood, whereas in the case of peritoneal dialysis, the belly lining is used as a natural filter, and the dialysis machine is not required.
In cases of acute kidney failure, dialysis is temporary until the body responds to the treatment and the kidney function reverts to normal. On the other hand, chronic kidney disease, which usually progresses to end-stage kidney failure, requires permanent dialysis.
Dialysis does not prevent urination but only reduces the amount of urine output. The dialysis patients urinate at least once daily, except those whose glomerular filtration rate has dropped to zero and their kidneys are totally damaged.
The prime reason for weight loss in dialysis patients is due to the reduced caloric intake, which should be maintained by consuming adequate calories needed to maintain your body mass and following the recommended diet plan.
- Intake of adequate calories.
- Protein-rich diet, which includes poultry, meat, egg white, dairy products, etc.
- Consume a low-phosphorus diet. Avoid milk, yogurt, cheese, chicken feet soup, pork bone soup, beans, nuts, canned foods, processed foods, chocolates, colas, etc.
- Potassium should be controlled in hemodialysis patients. Avoid foods rich in potassium like fruits, vegetables, cereals, coconut, brown sugar, chocolate, peanut butter, etc.
- Reduce salt intake.
- Do not drink excess fluids.
- Adequate intake of vitamin B12, C, iron, and folic acid help in preventing anemia.
When there is kidney failure, dialysis helps remove the salt, waste, and excess water from the body, thereby helping in maintaining the balance of certain chemicals like sodium, potassium, and bicarbonate. In addition, it also helps in managing the level of blood pressure.
Dialysis patients need to reduce their fluid intake to 32 ounces per day or 500 to 1000 ml per day. Thirst can be managed by taking sugar-free candies, frozen grapes, and ice chips.
- Salt consumption should be reduced.
- Foods rich in phosphorus like milk, yogurt, cheese, chicken feet soup, pork bone soup, organ meats, malt drinks, beans, nuts, canned foods, processed foods, chocolates, colas, etc., should be avoided.
- Avoid foods rich in potassium like fruits, vegetables, cereals, coconut, bottled sauces, brown sugar, chocolate, peanut butter, canned fruits and vegetable juices, etc.
More than half of dialysis patients recover from kidney failure within 90 days, 10 to 15% of patients recover rapidly within 30 days, and very few patients take about 180 days to recover.
Low blood pressure or hypotension is the most common side effect, which occurs after dialysis, which can be managed by consuming adequate fluids as recommended.
Depending on the treatment and underlying medical condition, the rate of survival ranges between 5 to 10 years. 20 to 30 years of survival rates are also seen in some individuals.
Last reviewed at:
30 Jul 2021 - 4 min read
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