What is dialysis treatment and when is it used?
Dialysis treatment is an artificial treatment procedure used to eliminate the waste and unwanted water from the blood in patients who have failed or damaged kidneys which are unable to perform their normal function. In short, dialysis is the artificial replacement of the lost kidney function.
Dialysis treatment is used for acute kidney failure patients who have temporarily lost their kidney function or for patients with chronic kidney disease who have lost their kidney function permanently.
Normal kidneys not only perform the task of removing waste and extra fluid from a person’s blood, but also carry out functions such as producing erythropoietin and calcitriol, both of which are endocrine functions. Dialysis does not replace the endocrine functions of the kidney but simply helps in waste removal and avoiding buildup of extra fluid in the blood.
For patients with chronic kidney disease, dialysis treatment plays an important role because if the wastes and extra fluids are allowed to build up in the blood, it severely affects the body and may lead the patient to a state of coma and possibly death.
What is hemodialysis?
A patient needs to be prepared before undergoing hemodialysis, a surgery is done to create a vascular access called an A-V fistula which connects an artery and a vein, usually in the arm.
The blood circulates outside the body through a catheter inserted in the vein by the vascular access surgery and flows through a machine called the dialyser which has special filters that perform the kidney function of removing waste products from the blood. The filtered blood then enters the patient’s body through another catheter. The dialyser thus acts as an artificial kidney. Hemodialysis treatment usually lasts for about 3 to 4 hours and needs to be performed about 3 times a week. The duration of the procedure depends on the kidney function of the patient and how much fluid weight is gained by the patient in between the sessions.
Patients can sometimes opt for hemodialysis at home, but it is very important to educate the patient or his/her caregiver about the procedure. Usually, the nephrologist takes a call on whether the patient is suitable for home hemodialysis. There are a lot of factors that are considered before allowing a patient to carry out hemodialysis at home. First, the patient’s condition should be stable while he/ she is undergoing dialysis. The patient should not suffer from other comorbidities and should have blood vessels suitable for catheter insertion. Also, the home of the patient should be suitable for the hemodialyzer to be set up.
Home hemodialysis saves travel time for the patient and is more comfortable for him/her as they are taking the treatment in their home environment. It also instills a feeling of confidence in the patient.
What is peritoneal dialysis?
In peritoneal dialysis, a sterile solution called the dialysate, containing minerals and glucose is passed through a tube inserted in the peritoneal cavity i.e., the abdominal body cavity around the intestine where the peritoneal membrane, the internal lining of the abdomen, acts as a semi-permeable membrane and filters waste products from the blood.
The dialysate is left for some time to absorb waste products. The unwanted water is removed through osmosis as the dialysate has a high concentration of glucose, causing the extra fluid from the blood to pass into the dialysate. Then, the dialysate containing waste products and extra fluid is drained out through a tube and discarded. This exchange must be carried out several times during the day, but if the patient is using an automated system, the procedure is carried out overnight when the patient is asleep.
Before going through peritoneal dialysis, the patient must undergo a small surgery in which a catheter is introduced into the abdomen. The tube is kept closed most of the time, except when the dialysate is being introduced or is being drained after the dialysis procedure.
Dialysis treatment done through this method offers the patient freedom from visiting the dialysis centre on a regular basis. It also allows patients who are active, to travel while the dialysis is carried out through a bare minimum of specialized equipment.
Kidney dialysis: Its Efficiency
Although kidney dialysis is the preferred mode of treatment for patients with kidney failure, it does not completely replace the lost functions of the kidneys. A special diet is recommended for patients on dialysis to keep a check on their food and fluid intake. Some patients may require additional medication.
Most patients on kidney dialysis are normally able to carry on their day-to-day activities and lead normal lives. Travel is also possible for dialysis patients as long as dialysis treatment is available at the destination of their choice.
Dialysis affects fertility in men and women. Women on dialysis usually find it difficult to conceive, but if they conceive during dialysis, the frequency and duration of the dialysis sessions will have to be increased.