Kidney failure? Let's talk about dialysis in simple terms

Have you ever heard a doctor talk about a kidney problem in your family or a loved one? When we hear something like, "Both kidneys have failed, and now we have to do dialysis," we feel a great sense of fear and shock. What exactly is dialysis? Is this really something to be afraid of? Can you live a normal life with this treatment? You probably have many questions like these in your mind. Don't worry. Today, we will talk about this very simply, in a way that you can understand very well.

What is dialysis, simply put?

Simply put, dialysis is a treatment method that artificially performs the work that our kidneys should do when they are not working properly.

Imagine that our body is a big factory. Every cell in this factory is working. This work produces various types of waste products. Our kidneys are like the best filter system in this factory. Their main job is to filter out unnecessary waste products, toxins, and excess water from the blood and excrete them from the body as urine. Things like nitrogen waste (urea) and waste products from muscles (creatinine) are removed in this way.

Now imagine what would happen if this filter system broke down or stopped working? All the waste produced in that factory would accumulate and the entire system would become chaotic, wouldn't it? That's how, when we have kidney failure, toxins, waste products, and unnecessary fluids start to accumulate in our blood. This situation is very dangerous for our lives.

That's what dialysis does. That is, it does the work of cleaning the blood that the kidneys can't do, either with the help of a machine or some other special method. Just like when our water filter at home breaks, we bring clean bottles of water from the store, when the kidneys don't work, we clean the blood through a process called dialysis.

Who needs dialysis treatment?

Not everyone with kidney disease needs dialysis. This is only needed for people with late-stage kidney disease, or end-stage kidney disease (ESKD).

There are generally five stages of kidney disease. By the fifth stage, the kidneys are functioning at less than 15% of their normal level. At this point, the body is no longer able to remove the toxins that accumulate in the body on its own. At that point, dialysis or a kidney transplant is absolutely necessary to survive. Some people receive dialysis treatment in between until they receive a kidney transplant.

What are the main causes of kidney failure?

• High Blood Pressure: High blood pressure that is not controlled for a long time is a major cause of kidney damage.
• Diabetes:High blood sugar levels due to diabetes damage the delicate blood vessels in the kidneys.
• Diseases such as Lupus: These are diseases in which the body's own immune system attacks its own organs.
• Other causes: Sometimes, a sudden accident or severe infection can cause kidney failure. Also, some people can develop kidney disease without any identifiable cause.

There are two main methods of dialysis:

When we think of dialysis, the only thing that comes to mind is the process of cleaning the blood by connecting it to a large machine. But there are actually two main methods of dialysis. Let's simply understand the difference between the two.

1. Hemodialysis

2. Peritoneal Dialysis

Your doctor will decide on these two methods after considering factors such as your health condition and your lifestyle.

A little more about hemodialysis

This is the most commonly used dialysis method in the world. Here's what happens:

1. Preparation: Because the dialysis machine needs to pump blood quickly, our normal veins can't handle it. So, a surgeon will perform a small operation and connect an artery and a vein in your arm to create a large, strong blood vessel (fistula). This is what is used to take and return blood for dialysis.

2. Treatment: When you go to the dialysis center, a nurse inserts two needles into the created blood vessel. One of them takes blood out of your body and sends it to the dialysis machine. As it passes through an artificial filter called a dialyzer inside the machine, waste products and excess water are removed from the blood. Then the cleaned blood is returned to your body through the other needle. This process takes about 3 to 4 hours. During this time, you can sit in a chair and do something like read a book or watch TV.

Details about Peritoneal Dialysis

This method is a little different. It doesn't use a big machine. Instead, it uses something in our own body as a filter.

1. Preparation: Before this treatment begins, a surgeon will insert a permanent, soft tube (catheter) into your abdomen, just above the skin surface.

2. Treatment: A special cleaning fluid called 'dialysate' is poured into the abdominal cavity through this tube. The membrane called 'peritoneum' that covers the inner wall of the abdomen has many fine blood vessels. When that fluid is in the abdomen, it acts like a magnet to attract waste products and excess water from the blood. After a few hours, the fluid that has accumulated in the waste products is taken out again through the same tube and removed. This process is called an 'exchange'.

There are two ways to do this:

• CAPD (Continuous Ambulatory Peritoneal Dialysis):In this case, you will have to change this fluid about 3-5 times a day. When a fluid bag is hung higher than your shoulder, gravity will cause the fluid to flow into your stomach. This will take about 30-40 minutes.
• APD (Automated Peritoneal Dialysis): This is convenient for most people. Before you go to bed at night, you are connected to a small machine. While you sleep, the machine automatically exchanges fluids several times throughout the night.

How is life with dialysis? Are there any concerns?

These are some of the biggest questions a person who is about to start dialysis faces. Let's look at each one one by one.

Does dialysis hurt?

• Hemodialysis: There is only a slight stinging sensation when the needle is inserted into the vein. After that, there is no pain during the treatment.
• Peritoneal dialysis: There is no pain in this. However, as the fluid fills the abdomen, it may feel a bit full and heavy.

What are the risks of dialysis treatment?

Like any medical treatment, dialysis has some risks.

• In hemodialysis: There is a risk of infection at the access site. Also, blood clots can block the blood vessel. Sometimes blood pressure can also drop. But don't worry, the machines have safety systems. If something goes wrong, an alarm will sound and the machine will stop, so there will be no major damage.
• In peritoneal dialysis: The biggest risk is peritonitis. This can happen if germs enter the area where the tube is inserted. Therefore, this process must be done with the utmost cleanliness. Also, over time, the abdominal muscles can weaken and hernias can occur.

Will dialysis make my kidneys better again?

This is a question that many people ask. Dialysis is not a cure for kidney disease. It only temporarily takes over the function of the kidneys. End-stage renal disease (ESKD) is a condition that cannot be reversed. Therefore, dialysis is required for the rest of your life until you receive a kidney transplant.

How long can someone on dialysis live?

There is no single answer to this. It varies greatly from person to person. It depends on many factors, such as your age, overall health, and the underlying condition that caused kidney failure. But there are many people who, with proper treatment and following their doctor's instructions, live happily for years, even decades.

Can I work normally with dialysis?

Of course you can.Dialysis doesn't mean your life is over. Most people go about their daily lives, doing their jobs, and taking care of their families. You can even travel. If you're on hemodialysis, you can talk to a dialysis center in your area and make arrangements to receive your treatment there. If you're on peritoneal dialysis, it's even easier because you can take your own fluid bags with you.

Watch out for these symptoms: Tell your doctor immediately

If you are receiving dialysis treatment, notify your doctor or treatment center immediately if you experience any of the following symptoms.