You have two bean-shaped kidneys on both sides of your spine just below your rib cage. Their function is to extract waste and fluid from your body, level your blood pressure, and keep your bones healthy. They also ensure that you have the right amount of nutrients in your blood. Finally, they make a hormone that causes your body to develop red blood cells. But when this function deteriorates, we may need dialysis. Let’s find out how dialysis works.
What’s dialysis?
Your kidneys filter your blood by eliminating waste and extra fluid from your body. This waste then leaves the body as urination through the bladder.
Dialysis serves the function of the kidneys if they have failed. According to the National Kidney Foundation, end-stage kidney failure happens when the kidneys perform just 10 to 15% of their normal function.
It is a procedure that filters and purifies the blood by the usage of a machine. This helps keep your fluids and electrolytes in balance. Doctors use this when your kidneys can’t do their job.
Doctors use dialysis to treat patients with kidney disorders since the 1940s.
Why do we need dialysis?
Properly working kidneys prevent additional water, waste, and other impurities from collecting in the body. They also help monitor blood pressure and manage the level of chemical elements in the blood. So, these can include sodium and potassium. Your kidneys also trigger a form of vitamin D that improves the absorption of calcium.
Suppose your kidneys cannot perform these tasks due to illness or injuries. Then dialysis can help keep your body working as normally as possible. Although without dialysis, salts and other waste materials accumulate in the blood, poison the body. They may even destroy other organs.
However, dialysis is not a treatment for kidney disease or other kidney disorders. Doctors may suggest different treatments to address these concerns.
What are the dialysis types? How do they work?
There are 3 main types of dialysis:
- Hemodialysis
- Peritoneal dialysis
- Continuous renal replacement therapy
How hemodialysis works?
Hemodialysis uses an external machine and a special filter form. It extracts excess waste materials and water from the blood.
During hemodialysis, blood flows from the patient’s body to the dialysis system through the sterile tube. And then through a dialysis membrane filter. The patient has a specialized vascular tube implanted in the arm or leg between the artery and the vein for this procedure.
There is a direct link between the artery and the vein in the arm called the Cimino fistula. Then doctors place the needles in the graft or fistula. The blood then passes through the dialysis machine, with the filter, and back to the patient. Suppose the patient needs dialysis before the doctor places the graft or fistula. In that case, a large diameter catheter is placed directly into a large vein in the neck or leg for dialysis. The solution on the other side of the filter receives the patient’s waste products in the dialysis machine.
How peritoneal dialysis works?
Peritoneal dialysis requires fluid inserted in the patient’s abdominal cavity through a plastic tube. It removes excess waste materials and fluid from the body.
Peritoneal dialysis uses the body tissue of the patient inside the abdomen to filter. The abdominal cavity is lined with a particular membrane called the peritoneal membrane. Doctors insert a plastic tube called a peritoneal dialysis catheter into the abdominal wall. The abdominal cavity is then flushed with a special fluid called the dialysate and washed around the intestines. The peritoneal membrane serves as a filter between the fluid and the bloodstream. Waste materials and excess water may extract from the body through this process.
How Continuous renal replacement therapy (CRRT) works
This treatment is used mainly in the intensive care unit for patients with acute kidney failure. It is also known as hemofiltration. The machine transfers the blood into the tube. Then the filter extracts waste materials and water. The machine then returns the blood to the body. This procedure is performed 12 to 24 hours a day, usually every day.
Are there any risks associated with dialysis?
Although these 3 types of dialysis can save your life, they still carry some risks.
Risks related to hemodialysis
Risks of hemodialysis include:
- Bacteremia, or a bloodstream infection
- Irregular heartbeat
- Sudden cardiac death, the leading cause of death of undergoing dialysis
Risks related to peritoneal dialysis
Peritoneal dialysis is associated with an elevated risk of infection at or around the abdominal cavity. For example, after the implantation of a catheter, a person can experience peritonitis. Peritonitis is an inflammation of the abdominal wall.
Other risks shall include:
- Abdominal muscle weakening
- High blood sugar because of the dextrose in the dialysate
- Weight gain
- Hernia
- Fever
- Stomach pain
Risks associated with CRRT
The risks associated with CRRT include:
- Infection
- Hypothermia
- Low blood pressure
- Electrolyte disturbances
- Bleeding
- Delayed renal recovery
- Weakening of bones
- Anaphylaxis
If you continue to have these problems while on dialysis, tell the doctor who is performing the treatment.
Many are still at risk of developing other medical problems, including amyloidosis. This condition can occur when amyloid proteins produced in the bone marrow build up in organs such as the kidneys, liver, and heart. Usually, this causes joint pain, irritation, and swelling.
Some patients can also develop depression after a diagnosis of long-term kidney failure. Suppose you’re worried about depression, such as thinking about hurting yourself or committing suicide. Then please contact the nearest emergency services. The National Association for Mental Disorders can also support you in dealing with depression.
What’s the life expectancy for those who are on dialysis?
The expected lifetime of patients undergoing dialysis in the United States Renal Data System (USRDS) was approximately 8 years for dialysis patients aged 40 to 44 years and approximately 4.5 years for those aged 60 to 64 years. This is a highly variable set that depends on a number of factors, such as:
- Race
- Age of the patient
- Quality of dialysis treatment
- Other medical issues in the patient (comorbidities)
- Quality of pre-dialysis treatment
- Control of potassium levels
- Overall compliance of the patient
Some people use dialysis as a bridge (time to find the appropriate donor kidney) to get a kidney transplant. Suppose a patient succeeds in getting a kidney and can stop the dialysis. Then the survival prognosis can increase significantly.
The Bottom Line
If you are thinking of stopping your dialysis, ask your doctor to monitor your blood pressure. These tests can help to determine whether the dialysis is successful.
Tell your doctor of any concerns before stopping treatment. It is your right to stop the treatment at any moment. But, talk to a mental health specialist before you finish your life-saving treatment.
