40-year-old Mr. Kumar had been feeling tired and lethargic for about a month now. A few years ago, he had to undergo a nephrectomy due to a cyst in his right kidney but was told that he could lead a healthy life on a single kidney with the right diet and lifestyle. However, with age and stress, his pressure and blood sugar levels also increased, and his feet and hands also felt swollen and heavy. His nephrologist asked him to undergo a few tests. High creatinine level suggested there was something wrong with his lone kidney and he was advised immediate Dialysis to bring down the creatinine levels, following which he could take medications to stay healthy. Unfortunately, his left kidney had also suffered damage and he would need regular dialysis or a transplant.
When is Dialysis required?
Kidneys prevent extra water, waste, and other impurities from accumulating in the body, help control blood pressure and regulate the levels of chemicals in the blood, like sodium, or salt, and potassium. Kidneys also help to activate vitamin D that helps in the better absorption of calcium.
Sometimes kidneys are unable to perform their natural functions due to a disease or an injury, and dialysis can help to keep the body function normally. When kidneys fail, salts and other waste products continue to accumulate in the blood and poison the body. However, dialysis is not exactly a cure for kidney disease or other problems affecting the kidneys.
Types of Dialysis – Features & Risks
Dialysis is mainly of two types:
Haemodialysis – It is the most common type of dialysis that uses a mechanical device, known as a haemodialyser, to remove waste and chemicals from one’s blood. To get the blood to flow to the machine or the artificial kidney, the doctors will surgically create access, or an entry point, into the blood vessels. This access created will allow a larger amount of blood to flow through your body during haemodialysis treatment so that more blood can be filtered and purified.
For dialysis treatments, an arteriovenous (AV) fistula (connecting an artery and a vein), and an AV graft (a plastic tube that connects an artery to a vein) is created. For short-term use, a catheter can be inserted into the vein in the neck for Dialysis. Haemodialysis usually last three to five hours.
Peritoneal Dialysis – In this type of dialysis, a catheter is implanted surgically into the abdomen of the patient. During peritoneal dialysis, a fluid known as dialysate flows into the abdomen and draws the waste out of the bloodstream and is later drained out.
Peritoneal dialysis can be of different types, but the two main types are continuous ambulatory and continuous cycler-assisted peritoneal dialysis.
During a Continuous cycler-assisted peritoneal dialysis, the machine directs the fluid into your abdomen to drain out the waste at any time of the day, even while one sleeps.
Peritoneal dialysis may be conducted at home but with proper training.
Continuous renal replacement therapies (CRRT) – While dialysis sessions last generally for 6 hours, continuous renal replacement therapies (CRRT) are designed for 24-hour use in an intensive care unit (ICU). In CRRT, the fluid removal is slower and has lesser complications.
- Low blood pressure
- Anaemia, or low red blood cells
- Muscle cramps
- Difficulty sleeping
- High blood potassium levels
- Inflammation of the membrane around the heart or pericarditis
In this type of dialysis, there is an increased risk for infections in or around the catheter, membrane that lines the abdominal wall. Risks involve:
- Weakens abdominal muscles
- Blood sugar levels rise due to the dialysate
- Gain in weight
Will dialysis help cure kidney disease?
No, Dialysis cannot cure a Kidney disease but does the work of healthy kidneys. One will need to have dialysis treatments for the whole life unless one can get a kidney transplant.
Is dialysis uncomfortable?
Slight discomfort is felt when the needles are put into the fistula or graft, but most patients have no other problems. Dialysis is painless but sometimes patients may experience a drop in their blood pressure. This may make them sick, vomit, or give headache or cramps. With frequent dialysis, those problems usually go away.
How long can you live on dialysis?
If kidneys fail, you will need to have dialysis treatments for your whole life unless there is a kidney transplant. Other medical conditions and the treatment plans being followed also contribute to the life expectancy of a dialysis patient. The life expectancy of people on dialysis is 5-10 years on average; however, many patients have lived well on dialysis for 20 or even 30 years.
Is dialysis expensive?
Yes. Dialysis is costly but Private health insurance can help with the costs.
Do dialysis patients have to control their diets?
Yes. Dialysis patients may have a special diet. They may not be able to eat everything and may need to limit how much they drink. Diet may vary according to the type of dialysis.
Can dialysis patients continue to work?
Many dialysis patients can go back to normal work life after they have gotten used to the dialysis treatment, provided it does not involve heavy physical labour.