What is Dialysis?

Dialysis is a treatment for patients whose kidneys have failed. When the patient suffers from kidney failure, his kidneys do not filter blood as they should, allowing wastes and toxins to continue accumulating in the blood. Dialysis assumes the work of the kidneys by removing waste products and excess fluids from the blood.

Who needs dialysis?

Often, people with end-stage renal disease or kidney failure need dialysis. Injury and disease, such as high blood pressure, diabetes, and lupus, also can damage the kidneys and cause kidney disease.

Other people may develop kidney problems for no apparent reason. Kidney failure may be a long-term condition, but it also can come on suddenly (acute) as a result of a severe illness or injury. This type of kidney failure may resolve as you recover.

Kidney disease is divided into five stages. Health care professionals classify patients with stage 5 kidney disease as having end-stage renal disease, or ESRD, or kidney failure. The kidneys currently perform between 10% and 15% of their typical functions. To survive, you could require kidney transplantation or dialysis. Dialysis is a treatment some patients receive while awaiting a transplant.

What are the functions of the kidneys?

Your kidneys are an organ in your urinary system. These are two bean-shaped organs that lie below your ribcage on either side of your spine. These organs clean toxins out of your blood, then send back the remaining nutrient-rich blood into the bloodstream.

It forms urine by waste and excess water and flows from your kidneys to your bladder. The kidneys also assist in controlling the blood pressure in your body.

What are the types of dialysis?

There are two ways to get dialysis:

Hemodialysis.
Peritoneal dialysis.

What is hemodialysis?

During hemodialysis, a machine removes blood from your body. It passes through a dialyzer artificial kidney- to remove wastes, minerals, and excess water, which then returns to your body. This 3- to 5-hour procedure may be done thrice a week in a hospital or dialysis center.

You can also do hemodialysis at home. You may have to have your treatments at home four to seven days a week for several hours a day. You might prefer doing nocturnal night home hemodialysis, allowing you to perform your treatment at night and sleep through it.

What leads up to hemodialysis?

Before you start having hemodialysis, you will receive a minor surgical procedure that prepares a location by which your blood can be accessed easily. You may experience:

Arteriovenous fistula (AV fistula): A surgeon attaches an artery and vein in your arm.
Arteriovenous graft (AV graft): If the artery and vein are not long enough to attach directly, your surgeon will attach a graft to clamp them. An AV fistula and AV graft enlarge the attached artery and vein, making dialysis access easier and allowing blood to move into and out of your body more quickly.

If dialysis is essential soon, your doctor can insert a catheter, a thin tube, into a vein in your neck, chest, or leg for temporary access.

Your physician will guide you on avoiding infections in your fistula or graft. In addition, the physician will train you on hemodialysis at your home if that is your preference.

What happens in hemodialysis?

For the time you are undergoing hemodialysis, the dialysis machine:

Draws blood out from a cannula stuck in the arm
Pumps blood from the body through the dialyzer filter, where waste products are transferred to the dialysis solution. This cleaning fluid contains water, salt, and other additives
Returns the cleaned blood into the body using the other cannula in the arm.
Takes blood pressure measures to regulate how fast the blood is pumped into and out of the body.

What happens after hemodialysis?

For example, you may have low blood pressure while on hemodialysis or at least within a few minutes. You may develop nausea, dizziness, or even faint.

Other side effects of hemodialysis are:

You feel pain in your chest or back.
You have headaches
You have an itching sensation on your skin
You experience muscle cramps
Restless legs syndrome

What is peritoneal dialysis?

In the case of peritoneal dialysis, it involves minute blood vessels in the lining of the abdomen filtering the blood through a solution dubbed dialysis solution. The essence of this solution is essentially a form of washing liquid that consists of water, salt, and additives.

Peritoneal dialysis can take place at home. There are two ways of undergoing this treatment:

Automated peritoneal dialysis utilizes a machine called a cycler.
CAPD is actually done manually in the form of continuous ambulatory peritoneal dialysis.

What are the steps before peritoneal dialysis?

Three weeks before you start peritoneal dialysis, you will have a minor surgery. A surgeon inserts a soft, thin flexible tube, called a catheter, into your stomach through your belly and down to the peritoneum. The catheter will stay there permanently.

A health professional will instruct you on how to perform peritoneal dialysis at home, as well as measures for preventing infections at the catheter site.

What is involved in peritoneal dialysis?

During peritoneal dialysis, you: Attach the catheter to one limb of a Y-shaped tube. The tube contains a bag of dialysis solution. The solution moves through the tube and catheter and into the peritoneal cavity.

Disconnect the tube and catheter approximately 10 minutes after the bag is empty.
Cover the catheter.
You can resume your usual activities during this period. The fluid infusing dialysis solution within the peritoneal cavity will drain excess fluids and wastes from your body, which will take about 60 to 90 minutes.
Remove the cap on the catheter. Use the other leg of the Y-shaped tube to guide the fluid into a clean, empty bag.
Do it up to four times a day. You sleep with solution in your stomach all night.
Some people have peritoneal dialysis at night. With automatic peritoneal dialysis, a cycler performs the cycle of taking fluids in and out of the body during your sleep.

What happen after peritoneal dialysis?

You may feel swelling or bloating in your tummy because of the fluid. It is unpleasant sometimes but not painful to treat. Your tummy may appear swollen when fluid is within it.

What are the potential complications or side effects of hemodialysis?

Some patients do not experience any issue with their AV fistula or graft. You can experience an infection or scar tissue or blood clotting which leads to poor flow or a blockage.

Sometimes, the dialysis needle or tube comes out of your arm during dialysis. A blood leak detection system notifies you and medical staff of this issue. Then, the machine shuts off automatically until someone corrects the problem. This system prevents blood loss.

What are the risks or complications of peritoneal dialysis?

Some patients develop skin infections around the catheter. You are also at risk of a condition referred to as peritonitis. This infection is established in your abdomen when bacteria enter the system through the catheter. You are expected to develop fever, abdominal tenderness, nausea, and vomiting.

Sometimes, if you are using an abdominal catheter and pumping your belly full of fluid, you may inadvertently weaken your abdominal muscles over time. You may be prone to a hernia, a condition in which an organ, such as the small intestine, pokes through the abdominal muscles. Sometimes, you might feel bulging in the groin area, or between your upper thigh and abdomen, or at the navel. Surgery is one of the ways your doctor can treat hernia.

While on peritoneal dialysis, your body absorbs the dextrose included in the dialysis solution as a sugar. You will eventually gain weight from this excess sugar over time.

What is the outlook-prognosis for someone on dialysis?

You may be able to survive as long as 10 to 20 years on dialysis. Prognosis varies according to your age, overall health, cause of kidney failure, and other factors. Once you have been started on a transplant, you can avoid dialysis if the kidney from the transplant will work normally.

Will I be limited in my activities while I am on dialysis?

Even people with end-stage renal disease can remain active—many of them work, raise their families, and travel. If you travel, your healthcare provider can arrange for you to receive dialysis at a center at your destination. If you are doing either of the two types of home dialysis, you can take the bags of dialysis solution with you and the portable home dialysis machine if needed.

Individuals on peritoneal dialysis may have to limit or avoid particular physical activities or exercise when their abdomen is filled with dialysis solution. For most other purposes, for example, exercise is not usually a problem for individuals undergoing dialysis. Ask your healthcare provider if you may participate in specific activities or sports.

When to contact the doctor?

You should contact your healthcare provider if you have:

Nausea and vomiting.
Trouble urinating.
Dizziness, fainting, unusual thirst (dehydration) or other symptoms of low blood pressure.
Fever or oozing and redness at the AV fistula or catheter site
Severe, severe pain in the abdomen
Swelling of an unusual nature in the abdomen or groin area, this is known as a hernia.

Why choose Tender Palm Super-Speciality Hospital for Dialysis in Lucknow, India?

Tender Palm Super-Speciality Hospital is one of the best hospitals for Dialysis in Lucknow, India. Our experienced Nephrologists uses advanced technology, and provides patient-focused care, the hospital ensures safer procedures, quicker recovery, and improved long-term outcomes.