Dialysis is one of the few medical procedures that almost everybody knows about from elders to children. We know that dialysis aids people who have kidney malfunctions but what is this process actually is, how it is conducted and what are the risks to people taking this treatment, etc. are some points that we don’t know much about. In this article, we will take you through the whole process of dialysis, read on to know.
What is dialysis?
First things first, what is dialysis? Dialysis is a treatment that replicates kidney functions when they fail or are unable to function properly. Most of us know that the role of kidneys is to detox the body by eliminating excess fluid and waste in the form of urine and faeces. It sends the waste to the bladder from where it is excreted. When the kidneys fail or in cases where only 15-20% of the kidney is functioning, dialysis is suggested.
Dr. Shrirang Bichu, Nephrologist from Bombay Hospital, Mumbai says, dialysis is conducted using a machine that purifies the blood and filters the impurities. Since the 1940s, dialysis process is being used to treat kidney patients. It helps in balancing electrolytes and fluids to compensate for kidney functions.
What is the need for dialysis?
Working kidneys prevent the accumulation of extra water, water and other impurities in the body as it flushes them out. Besides, kidneys also regulate the levels of chemicals including sodium & potassium; keep blood pressure in control and allow quick absorption of vitamins & minerals in the body. When kidneys are unable to function properly due to either injury or kidney disease, dialysis helps in conducting kidney functions to the maximum extent. If patients don’t get dialysis done regularly, salt may accumulate in the blood which can turn fatal as this may damage other organs as well.
Types of Dialysis
Did you know there are three types of dialysis? Keep reading to know.
This is the most common dialysis process that uses hemodialyzer aka artificial kidney to eliminate extra fluid and waste from the blood. When the blood passes through this machine, it is filtered and purified blood is then returned to the body through the machine. In this dialysis, doctors first make an entry point in the body by conducting surgery. This point allows the artificial kidney to get access to the blood vessels. The three common types of points that doctors create are:
- Arteriovenous (AV) fistula is most preferred as it connects a vein and an artery
- AV graft which is a looped tube
- Vascular access catheter that is connected to the large vein in the patient’s neck
Out of these three, AV fistula and AV graft are for long-term use while the catheter is for temporary or short-term use. Patients can start dialysis in 2-3 months after getting AV fistula whereas AV graft takes only 2-3 weeks to heal and begin the dialysis procedure.
- It takes about 3 to 5 hours for one session of the hemodialysis procedure. Also, this is conducted 2-3 times a week depending upon the health condition of the patient.
- This dialysis is performed only in hospitals, dialysis centers or a doctor’s clinic.
- Duration of dialysis depends on the side of the body of the patient, his current health stat and the amount of waste in the body.
2. Peritoneal dialysis
This type of dialysis involves the implantation of a peritoneal dialysis catheter or PD in the abdomen through the surgical procedure. The role of this catheter is to filter the blood through a thin membrane around the abdomen named peritoneum. When this dialysis is conducted, a special fluid ‘dialysate’ flows in the membrane which carries the waste absorption process. When all the waste is drawn, this fluid is drained from the abdomen.
This is a long process as one session takes hours to complete and the patient needs to conduct 4-6 sessions every day. The main types of peritoneal dialysis are:
- Continuous cycling peritoneal dialysis or CCPD: This dialysis is usually done at night during sleep. It uses a machine to pump the fluid inside and out of the body.
- Continuous ambulatory peritoneal dialysis or CAPD: This method is conducted multiple times in a day and doesn’t require a machine to carry the process. This can only be performed in the awake state.
- Intermittent peritoneal dialysis or IPD: This dialysis is similar to CCPD as it uses the same machine but it takes longer to complete. Also, this can be done at both home and hospital.
3. Continuous renal replacement therapy (CRRT) or Hemofiltration
This type of dialysis is mainly for patients with acute kidney failure. This therapy is conducted when the person is in the ICU and undergoing treatment. With the help of a tube, a machine passes the blood and then a filter flushes out the water and waste products from the blood. After this, the blood is sent back to the body with some additional replacement fluid. This dialysis is performed every day for 12 to 24 hours.
Dialysis Risks and Side-Effects
Dialysis is a life-saving procedure with many benefits but it has got some disadvantages also. All three types of dialysis have a different set of potential risks involved. Let us go through them all one by one.
- Anaemia or insufficient RBC in the blood
- Low blood pressure
- Muscle cramps
- Problem in sleeping or insomnia
- High levels of potassium in the blood
- Irregular heartbeat
- Pericarditis, an inflammation of the heart
- Bacteremia or blood infection
- Cardiac death
Peritoneal Dialysis Risks
- Risk of abdominal infections like peritonitis
- Diabetes or high blood sugar due to dialysate fluid
- Weak abdominal muscle
- Unexplained weight gain
- Stomach pain
- Low blood pressure
- Electrolyte imbalance
- Weak bones
- Delayed recovery from a kidney disease
These were some common risks but there are certain risks that can turn fatal for the person. Dialysis also increases the risk of other conditions such as amyloidosis which is a condition where a protein that is supposed to produce in a bone marrow starts to build up in the heart, liver and kidneys. Another issue that is often overlooked is depression. People who undergo dialysis often deal with depressive thoughts. They are highly likely to slip into depression.
Are there any other treatment options available in place of dialysis?
This is a common query of people whether it is possible to opt for some other treatment method other than dialysis. This is mainly because dialysis is a long-term, time-consuming and expensive process. People who are unable to afford this process want to find a suitable alternative for this. Here are some options that one can consider to alleviate the symptoms but only after talking to their doctor.
- Erythropoietin or EPO injection: This one comes under anaemia management wherein the injection of erythropoietin hormone is given weekly to aid under-functioning kidney(s).
- Blood pressure management: To prevent further kidney damage, one should maintain their blood pressure. One should consume water and healthy fluids to prevent dehydration.
- Kidney Transplant: This is the last option in some cases, however, finding the donor is a difficult task.
Dialysis is a safe and effective treatment for people with kidney failure. It helps in eliminating waste and water from the body thereby preventing damage to other organs. There are different types of dialysis and you can ask your doctor about the best treatment.
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