What is Dialysis, and how can It Help?
What is dialysis?
Dialysis can perform the function of the kidneys if the kidneys are no longer able to do so.
The kidneys of a healthy person filter around 110 to 140 quarts of blood each day. When the kidneys are malfunctioning, waste accumulates in the blood. This can lead to death.
Dialysis prevents the accumulation of waste products in the blood. Removes toxins and other unwanted drugs from the blood in an emergency situation.
Types of dialysis
There are 3 main types of dialysis.
· Intermittent hemodialysis (IHD)
· Peritoneal dialysis (PD)
· Continuous renal replacement therapies (CRRT)
Here, the blood circulates outside the body. It passes through special filters in a machine.
The blood exits the patient through a flexible tube inserted into the vein.
The filters remove the waste products from the blood. The filtered blood then goes back to the patient through another tube. The system replicated the exact functions of a kidney.
The process of hemodialysis requires a surgical procedure to enlarge a blood vessel in the arm through which the tube will be passed.
Hemodialysis is usually conducted three times a week, for 3 hours a day. This depends on how well the kidneys function, and how much fluid weight they have acquired in between treatments.
Hemodialysis can be done at home for the following people:
· Who has been in a stable condition while undergoing dialysis
· Who do not have other diseases that would make home hemodialysis unsafe
· Who has acceptable blood vessels for inserting the catheters
· Who has a caregiver who is willing to assist with hemodialysis
· Have a comfortable home environment suitable for taking hemodialysis equipment.
Hemodialysis works by removing impurities through blood filtration while peritoneal dialysis works through diffusion.
In peritoneal dialysis, a sterile solution, rich in glucose and minerals is run through a tube into the peritoneal cavity, through the semi-permeable peritoneal membrane.
Peritoneal dialysis uses the natural filtering ability of the peritoneum membrane to filter waste products from the blood.
The sterile solution is positioned in the peritoneal cavity for some time, to allow the absorption of waste products. After that, it is drained out through a tube and discarded.
This process is repeated several times in a day and can be done through the night with an automated system.
This process uses the principle of osmosis in the elimination of unwanted water. The high concentration of glucose in the dialysis solution causes osmotic pressure. The pressure forces the fluid to move from the blood into the dialysate. This process allows for more fluid to be drained than is introduced.
Peritoneal dialysis is not as efficient as hemodialysis. It consumes more time to remove the same quantity of total waste product as hemodialysis.
However, peritoneal dialysis has the advantage of giving flexibility and independence to the patient because it can be done at home instead rather than visiting the clinic multiple times each week. This procedure can also be done while in transit with a minimum of specialized equipment.
The process of peritoneal dialysis requires a surgical procedure to place the catheter in the abdomen. This is kept closed off, except when carrying out dialysis.
Peritoneal dialysis has two main types:
· Continuous ambulatory peritoneal dialysis (CAPD) – this procedure requires no equipment. The caregiver or the patient that carries it out. The dialysis solution is allowed to stay in the abdomen for up to 6- 7 hours after which it is replaced with a fresh solution. This happens four times a day.
· Continuous cyclic peritoneal dialysis (CCPD) – this procedure requires equipment to replace the fluids. It is performed every night, while the patient sleeps.
Each of these sessions lasts from 9 – 11 hours. Having spent the whole night attached to the machine, most people will carry the fluid inside their abdomen during the day while some may need another exchange during the day.
Peritoneal dialysis is preferred by patients who find haemodialysis complicated, such as children and elderly people. It can be done while in transit, making it more convenient for career individuals or students.
Does dialysis replace the kidneys?
Dialysis helps patients with kidney failure, but not as efficient as a normal kidney. Patients who receive dialysis are placed on controlled food and fluid intake. They also need to be on a regular medication.
Many people who are on dialysis can lead normal lives, work, and travel, as long as they have access to dialysis treatment at the destination.
Women who have dialysis tend to experience infertility because of high levels of waste products in the body which interferes with fertility. If eventually a woman has a successful kidney transplant, her fertility should return to normal. Dialysis effect on male fertility is less as compared with female fertility.
Symptoms of kidney failure
Chronic kidney failure is not a spontaneous process. It happens gradually. When only one kidney works, or both work partially, the kidney still performs its normal functions. It takes a long time for the symptoms of a kidney disease to appear.
Symptoms of kidney failure:
· Frequent need to urinate, especially at night
· Itchy skin
· Erectile dysfunction
· Shortness of breath
· Swollen feet due to water retention.
· Blood in urine
· Protein in urine
Side effects of kidney dialysis:
· Muscle cramps
· Itchy skin
· Low blood pressure
· Fluid overload
· Infections at the access site for dialysis
Kidney disease poses a serious challenge. The kidneys are unlikely to recover among people with chronic kidney failure, but dialysis can support well-being and prolong life for up to 15 years or more.