When is Dialysis Needed?

Dialysis Explained: When Do Kidney Patients Need It?

Chronic kidney disease is diagnosed when the kidneys fail to function properly. However, various stages of this disease require different treatment options. Dialysis is one such life-saving treatment for kidney patients with permanent kidney failure, which is often the end-stage of chronic kidney disease. 

This guide briefly explains when kidney patients undergo dialysis, its types, guidelines, and side effects. Read on to learn more! 

When Do Kidney Patients Require Dialysis? 

Dialysis is generally considered when eGFR falls below 15 mL/min/1.73 m² in the presence of uremic symptoms or complications, rather than based on eGFR alone. The doctor may also recommend dialysis if you face any serious complications like shortness of breath, fatigue, muscle cramps, nausea, or vomiting. 

To determine if the patient needs dialysis or not, healthcare providers perform these diagnostic tests: 

1. Creatinine Levels Test 

It is also called the creatinine clearance test, which measures the efficiency of kidney function. This test measures the amount of creatinine in the urine and the blood. By comparing these two levels, the doctor can get a fair idea about the efficiency of kidney function. If creatinine clearance falls to 10-12 cc/minute, then the patient needs dialysis. However, creatinine clearance is one of several factors considered, but dialysis initiation depends on clinical symptoms and complications rather than a specific clearance value alone. 

2. Blood Urea Nitrogen (BUN) Level Test 

It is a common blood test to measure the amount of urea nitrogen in the blood. If the urea nitrogen levels are higher than normal, the kidneys are not functioning properly. Generally, 6 to 24 mg/dL is considered the normal range for the BUN test. 

What are the Different Types of Dialysis? 

Chronic kidney disease has five stages, with stage five being categorized as end-stage kidney disease. It is when the kidneys stop functioning completely. In that case, the person must undergo dialysis to filter out waste substances and excessive bodily fluids. There are largely two kinds of dialysis: 

1. Hemodialysis 

This procedure is done with a tube attached to a needle in your arm, through which blood will pass to the outside machine (dialyzer). The dialyzer will filter out the waste substances from the blood and then pass it back to you. This can be done at dialysis centres or at home. A hemodialysis session usually lasts around 4 hours and is done thrice a week. 

2. Peritoneal Dialysis 

In peritoneal dialysis, no external machine or dialyzer is involved. This procedure uses the inner lining of your stomach (peritoneum) as a filter. The peritoneum contains several tiny blood vessels that act like a filtering device. 

A cut is made close to the belly button; using this incision, a long, thin tube called a catheter is inserted into the peritoneal cavity in the stomach. It is then left in place permanently. 

Process of Peritoneal Dialysis    

• Firstly, the dialysis fluid is pumped into the peritoneal cavity through the catheter, allowing blood to pass through the tiny vessels in the peritoneum. 
• The peritoneum filters out toxins and excess bodily fluids from the blood and drains them back into the dialysis fluid. 
• The used fluid is drained out and is substituted with fresh fluid. This procedure needs to be done about four times a day. 
• Changing the dialysis fluid requires around 30 to 40 minutes, but the whole process can be carried out by a machine overnight while you sleep. 

3. Renal Replacement Therapy 

Renal replacement therapy (RRT) includes dialysis (haemodialysis and peritoneal dialysis) as well as kidney transplantation.  It is a life-saving measure carried out slowly over 24 hours a day to filter out impurities and excess fluids from the blood.   

What are the Side Effects of Dialysis? 

Dialysis is a life-saving treatment for kidney patients. However, it also comes with several side effects. Here are the side effects of different kinds of dialysis: 

Side Effects of Hemodialysis Include:

• Skin infections 
• Poor blood flow 
• Blockage of scar tissues 
• Blood clots 
• Anemia 
• Heart attack 

Side Effects of Peritoneal Dialysis Include: 

• Weight gain 
• Skin infection in the area surrounding the catheter 
• An infection called peritonitis results when bacteria enter your abdomen through the catheter. 
• The peritoneal cavity continuously pumps fluid, which may weaken the abdominal muscles and lead to a hernia.

Reader information: This article is intended for informational and educational purposes only and should not be considered a substitute for professional medical advice, diagnosis, or treatment. The information provided is based on general clinical guidelines and may not apply to every individual. Dialysis decisions depend on a patient’s specific medical condition, symptoms, and physician assessment. Readers are advised to consult a qualified nephrologist or healthcare professional for personalized medical advice.

Also Read:

→ Can Kidney Disease be Cured

→ How to Stop Kidney Stone Pain Immediately

→ What are the Signs of Kidney Damage

→ What are the Stages of Chronic Kidney Disease

→ What Food is Good for a Kidney Patient