The body's entire blood content circulates through the kidney 12 time per hour. The kidney filters about 80000 litres of blood daily. Dialysis is a tratment option for people who do not have healthy kidneys. It is prescribes when your own kidneys cannot take care of your body's needs.
When is dialysis prescribed?
You need dialysis when you develop end stage kidney failure --usually by the time you lose about 85 to 90 percent of your kidney function and have a GFR of <15. It may also be recommended for some acute kidney related problems.
What does dialysis do?
Dialysis acts as an alternative to your kidneys and keep the balance in your body. It does the following functions:
- Removes toxins salt and extra water to prevent them from building up in the body
- keeps a safe level of certain chemicals in your blood, such as bicarbonate, potassium and sodium
- helps in controlling blood pressure
Is kidney failure permanent?
Usually, but not always. It is possible for some acute renal diseases to get better after treatment. In some cases of acute renal failure, dialysis may only be needed for a short time until the kidneys get better.
In chronic or end stage kidney disease, kidneys do not get better and you will need dialysis for the rest of your life.
Where is dialysis done?
Dialysis can be done in a dialysis unit or at home. You and your nephrologist can decide which place is best, based on your medical condition, preferences and your lifestyle.
Are there different types of dialysis?
Yes, there are two types of dialysis --hemodialysis and peritoneal dialysis.
What is hemodialysis?
In hemodialysis, an artificial kidney (dialyzer) is used to bring balance in your body by removinge waste and extra chemicals and fluid from your blood. To get your blood into the artificial kidney, the doctor needs to make a vascular access (entrance) into your blood vessels. This is done by minor surgery to your arm or leg.
Sometimes, an access is made by joining an artery to a vein under your skin to make a bigger blood vessel called a fistula.
Occasionally, an access is made by means of a narrow plastic tube, called a catheter, which is inserted into a large vein in your neck. This type of access may be temporary, but is sometimes used for long-term treatment.
How long do hemodialysis treatments last?
The time needed for your dialysis depends on:
- how well your kidneys work
- the type of dialysis you opt for
- how much fluid weight you gain between treatments
- how much waste you have in your body
- how big you are
- the type of artificial kidney used
Usually, each hemodialysis treatment lasts about four hours and is done three times per week.
A type of hemodialysis called high-flux dialysis may take less time. You can speak to your doctor to see if this is an appropriate treatment for you.
What is peritoneal dialysis and how does it work?
In peritonial dialysis, your blood is cleaned inside your body. The doctor will do surgery to place a plastic tube called a catheter into your abdomen (belly) to make an access. During the treatment, your abdominal area (called the peritoneal cavity) is slowly filled with dialysate through the catheter. The blood stays in the arteries and veins that line your peritoneal cavity. Extra fluid and waste products are drawn out of your blood and into the dialysate.
What are the different kinds of peritoneal dialysis and how do they work?
There are two major kinds of peritoneal dialysis:
Continuous Ambulatory Peritoneal Dialysis (CAPD) is the only type of peritoneal dialysis that is done without machines. You do this yourself, usually four or five times a day at home and/or at work. You put a bag of dialysate (about two litres) into your peritoneal cavity through the catheter. The dialysate stays there for about four or five hours before it is drained back into the bag and thrown away. This is called an exchange. You use a new bag of dialysate each time you do an exchange. While the dialysate is in your peritoneal cavity, you can go about your usual activities at work, at school or at home.
Automated Peritoneal Dialysis (APD) usually is done at home using a special machine called a cycler. This is similar to CAPD except that a number of cycles (exchanges) occur. Each cycle usually lasts 1-1/2 hours and exchanges are done throughout the night while you sleep.
Will dialysis help cure the kidney disease?
No. Dialysis does some of the work of healthy kidneys, but it does not cure your kidney disease. You will need to have dialysis treatments for your whole life unless you are able to get a kidney transplant.
Is dialysis uncomfortable?
There is some discomfort when the needles are put into your fistula, but most patients have no other problems. The dialysis treatment by itself is quite painless. Initially some patients may have small complications like drop in blood pressure which may result in stomach ache, vomitting, headache or cramps. With frequent treatments, those problems usually go away.
Do dialysis patients feel normal?
Many patients live normal lives except for the time needed for treatments. Dialysis usually makes you feel better because it helps many of the problems caused by kidney failure. You and your family will need time to get used to dialysis.
Do dialysis patients have to control their diets?
Yes. You may be on a special diet. You may not be able to eat everything you like, and you may need to limit how much you drink. Your diet may vary according to the type of dialysis.
Click here to learn more about diet for dialysis patients
Can dialysis patients travel?
Yes. Dialysis centers are located in every part of the United States and in many foreign countries. The treatment is standardized. You must make an appointment for dialysis treatments at another center before you go. The staff at your center may help you make the appointment.
Can dialysis patients continue to work?
Many dialysis patients can go back to work after they have gotten used to dialysis. If your job has a lot of physical labor (heavy lifting, digging, etc. ), you may need to get a different job.