Dialysis is one of the treatment methods for people who have kidney problems. In fact, in this method, special devices perform kidney functions in the body. This treatment has been used since the 1940s. In the following, you will read more about dialysis and its types and complications.
What is dialysis?
The kidneys filter and purify the blood by removing waste products and excess fluids from the body. These wastes are sent to the bladder and excreted in the urine. Kidney failure in the final stage occurs when the kidneys perform only 10 to 15% of their normal function.
If the kidneys fail, dialysis will work. Dialysis is a treatment in which the blood is purified using a special device. This treatment helps maintain the body’s fluid and electrolyte balance when the kidneys are unable to do their job.
Why is dialysis used to treat patients?
If the kidneys are functioning properly, they prevent the accumulation of excess water, waste products and other impurities in the body. It also helps control blood pressure and regulates the levels of chemical elements in the blood. These elements may include sodium and potassium. The kidneys even activate a type of vitamin D that improves calcium absorption.
When the kidneys are unable to perform these functions due to illness or injury, this treatment keeps the body as normal as possible. Without this method, salts and other waste products accumulate in the blood, poisoning the body and damaging other organs. One of the signs of a kidney problem is the color of the urine. The color of healthy kidney urine ranges from pale yellow to amber yellow. However, dialysis is not a cure for kidney disease or other kidney problems. Different treatments may be needed to address these problems. In fact, dialysis only takes over part of the kidney function.
Types of kidney dialysis
There are three different types of dialysis.
Hemodialysis is the most common type of dialysis. In this process, an artificial kidney (hemodialysis) is used to remove waste products and excess fluid from the blood. In this method, blood is removed from the body and filtered through an artificial kidney. The purified blood is then returned to the body using a dialysis machine. In order for blood to be transferred to an artificial kidney, the doctor performs surgery to create a point of entry (vascular access) to the blood vessels. There are 3 types of inputs:
- Graft or AV graft: This method is a ring tube;
- Vascular access catheter: This device may enter a large vein in the neck;
- Arteriovenous fistula (AV) fistulaIn this method, an artery and a vein are connected.
AV fistulas and AV transplants are designed to treat long-term dialysis. People who receive an AV fistula recover 2 to 3 months after surgery and are ready to start hemodialysis. People who receive an AV graft are ready within 2 to 3 weeks. Catheters are designed for short-term or temporary use.
Hemodialysis treatments usually last 3 to 5 hours and are performed 3 times a week. However, hemodialysis treatment can be done in shorter, more frequent sessions. Most hemodialysis treatments are performed in a hospital, doctor’s office or dialysis center. The duration of treatment depends on the size of the body, the amount of waste in the body and the current state of health.
After long-term hemodialysis, your doctor may decide that you are ready to have dialysis treatment at home. This option is more common for people who need long-term treatment.
2. Peritoneal Dialysis
In response to the question of what is peritoneal dialysis, it should be said that this process involves surgery to implant peritoneal dialysis catheter in the abdomen. The catheter helps filter your blood through the peritoneum, the membrane in the abdomen. During treatment, a special fluid called dialysis flows into the peritoneum. Dialysis absorbs waste. After this, dialysis removes waste products from the bloodstream and is emptied from the abdomen. This process takes several hours and should be repeated 4 to 6 times a day. This process can be done while sleeping or waking up.
3. Continuous kidney replacement therapy (CRRT)
This treatment is mainly used in the intensive care unit for people with acute renal failure. This method is also called homofiltration. In this method, a device passes blood through a tube. A filter then removes waste and water. The blood is returned to the body with the replacement fluid. This procedure is usually done 12 to 24 hours a day and almost every day.
Complications of dialysis
While all three forms of dialysis can save patients’ lives, they also have certain side effects.
Risks associated with hemodialysis
Risks of hemodialysis include the following:
- Skin rash;
- Low blood pressure;
- Muscle cramps;
- Difficulty sleeping;
- Irregular heartbeat;
- Septicemia or anemia;
- High blood potassium levels;
- Bacteremia or infection of the bloodstream;
- Pericarditis, inflammation of the membranes around the heart;
- Anemia or decrease in red blood cells;
- Sudden cardiac death (the leading cause of death in people on dialysis).
Risks associated with peritoneal dialysis
Peritoneal dialysis is associated with an increased risk of infection in or around the catheter site in the abdominal cavity; For example, after a catheter is implanted, a person may experience peritoneal inflammation. Peritonitis is a membrane infection that covers the abdominal wall. Other risks include:
- Stomach ache;
- Weight Gain;
- Weak abdominal muscles;
- High blood sugar due to dextrose in dialysis.
Risks associated with CRRT
Risks associated with CRRT include:
- low blood pressure;
- Electrolyte disturbances;
- Delay in kidney recovery;
- Weakening of the bones.
If you still have these symptoms while on dialysis, tell your doctor who is treating you. People who receive long-term treatment are also at risk for other diseases, including amyloidosis. It occurs when amyloid proteins produced in the bone marrow accumulate in organs such as the kidneys, liver and heart. The disease usually causes joint pain, bruising and swelling.
Some people may also become depressed after being diagnosed with long-term kidney failure. If you have thoughts of depression, such as thoughts of self-harm or suicide, call the emergency room or contact a counselor.
Is there an alternative to dialysis?
This treatment is time consuming and expensive. Not everyone chooses it; Especially if you experience severe acute renal failure.
1. Control of anemia
If you decide not to follow this procedure, there are other treatment options that may help reduce our symptoms. One of these options is to control anemia. When the kidneys are working properly, the hormone erythropoietin (EPO) is produced naturally in the body. You can have an EPO injection every week to compensate for kidney failure.
2. Kidney transplant
Kidney transplantation is another option that is recommended for some people. Talk to your doctor to see if a transplant is right for you. If you have the following conditions, a kidney transplant may not be right for you:
- Excessive alcohol consumption;
- Untreated mental illness.
What type of dialysis can be done at home?
Hemodialysis and peritoneal dialysis can be done at home. Peritoneal dialysis can be done alone; While hemodialysis requires a companion. This companion can be a friend or family member; You can also hire a dialysis nurse. For both types of treatment, you will receive full training from a medical professional in advance.
Who needs dialysis?
If your kidney disease becomes so severe that it does not function well enough to keep your body healthy, you may need a transplant or dialysis. This treatment is usually started on the advice of a doctor when you have symptoms or your tests show high levels of waste products in the blood. Symptoms of kidney failure include nausea, fatigue, swelling, and bloating.
When to start dialysis depends on your age, energy level, general health, test results, and how willing you are to have this treatment program. This method, although it can make you feel better and prolong your life, it takes a lot of time. Your doctor will advise you on when to start and the type of treatment.
What is the long-term vision for someone who needs dialysis?
Not all kidney disorders are permanent. This treatment can temporarily do the same job for the kidneys until the individual’s kidneys repair and start working again. However, in chronic kidney disease, the kidneys rarely heal. If you have this condition, you should have dialysis on a regular basis or until you have a kidney transplant. Lifestyle changes are also essential.
Limit your intake of potassium, phosphorus and sodium during dialysis. This includes sodium in vegetable juices and sports drinks. You should record the amount of fluids you consume. Excess fluid in the body can cause problems. Some sources of fluids are hidden, such as fruits and vegetables such as lettuce and celery. Regular dialysis reduces the need for a kidney transplant.