Dialysis for kidney failure or renal failure
Kidney failure, haemodialysis, peritonial dialysis and kidney transplant
Things you need to know about Dialysis
What is dialysis and what are the types of dialysis?
Kidneys work day and night to clean the blood and filter it free from toxins and other waste materials. In addition, kidneys also produce certain hormones related to bone health and blood production. When kidneys are unable to perform their function of waste removal from blood, the task has to be done artificially with the help of certain machines. This process is called dialysis.
Dialysis may be of two types:
Haemodialysis: A machine (artificial kidney) is used to filter the blood. The process is performed in a hospital/clinic setting several times a week.
Peritoneal dialysis: This lesser performed procedure makes use of the peritoneal membrane, that is the lining of the abdomen, to filter blood.
Kidney Failure
When is dialysis needed?
Dialysis is performed when the kidneys are unable to remove enough wastes and fluid from the blood, or when the kidney function is reduced to 10-15%, in a condition called “kidney failure or renal failure”. Kidney failure maybe acute (sudden) or chronic (long term). It may be accompanied with symptoms like:
- Nausea
- Vomiting
- Swelling
- Tiredness
Even in the absence of any symptoms, there may be high level of wastes in the blood that need to be removed. Generally, in cases of acute renal failure, dialysis may be required temporarily for a short period (e.g. in cases with renal injury, certain heart conditions of poisoning) or till the underlying cause is treated. A nephrologist is the best person to decide when to start dialysis.
What are the causes of kidney failure or renal failure?
Some of the leading causes of acute kidney failure or renal failure include:
- Severe dehydration of sudden onset
- Injury to cells of kidney due to poisons or certain medications
- Diseases of kidney like autoimmune kidney diseases
- Sudden obstruction of urinary tract
- A reduced blood flow to the kidney in conditions like: low blood pressure, injuries, burns, sudden blood loss, illness, septic shock etc
- Complications of pregnancy
Some of the leading causes of chronic kidney failure include:
- Autoimmune kidney diseases
- Diabetes
- Glomerular kidney diseases
- High blood pressure
- Kidney-related birth defects
- Polycystic kidney disease (and other genetic diseases)
How does haemodialysis work?
Haemodialysis makes use of a dialysis machine and a filter or the dialyzer which is often called as an artificial kidney. Patients are generally required to undergo ‘access’ preparation several weeks to months before haemodialysis is started. In this step, an ‘access’ or entrance is created surgically to allow the circulation of blood between the body and the dialyzer. The most common type of access is the primary arteriovenous fistula, where a direct connection between an artery and a vein is created. It is mostly created in the arm.
For how long can one live with dialysis?
In case of chronic kidney failure where the kidneys have been permanently damaged, a patient will need to undergo dialysis treatment lifelong unless a kidney transplant is done. Life expectancy of a person on dialysis depends on many factors like underlying medical conditions, lifestyle and adherence to the prescribed treatment plan. Though life expectancy on dialysis is likely to be at least 5-10 years, it is seen that many patients may live well on dialysis for as long as 20-30 years on following healthy practices and adherence to treatment plan.
Patients may live well on dialysis for a long period
What are the long term side effects of dialysis?
Dialysis can have some procedure-related side effects. Also, it being an artificial procedure, it can compensate for the loss of kidney function only partly. Some of the side effects are:
- Anxiety
- Bone and joint pain
- Chronic tiredness
- Difficulty in falling asleep or insomnia
- Dryness of mouth
- Increased risk of sepsis
- Itchy skin
- Loss of libido i.e sex drive and erectile dysfunction
- Low blood pressure or hypotension
- Muscle cramps
What should you consider while choosing a dialysis center?
Haemodialysis can be carried out in hospital/clinic settings. Since haemodialysis is a life-long process, choosing a right setting is important. Some of the factors that should be considered while selecting a dialysis center include:
- A safe and caring environment
- Comprehensive and supportive treatment for kidney diseases
- Facilities for maintenance haemodialysis and management of complications and emergencies
- Adequate infection control practices
- Monitoring and management support for haemodialysis access related issues
Trained professional nursing staff under a close supervision of a nephrologist and round the clock support services like diagnostics, dietary, pharmacy etc.
What is a haemodialysis diet?
A special diet plan may be designed for patients on haemodialysis, to minimise the amount of fluid and waste accumulation between haemodialysis sessions. A dietitian can be consulted to determine the amount and type of food items needed, under supervision of a nephrologist.
Patients on haemodialysis are generally advised to consume a variety of nutritious foods, with a focus on high-quality proteins. On the other hand, food items high on sodium, phosphorus and potassium need to be restricted.
Haemodialysis Diet
What is kidney transplant or renal transplant?
Dialysis is generally advised for treatment of acute (short-term) and chronic (long-standing) kidney failure. Though patients may survive on dialysis for long periods, a kidney transplant is the definitive treatment in selected cases. In transplant, the patient’s diseased kidney is replaced with a healthy kidney of a related or unrelated donor.
Kidney transplant is a complex procedure that requires highly experienced team of surgeons and doctors, as well as advanced set-ups.
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References
- Dialysis Safety. Available at: https://www.cdc.gov/dialysis/patient/index.html . Accessed on January 16, 2018.
- National Kidney Foundation. Dialysis. Available at: https://www.kidney.org/patients/dialysis. Accessed on January 16, 2018
- National Institute of Diabetes and Digestive and Kidney Diseases. What are the symptoms of breast cancer? Available at: https://www.niddk.nih.gov/search?s=all&q=dialysis Accessed on January 16, 2018
- Mayo Clinic. Hemodialysis. Available at:https://www.mayoclinic.org/tests-procedures/hemodialysis/about/pac-20384824 Accessed on January 16, 2018
