Dialysis Treatment - Types, Risks & Nutrition Tips

Dialysis Explained: Functions, Effectiveness & Treatment Options

Dialysis is a common treatment that helps remove extra waste products and fluids from the body when the kidneys cannot. Historically, it is a standard treatment procedure for kidney failure. Since 1970, millions of people have been treated by dialysis. There are mainly three types of dialysis, including haemodialysis, peritoneal dialysis, and continuous renal replacement therapy (CRRT).

Introduction

People whose kidneys are not working should undergo dialysis. More than 2 million people in the world receive dialysis treatment and a kidney transplant to stay alive. Dialysis removes muscle waste, nitrogen waste, and other common wastes. In this blog, let us understand the concept of dialysis, why it is needed, its effectiveness, and risks.

Why Do People Need Dialysis?

You need to undergo dialysis treatment if your kidneys stop functioning properly. When you have advanced kidney failure, you might not be able to clean the blood properly. While you are dealing with diabetes, high blood pressure, and lupus, the remaining waste products and fluids can harm your body by causing plenty of unpleasant symptoms.

Healthcare professionals consider kidney failure when you reach stage 5 of kidney disease. At this point, your kidneys cannot function at more than 15% of their normal rate. Dialysis and a kidney transplant are the treatments to keep you alive in this situation.

Effectiveness of Dialysis

Undergoing dialysis can help you treat your kidney problems by clearing the waste products and fluids from your body. However, it cannot replace the kidney functions, so it is not considered a cure for kidney failure or chronic kidney disease. If you do not want to transplant your kidneys, you need dialysis for the rest of your life.

Dialysis restricts the accumulation of waste products and salts in the blood, which protects other organs. Each type of dialysis has different effectiveness, so you should undergo a particular type according to your personal preferences and medical condition. You must discuss this with your doctor and decide which is best for you. In addition, you must follow the below considerations to increase the effectiveness of your dialysis treatment:

• Complete your treatments following your prescribed schedule.
• Consult your dialysis provider for medications or herbal products you are considering taking.
• Discuss with your dialysis provider any health concerns or side effects you may experience.
• Do plenty of physical activity that is possible for you to boost your heart health and strength.
• Stick to the eating plan recommended by your dietitian.
   

What are the Different Types and Functions of Dialysis?

There are two primary types of dialysis to save your life, namely, haemodialysis and peritoneal dialysis. In addition, another therapy is the CRRT therapy, which is for critically ill patients with acute kidney injury, who cannot tolerate the other two types of dialysis. Each of them has a distinct function, benefits, and effect. Let us understand these three types of treatment:

Haemodialysis

The haemodialysis process puts your blood through a filter outside your body. It gets cleaned and returned to you. You can undergo haemodialysis in your home or at a dialysis centre. This procedure of cleansing blood takes three to five hours, and you must undergo it on average three times a week.

The healthcare provider will perform minor surgery to make an entry point to your blood vessels through an arteriovenous (AV) fistula, a vascular access catheter, and an AV graft.

Peritoneal Dialysis

This process includes a peritoneal dialysis catheter in your abdomen to ensure blood filtration. This catheter instills and drains dialysate in the peritoneum, an abdominal membrane. This process of dialysis primarily has two types, which are continuous ambulatory peritoneal dialysis (CAPD) and automated peritoneal dialysis (APD).

The CAPD procedure takes an average of 30 minutes to fill your abdomen and drain it numerous times a day. This process does not need a machine and can be done when awake. The APD process uses a machine that adds a dialysis solution to your peritoneum and drains it. Each of these sessions includes three to five exchanges and is performed when you are asleep.

CRRT

The CRRT can help people when they need intensive care for acute kidney disease, which is also known as haemofiltration. This process includes a machine that passes the blood through tubing. A filter removes the waste products and fluids thereafter. Your blood is returned to the body with a machine, along with replacement fluid. Healthcare providers perform this procedure within a minimum of 24 hours.

How Painful is Dialysis?

The peritoneal dialysis process is not painful, but the addition of dialysis solution to your abdomen can make you feel bloated and uncomfortable. In addition, you may feel a little pain when the needle is inserted into the access site while performing the haemodialysis process.

Risks of Dialysis

All of the dialysis types carry some risks or health complications. Below are the risks associated with haemodialysis, peritoneal dialysis, and CRRT:

Haemodialysis
 

• Hypotension or low blood pressure
• Hypokalaemia or low levels of blood potassium
• Irregular heartbeat
• Sudden cardiac arrest
• Difficulty in sleeping
• Pericarditis, which is an inflammation of the membrane around the heart
• Poor blood flow or a blood clot
   

Peritoneal Dialysis
 

• Weight gain due to dextrose and excessive fluids
• Hernia
• Weakening of the abdominal muscles
• Nausea and vomiting
• Fever
• Stomach pain
• Peritonitis or risk of peritoneal inflammation
   

CRRT

• Delay in renal recovery
• Electrolyte disturbances
• Excessive bleeding
• Hypothermia
• Anaphylaxis
• Weaker bones
• Hypertension or low blood pressure
   

How Long Should I Continue Dialysis?

Dialysis can improve your life by helping you remove the body fluids and wastes when your kidneys are not functioning. You can stop it or not have it at any time you want. Remember, for ESRD, kidney function does not recover. Stopping dialysis leads to death within days/weeks. Discontinuation is an end-of-life decision requiring extensive counseling. AKI may recover, but timing is unpredictable. 

You must also prioritise sharing your feelings, as well as taking antidepressants if you feel you are ashamed or depressed while performing dialysis. You should wait until the malfunctioning of your kidneys has been restored. Stopping dialysis before this can even lead to death.

What Are the Dietary Restrictions You Should Follow in a Dialysis Procedure?

While undergoing dialysis, you must maintain the dietary restrictions and implement a kidney-friendly diet. Limiting fluids, certain foods, and condiments are some restrictions that you must follow to improve your kidney health. Below are the instructions regarding your diet that you must follow during dialysis treatment:

• Avoid food high in salt and sodium.
• Consume less potassium and phosphorus.
• Consume foods rich in protein.
• Restrictions focus on total fluid volume (typically 1,000-1,500 mL/day) and electrolytes (K, P, Na).
   

Final Words

Dialysis is an effective treatment that replaces the functioning of your kidneys when they stop working. Dialysis is not a severely painful treatment. It removes the waste and body fluids from your body. However, dialysis is not for everyone, especially those who are older or have severe medical conditions. Consider contacting a doctor or healthcare provider if you need to undergo dialysis.