Kidney Dialysis:
Dialysis is a treatment that does some of the things done by healthy kidneys.
It is needed when your own kidneys can no longer take care of your body's needs.
When is dialysis needed?
You need dialysis when you develop end stage kidney failure --usually by the
time you lose about 85 to 90 percent of your kidney function.
What does dialysis do?
Like healthy kidneys, dialysis keeps your body in balance. Dialysis does the
following:
removes waste, salt and extra water to prevent them from building up in the
body
keeps a safe level of certain chemicals in your blood, such as potassium,
sodium and bicarbonate
helps to control blood pressure
Is kidney failure permanent?
Not always. Some kinds of acute kidney failure get better after treatment. In
some cases of acute kidney failure, dialysis may only be needed for a short
time until the kidneys get better.
In chronic or end stage kidney failure, your kidneys do not get better and you
will need dialysis for the rest of your life. If your doctor says you are a
candidate, you may choose to be placed on a waiting list for a new kidney.
Where is dialysis done?
Dialysis can be done in a hospital, in a dialysis unit that is not part of a
hospital, or at home. You and your doctor will decide which place is best,
based on your medical condition and your wishes.
Are there different types of dialysis?
Yes, there are two types of dialysis --hemodialysis and peritoneal dialysis.
What is hemodialysis?
In hemodialysis, an artificial kidney (hemodialyzer) is used to remove waste
and extra chemicals and fluid from your blood. To get your blood into the
artificial kidney, the doctor needs to make an access (entrance) into your
blood vessels. This is done by minor surgery to your arm or leg.
Sometimes, an access is made by joining an artery to a vein under your skin to
make a bigger blood vessel called a fistula.
However, if your blood vessels are not adequate for a fistula, the doctor may
use a soft plastic tube to join an artery and a vein under your skin. This is
called a graft.
Occasionally, an access is made by means of a narrow plastic tube, called a
catheter, which is inserted into a large vein in your neck. This type of access
may be temporary, but is sometimes used for long-term treatment.
How long do hemodialysis treatments last?
The time needed for your dialysis depends on:
how well your kidneys work
how much fluid weight you gain between treatments
how much waste you have in your body
how big you are
the type of artificial kidney used
Usually, each hemodialysis treatment lasts about four hours and is done three
times per week.
A type of hemodialysis called high-flux dialysis may take less time. You can
speak to your doctor to see if this is an appropriate treatment for you.
What is peritoneal dialysis and how does it work?
In this type of dialysis, your blood is cleaned inside your body. The doctor
will do surgery to place a plastic tube called a catheter into your abdomen
(belly) to make an access. During the treatment, your abdominal area (called
the peritoneal cavity) is slowly filled with dialysate through the catheter.
The blood stays in the arteries and veins that line your peritoneal cavity.
Extra fluid and waste products are drawn out of your blood and into the
dialysate. There are two major kinds of peritoneal dialysis.
What are the different kinds of peritoneal dialysis and how do they work?
There are several kinds of peritoneal dialysis but two major ones are:
Continuous Ambulatory Peritoneal Dialysis (CAPD) and Continuous Cycling
Peritoneal Dialysis (CCPD).
Continuous Ambulatory Peritoneal Dialysis (CAPD) is the only type of peritoneal
dialysis that is done without machines. You do this yourself, usually four or
five times a day at home and/or at work. You put a bag of dialysate (about two
quarts) into your peritoneal cavity through the catheter. The dialysate stays
there for about four or five hours before it is drained back into the bag and
thrown away. This is called an exchange. You use a new bag of dialysate each
time you do an exchange. While the dialysate is in your peritoneal cavity, you
can go about your usual activities at work, at school or at home.
Continuous Cycling Peritoneal Dialysis (CCPD) usually is done at home using a
special machine called a cycler. This is similar to CAPD except that a number
of cycles (exchanges) occur. Each cycle usually lasts 1-1/2 hours and exchanges
are done throughout the night while you sleep.
Will dialysis help cure the kidney disease?
No. Dialysis does some of the work of healthy kidneys, but it does not cure
your kidney disease. You will need to have dialysis treatments for your whole
life unless you are able to get a kidney transplant.
Is dialysis uncomfortable?
You may have some discomfort when the needles are put into your fistula or
graft, but most patients have no other problems. The dialysis treatment itself
is painless. However, some patients may have a drop in their blood pressure. If
this happens, you may feel sick to your stomach, vomit, have a headache or
cramps. With frequent treatments, those problems usually go away.
How long has dialysis been available?
Hemodialysis and peritoneal dialysis have been done since the mid 1940's.
Dialysis, as a regular treatment, was begun in 1960 and is now a standard
treatment all around the world. CAPD began in 1976. Thousands of patients have
been helped by these treatments.
How long can you live on dialysis?
We do not yet know how long patients on dialysis will live. We think that some
dialysis patients may live as long as people without kidney failure.
Is dialysis expensive?
Yes. Dialysis costs a lot of money. However, the federal government pays 80
percent of all dialysis costs for most patients. Private health insurance or
state medical aid also help with the costs.
Do dialysis patients feel normal?
Many patients live normal lives except for the time needed for treatments.
Dialysis usually makes you feel better because it helps many of the problems
caused by kidney failure. You and your family will need time to get used to
dialysis.
Do dialysis patients have to control their diets?
Yes. You may be on a special diet. You may not be able to eat everything you
like, and you may need to limit how much you drink. Your diet may vary
according to the type of dialysis.
Can dialysis Patients travel?
Yes. Dialysis centers are located in every part of the United States and in
many foreign countries. The treatment is standardized. You must make an
appointment for dialysis treatments at another center before you go. The staff
at your center may help you make the appointment.
Can dialysis patients continue to work?
Many dialysis patients can go back to work after they have gotten used to
dialysis. If your job has a lot of physical labor (heavy lifting, digging, etc.
), you may need to get a different job.
Information By: National Kidney Foundation.
