Dialysis is a medical treatment that serves as an intervention for kidney failure. When a patient’s glomerular filtration rate (GFR), or the measurement of how much blood their kidneys can filter per minute, is less than 15—meaning that they’ve lost between 85 per cent and 90 per cent of their kidney function—dialysis is typically recommended as a last recourse.
Patients whose chronic kidney failure has progressed into end-stage renal disease (ESRD) are expected to prepare for dialysis, especially if they suffer from additional health complications like hypertension and diabetes. But the treatment may also be required for a short time before a kidney transplant or after the surgery is done, while the patient waits for their new kidney to acclimatize to the rest of their body.
The prospect of kidney dialysis may be daunting to some, but more knowledge of the procedure and what it entails may help to quell a patient’s anxieties. If you’re due to start your own dialysis sessions soon, here’s a briefer on what to expect and how to prepare for your treatment.
What Is Kidney Dialysis Meant to Do?
In essence, dialysis is meant to take care of processes that are naturally conducted by the human kidneys when they’re healthy. Such processes include the following:
- Getting rid of waste, salt, and toxins that would otherwise build up in the person’s system and threaten their overall health
- Balancing out the amounts of sodium, bicarbonate, potassium, and phosphorus in the patient’s body so that these can return to healthy levels
- Removing extra fluid from the patient’s body and normalizing their blood pressure as a result
In the face of permanent kidney failure, in which the kidneys cannot be depended on to fulfill these functions reliably, a patient will need to undergo dialysis on a regular basis. But for reversible cases of renal failure, dialysis may only be needed until the kidneys properly heal. The frequency of dialysis, as well as the type of treatment the patient must undergo, depends on the severity of their condition.
What Happens During Dialysis?
There are two types of dialysis that a patient with kidney failure may go through, with the key difference being the method used to extract toxins. The first type is called haemodialysis, which uses a machine called a dialyser to help extract toxic substances from the blood. The second type is called peritoneal dialysis, which utilizes the peritoneal lining of the abdomen for the purification process.
Haemodialysis
To commence haemodialysis, doctors need to determine a vascular access site for the procedure. They will join an artery and vein either through an arteriovenous (AV) graft under the patient’s skin or through an AV fistula under the skin of the patient’s arm. Next, the medical team will connect two needles to the patient’s graft or fistula so that their blood can go through the dialyser.
The patient’s unfiltered blood will go through the first needle into the dialyser’s filtering fibers, which will remove waste products and excess fluid, and through dialysate, a solution which absorbs undesirable substances from the blood. The purified blood will then flow back into the second needle and into the access site, returning to the patient’s body. At the end of the procedure, the needles will be removed and the patient’s skin will be safely bandaged.
Peritoneal Dialysis
Peritoneal dialysis is also referred to as an “exchange.” Unlike haemodialysis, this type of dialysis does not involve the external removal of blood from the patient’s body. Instead, a soft catheter is inserted into the patient’s abdomen near their navel so that dialysate can enter directly into their bloodstream.
The dialysate stays in the patient’s body for a period determined by the doctor, where it facilitates continuous filtration of waste products and excess fluids through the peritoneal membrane. These are subsequently drained out of the body and into a disposable waste collection bag.
Other Details Pertaining to Dialysis
Dialysis usually takes a few hours to complete, although some patients are recommended to undergo nocturnal or overnight dialysis as they sleep. Both types of dialysis can be done at a hospital, clinic, or health center. It may also be an option for the patient to do home dialysis, which is likely to be both more comfortable and more convenient for them.
How to Prepare for Your Upcoming Dialysis Sessions
Whether you’re expecting to undergo haemodialysis or peritoneal dialysis, there are a few things you should do to ensure the success of the procedure. Here are some important reminders to observe before you begin your dialysis:
Make sure to go over your treatment plan with your doctor and see how much time every week you need to dedicate to your dialysis sessions. This should give you an idea of how much you’ll need to spend for the treatment, as well as how often you’ll need to travel if you’ll be doing your dialysis outside your home.
Once you begin your dialysis, pay special attention to how your body is behaving. Side effects like low blood pressure, nausea, and fatigue are common, but you must consult a doctor if you experience anything more serious. Be particularly vigilant about potential infections, especially in the area where your graft or fistula is. Contact your nephrologist if you suspect that you have an infection and are experiencing symptoms like feverishness and erythema or red rashes.
Knowing that dialysis cannot permanently replace a fully functional kidney, remain conscientious about your health throughout the duration of your dialysis sessions. Eat healthy food, don’t be remiss in taking any medications your nephrologist has prescribed you, and get sufficient rest before each session.
Going through dialysis can be nerve-wracking at first, but it will be a significant step toward addressing your kidney problems and improving your overall health. If you have any further questions or concerns about your dialysis, don’t hesitate to bring them up to your nephrologist and to the medical staff who’ll oversee your treatment.
