When your kidneys are healthy, they clean your blood. They also make hormones that keep your bones strong and your blood healthy. When your kidneys fail, you need treatment to replace the work your kidneys used to do. Unless you have a kidney transplant, you will need a treatment called dialysis.
Dialysis is an artificial way of replacing some of the kidneys’ functions. The kidney performs a lot of essential functions in the body, beyond just making urine. It’s a treatment that basically filters and purifies the blood using a machine. You can get treatment in a hospital, in a dialysis unit that is not part of a hospital, or at home. You and your doctor will decide which place is best, based on your medical condition and your wishes.
Why and when do i need dialysis?
If your kidneys aren’t working properly e.g. because you have advanced kidney failure. The kidneys may not be able to clean the blood properly. Waste products and fluid can build up to dangerous levels in your body.
Left untreated, this can cause a number of unpleasant symptoms and eventually be fatal. Dialysis filters out unwanted substances and fluids from the blood before this happens.
You need dialysis when you develop end stage kidney failure. That’s usually by the time you lose about 85 to 90 percent of your kidney function. However, it isn’t a cure for kidney disease or other problems affecting the kidneys.
What does dialysis do?
When your kidneys fail, dialysis keeps your body in balance by:
- removing waste, salt and extra water to prevent them from building up in the body
- keeping a safe level of certain chemicals in your blood, such as potassium, sodium and bicarbonate
- helping to control blood pressure
Is kidney failure permanent?
Usually, but not always. Some kinds of acute kidney failure get better after treatment. In some cases of acute kidney failure, you may only need dialysis for a short time until the kidneys get better.
In chronic or end stage kidney failure, your kidneys do not get better and you will need dialysis for the rest of your life. If your doctor says you are a candidate, you may choose to await for a new kidney.
What are the different types?
There are two types thus hemodialysis and peritoneal dialysis. Both types filter your blood to get rid of your body from harmful wastes, extra salt, and water.
Hemodialysis is the most common type of dialysis. It uses a machine. This process uses an artificial kidney (hemodialyzer) to remove waste and extra fluid from the blood. The blood is removed from the body and filtered through the artificial kidney. The filtered blood is then returned to the body with the help of a dialysis machine.
To get your blood into the artificial kidney, the doctor needs to make an 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.
During the procedure, a tube is attached to a needle in your arm. Blood passes along the tube and into an external machine that filters it, before it’s passed back into the arm along another tube.
Hemodialysis treatments usually last three to five hours for three times per week. However, hemodialysis treatment can also be completed in shorter, more frequent sessions. You usually go to a special clinic for treatments. The length of treatment depends on your body size, the amount of waste in your body, and the current state of your health.
Peritoneal dialysis uses the lining of your abdomen, called the peritoneal membrane, to filter your blood. Like the kidneys, the peritoneum contains thousands of tiny blood vessels, making it a useful filtering device.
Before treatment starts, a cut (incision) is made near your belly button. A thin tube called catheter is inserted through the incision and into the space inside your abdomen (the peritoneal cavity). This is left in place permanently.
Fluid is pumped into the peritoneal cavity through the catheter. As blood passes through the blood vessels lining the peritoneal cavity, waste products and excess fluid are drawn out of the blood and into the dialysis fluid.
The used fluid is drained into a bag a few hours later and replaced with fresh fluid. Changing the fluid usually takes about 30 to 40 minutes and normally needs to be repeated around 4 times a day.
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?
You may feel uncomfortable during needle insertion besides, there’s no other problems. The dialysis treatment itself is painless. However, some patients may have a drop in their blood pressure. If this happens, you may feel sick to your stomach, vomit, have a headache or cramps. With frequent treatments, those problems usually go away.
How long can you live?
For chronic kidney disease, you will need to have dialysis treatments for your whole life unless you are able to get a kidney transplant. Life expectancy can vary depending on your other medical conditions and how well you follow your treatment plan. Average life expectancy on dialysis is 5-10 years, however, many patients have lived well for 20 or even 30 years. Talk to your healthcare team about how to take care of yourself and stay healthy on dialysis.
What are the side effects?
Hemodialysis can cause itchy skin and muscle cramps. Peritoneal dialysis can put you at risk of developing peritonitis, an infection of the thin membrane that surrounds your abdomen.
Both types of dialysis can make you feel exhausted.
Can you travel ?
Yes, you can travel but you need to plan for it. If you choose in-center hemodialysis, you can do your treatment sessions at a dialysis center in the city you’re visiting. If you do any type of home hemodialysis, you can bring your dialysis machine with you on your trip. Remember that you will need a trained care partner to help you with each treatment. Talk to your doctor and your social worker about ways to have treatment while traveling and what type of dialysis schedule would be best for you if you travel often.
Is dialysis expensive?
Yes. It costs a lot of money. Medicare, Medicaid and many private insurance plans cover most of the costs of dialysis. Most people on dialysis are able to get Medicare coverage, no matter their age. However, depending on the type of treatment you choose, you may have to wait a few months before insurance coverage begins. You may also need to pay deductibles or co-pays. Check with your insurance company to learn more about your coverage. Your social worker can also help answer questions.
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 feel normal with it.
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 treatment.
Can dialysis patients continue to work?
Many dialysis patients can go back to work after getting use to it. If your job has a lot of physical labor (heavy lifting, digging, etc. ), you may need to get a different job.