The two kidneys in our body are like two super filters. The main function of the kidneys is to filter all the waste and unnecessary fluids in the body and excrete them as urine. However, due to various reasons such as diabetes and high blood pressure, the functioning of these kidneys can gradually decrease. When the kidneys become completely dysfunctional, waste products accumulate in the body and pose a great risk to life. That is when we need a treatment called dialysis.
Simply put, what is dialysis?
Dialysis is a procedure that is performed artificially when your kidneys fail, using a machine or other method to do the work that your kidneys should do. To be precise, it involves taking your blood, filtering out waste products (such as urea and creatinine) and unnecessary fluids, and returning the cleaned blood back to your body. This does not cure your kidneys, but it does help your kidneys do their job, allowing you to live a healthy life.
What kind of people need dialysis?
Dialysis is required for people with end-stage kidney disease (ESKD), meaning their kidney function has decreased by more than 15%. There are several main causes of kidney failure.
- High blood pressure
- Diabetes
- Immune system diseases such as lupus
Sometimes the kidneys can fail for no apparent reason. Sometimes, a serious illness or accident can cause sudden kidney failure (acute kidney failure). In such a situation, there is a chance that the kidneys will recover.
Dialysis is a serious condition. If your doctor decides that you need dialysis and you don't do it, toxic waste products can build up in your body (uremia) and become life-threatening. Therefore, this is a life-saving treatment.
There are two main types of dialysis.
There are two main types of dialysis. Your doctor will explain to you which method is best for you, based on your lifestyle and health status.
| Type of dialysis | How it happens | Time and frequency |
|---|---|---|
| Hemodialysis | Blood is taken from a vein in the arm, passed through a machine (dialyzer) to clean it, and then returned to the body. This is usually done in a hospital or dialysis center. | About 3 days a week, 3-4 hours at a time. |
| Peritoneal Dialysis | A tube (catheter) is inserted into the abdominal cavity (inside the stomach), a special fluid (dialysate) is injected through it, and the blood is cleaned using the lining of the abdomen (peritoneum). It can be done at home. | You can do it 3-5 times a day (30-40 minutes each) or at night while you sleep with a machine (8-10 hours). |
Hemodialysis
This is the most common method. Before starting this treatment, a large blood vessel (fistula) is created by connecting an artery and a vein in your arm. This is done to make it easier to take blood to and return it to the dialysis machine.
Peritoneal Dialysis
Before starting this procedure, a soft tube (catheter) is surgically inserted into your stomach. The hospital will teach you how to inject and remove this fluid at home. There are two main methods for this:
- CAPD (Continuous Ambulatory Peritoneal Dialysis): In this, you manually change the fluid several times a day.
- APD (Automated Peritoneal Dialysis): This involves automatic fluid exchange using a machine while you sleep.
Are there any risks to dialysis?
Yes, both treatments have some risks. The main risk is the possibility of infections.
- During hemodialysis: things like poor blood circulation, blood clots, and scarring at the needle insertion site can occur.
- Peritoneal dialysis: Peritonitis is an infection of the lining of the abdomen. Over time, the abdominal muscles may weaken and a hernia may form.
Your doctor will inform you thoroughly about all these risks.
Can you live a normal life while on dialysis?
Of course you can. Most people on dialysis go about their jobs, family lives, and hobbies as normal. You can even travel. If you are on hemodialysis, your doctor can help you connect you with a dialysis center in your area. If you are on peritoneal dialysis, you can take the necessary fluid bags and machine with you.
Exercise is also good. However, if you are on peritoneal dialysis, you may need to limit some strenuous activities while your abdomen is filled with fluid. Talk to your doctor about this and get advice.
When to call a doctor immediately
If you experience one or more of the following symptoms, talk to your doctor as soon as possible.
| Risk characteristic | Description |
|---|---|
| Signs of infection | Fever, chills, headache, and discharge, redness, or discoloration from the tube site. |
| Symptoms of low blood pressure | Dizziness, fainting, unusual thirst. |
| Abdominal pain | Severe, persistent stomach pain (especially in people on peritoneal dialysis). |
| Other features | Difficulty urinating, nausea and vomiting, unusual swelling in the abdomen or groin (signs of a hernia). |
Dialysis is an essential treatment that keeps you alive and well until you have a kidney transplant. It takes a little time and makes a big difference in your life, but it gives you your life.
Take-Home Message
- Dialysis is a life-saving treatment for kidney failure, not a cure.
- There are two main types: hemodialysis and peritoneal dialysis. Your doctor will help you choose the method that is best for you.
- Many people are able to lead active lives, including work and family life, while undergoing dialysis treatment.
- Always be on the lookout for signs of infection, severe pain, and dizziness. If you have any concerns, tell your doctor immediately.
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