Dialysis is a medical treatment that helps remove waste and excess fluids from the blood when the kidneys are no longer able to do so. It is a life-saving treatment for people with kidney failure, also known as end-stage renal disease (ESRD). In this article, we will discuss in detail what dialysis is, how it works, the different types of dialysis, and what to expect during the procedure.
What is Dialysis?
The kidneys are vital organs that filter waste and excess fluids from the blood. They also help regulate blood pressure and maintain the body’s electrolyte balance. When the kidneys fail, waste and toxins can build up in the blood, leading to serious health complications.
Dialysis is a medical procedure that mimics the kidneys’ function by filtering the blood outside the body. The procedure involves using a machine to filter the blood or a special solution (dialysate) to draw out waste and extra fluids from the body.
How Does Dialysis Work?
Dialysis works by using a semi-permeable membrane, which acts as a filter to remove waste and extra fluids from the blood. During the procedure, the patient’s blood is drawn from a vein in the arm or leg and circulated through the dialysis machine.
The dialysis machine pumps the blood through the semi-permeable membrane, which filters out the waste and excess fluids. The clean blood is then returned to the patient’s body.
Types of Dialysis
There are two types of dialysis: hemodialysis and peritoneal dialysis.
Hemodialysis is the most common type of dialysis. It is performed using a machine called a hemodialyzer, which filters the blood outside the body. Hemodialysis requires the creation of a vascular access, which is a surgical connection between an artery and a vein. This connection can be done in two ways:
- Fistula: A fistula is created by connecting an artery and a vein in the arm, creating a larger blood vessel. The fistula is the preferred method of access for hemodialysis because it lasts longer and has a lower risk of infection than other types of access.
- Catheter: A catheter is a thin, flexible tube that is inserted into a large vein in the neck, chest, or groin. A catheter is often used as a temporary access until a fistula can be created.
During hemodialysis, the patient is connected to the hemodialysis machine, which pumps the blood through the dialyzer. The dialyzer is filled with a special fluid (dialysate), which removes waste and extra fluids from the blood. The clean blood is then returned to the patient’s body.
Hemodialysis is typically performed three times a week, and each session lasts for four hours. During hemodialysis, patients may experience side effects such as low blood pressure, muscle cramps, or nausea. These side effects can be managed with medication or adjustments to the dialysis prescription.
Peritoneal dialysis is a type of dialysis that uses the patient’s peritoneal membrane, which lines the abdominal cavity, as the filter. Peritoneal dialysis is performed by introducing a special fluid (dialysate) into the peritoneal cavity through a catheter that is placed in the abdomen. The dialysate remains in the peritoneal cavity for several hours, allowing it to draw out waste and extra fluids from the blood. The used dialysate is then drained out of the body, and fresh dialysate is introduced for the next cycle.
Peritoneal dialysis can be done at home, and the patient can perform the procedure themselves several times a day. There are two types of peritoneal dialysis:
- Continuous Ambulatory Peritoneal Dialysis (CAPD): This type of peritoneal dialysis involves exchanging the dialysate fluid four to five times a day, and the patient does not need a machine to do it. The patient carries the fluid in a bag and drains it after the prescribed time.
- Automated Peritoneal Dialysis (APD): This type of peritoneal dialysis uses a machine called a cycler to perform the exchanges overnight while the patient sleeps. During the day, the patient can carry out their normal activities.
Peritoneal dialysis may be more suitable for some patients, such as those who have difficulty with vascular access, or those who prefer to have more control over their treatment. However, peritoneal dialysis may not be recommended for patients who have had abdominal surgery or have digestive problems.
What to Expect During Dialysis
Before starting dialysis, the healthcare team will perform a medical assessment to determine the best type of dialysis for the patient. The healthcare team will also provide information on the procedure, including what to expect during the treatment and how to manage any potential side effects.
During the dialysis procedure, the patient will be seated or lying down. A needle will be inserted into the patient’s vascular access, or the catheter will be connected to the peritoneal dialysis bag. The dialysis machine will then start, and the patient’s blood will be drawn out of their body, or the dialysate will be introduced into the peritoneal cavity.
The patient may experience side effects during dialysis, such as low blood pressure, muscle cramps, or nausea. These side effects can be managed with medication or adjustments to the dialysis prescription.
After the dialysis procedure, the patient will be monitored for any adverse reactions. The healthcare team will also provide instructions on how to care for the vascular access or catheter site to prevent infection.
In addition to the physical effects of dialysis, it can also have emotional and social impacts on patients. Patients may feel isolated or depressed due to the time commitment required for dialysis and the limitations it can place on their daily activities. It is important for patients to have a support system, such as friends, family, or support groups, to help them manage the emotional and social aspects of living with kidney failure.
Patients should also make lifestyle changes to support their kidney health, such as following a low-salt and low-potassium diet, getting regular exercise, and avoiding smoking and excessive alcohol consumption. These changes can help slow the progression of kidney failure and improve the patient’s overall health.
It is important for patients to attend all their scheduled dialysis appointments and follow their treatment plan to prevent complications and maintain their health. Missing appointments or deviating from the treatment plan can lead to serious complications, such as fluid overload, electrolyte imbalances, or infection.
Patients should also inform their healthcare team of any changes in their health or medications, as these can affect their dialysis treatment. It is important for patients to work closely with their healthcare team to manage their condition and make any necessary adjustments to their treatment plan.
In conclusion, dialysis is a critical treatment for people with kidney failure. Understanding how dialysis works, the different types of dialysis, and what to expect during the procedure can help patients make informed decisions about their treatment and manage their condition more effectively. By following their treatment plan, making lifestyle changes, and seeking emotional and social support, patients with kidney failure can lead fulfilling and healthy lives.
About The Author
Dr. Krisca is a highly-educated and skilled physician who has obtained a BS Public Health degree from the University of the Philippines Manila and a Doctor of Medicine degree from the De La Salle Medical Health Sciences Institute. She is a licensed physician and also a Registered Medical Technologist. She has received additional training in Hemodialysis for Non-Nephro Physicians on duty and has completed online courses in related fields like depression in populations from John Hopkins University and positive psychiatry from The University of Sydney. Currently, she is pursuing a Master of International Health in the University of the Philippines.
Dr. Krisca is known for her outstanding skills and compassionate approach to healthcare that make a positive impact on people’s lives. Through her passion for healthcare, she hopes to make a difference in the world and help people lead healthier, happier lives.