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KIDNEY DIALYSIS

Your kidneys are two bean-shaped organs that lie just below your rib cage, on each side of your spine. They remove waste from your body, level out your blood pressure, and keep your bones strong. They also ensure that you have the right amount of chemicals, like potassium and sodium (salt), in your blood. Finally, they make the hormone that causes your body to create red blood cells.

What’s Dialysis?

It’s a treatment that takes over your kidney functions if those organs stop doing their job. There are two types of dialysis:

Hemodialysis: Your blood is put through a filter outside your body, cleaned, and then returned to you. This is done either at a dialysis facility or at home.

Peritoneal dialysis: Your blood is cleaned inside your body. A special fluid is put into your abdomen to absorb waste from the blood that passes through small vessels in your abdominal cavity. The fluid is then drained away. This type of dialysis is typically done at home.

Who Needs Dialysis?

If you have chronic kidney disease, you’ll need dialysis or a kidney transplant at some point. “Chronic” means you’ve been slowly losing kidney function over a period of time.Some people choose to start dialysis before they have symptoms of kidney failure such as nausea, fatigue, swelling, and throwing up. Even if you don’t have symptoms, you may choose to start treatment if lab tests show toxic levels of waste in your blood.When you should start dialysis depends on your age, energy level, overall health, and how willing you are to commit to a treatment plan. Although it can make you feel better and live longer, it involves a lot of your time.Your physician will let you know when you should start treatment. He’ll also explain which type might work best for you.

Dialysis facts

• Kidney dialysis is a procedure that is a substitute for many of the normal functions of the kidneys.
• Dialysis allows patients with kidney failure a chance to live productive lives.
• There are two types of dialysis: hemodialysis and peritoneal dialysis.
• Each type of dialysis has advantages and disadvantages. Patients can often choose the type of long term dialysis that best matches their needs.

How Does Dialysis Work?

Hemodialysis

Hemodialysisis the most common type of dialysis. It uses an artificial kidney, known as ahemodialyzer, to remove waste and chemicals from your blood. To get the blood to flow to the artificial kidney, your physician will create a vascular access, or an entrance point, into your blood vessels. This vascular access will allow a larger amount of blood to flow through your body during hemodialysis treatment. This means more blood can be filtered and purified. The two type of vascular access designed for long-term dialysis treatments are an arteriovenous (AV) fistula, which connects an artery and a vein and an AV graft, which is a looped tube. For short-term use, a catheter may be inserted into the large vein in your neck.Hemodialysis treatments usually last three to five hours. The treatment is typically needed three times per week. However, hemodialysis treatment can also be done in shorter, more frequent sessions.Most hemodialysis treatments are done at a hospital, physician’s office, or dialysis center. The length of treatment depends on your body size and the amount of waste in your body. After you’ve been on hemodialysis for an extended amount of time, your physician may feel that you’re ready to give yourself dialysis treatments at home. This option is more common for people who will need long-term treatment.

Peritoneal Dialysis

Peritonealdialysis involves an operation to implant a catheter into your belly area. During treatment, a special fluid calleddialysateflows into your abdomen. Once the dialysate draws waste out of the bloodstream, it’s drained from your abdomen.There are numerous different types of peritoneal dialysis, but the main ones are continuous ambulatory peritoneal dialysis andcontinuous cycler-assisted peritoneal dialysis. In continuous ambulatory peritoneal dialysis, your abdomen is filled and drained multiple times each day. Continuous cycler-assisted peritoneal dialysis, however, uses a machine to cycle the fluid in and out of your abdomen. It’s usually done at night while you sleep. Peritoneal dialysis can be done at home. You’ll receive training on how to perform the steps of the treatment.

Are there alternatives to dialysis?

• • Clinical Treatment: It is important to know that just because you are not having dialysis, this does not mean that you cannot have any active treatment for your kidney problem. Treatments are available which aim to protect and maintain the small amount of kidney function which remains and prevent or manage symptoms of kidney failure. There are a number of aspects of kidney failure which dialysis does not help, but for which there are well-established treatments – useful whether or not patients are being dialysed. Anaemia management is an example. The main purpose of dialysis is to remove waste products and excess salt and water. Some aspects of this may be managed in other ways, and in some cases the effects of having kidney failure can be reduced.

• • Measures which can help to preserve your remaining kidney function A small amount of kidney function can go a long way to keeping you feeling well of major symptoms. The natural tendency is for remaining kidney function to get slowly worse, but the rate at which this occurs can be reduced. Ensuring good control of blood pressure is important in this respect. Damaged kidneys are also more prone to further damage and some substances can cause major problems. These include remedies that can be bought over the counter, such as non-steroidal anti-inflammatory agents [eg Ibuprofen ((Nurofen) and Diclofenac (Voltarol)], which are used for arthritis and general aches and pains. It is advisable to check with one of your physicians before taking any new medicines. Avoiding dehydration is also important, especially during episodes of illness such as diarrhoea and/or vomiting, which may be going round the family.

• Treatment of anaemia: Anaemia is very common in patients with kidney failure and tends to become more severe as the problem progresses. Normal kidneys produce a hormone called erythropoietin (EPO), which stimulates the bone marrow’s formation of red blood cells. Damaged kidneys produce less EPO, and that causes anaemia. Shortage of iron may add to the problem. Anaemia accounts for many of the symptoms of kidney failure, particularly tiredness and weakness. EPO is a very effective treatment for anaemia in kidney failure and usually needs to be given every week or fortnight by insertions, initially by the district nurse but subsequently often by patients themselves or by their carers.