What is dialysis?
The kidneys are responsible for discharging toxins from the blood. Dialysis is a procedure that can replace part of the duties of kidneys. The kidneys are two bean-shaped organs that are located on either side of the back of the abdominal cavity. Dialysis, by doing the job that kidneys fail to do, can help to reduce the complications of kidney failure and prolong people’s life expectancy.
The kidneys have many roles. An essential one is to regulate the balance of fluid. It does this by regulating the urine that is produced on a daily basis. On hot days, the body sweats more, so less water needs to be discharged by kidneys; on cold days, on the other way round, the body sweats less and more water needs to be removed. The kidneys regulate the fluid balance by regulating urine output. In addition, the kidneys remove waste toxins the body produces in the metabolic process. The wastes accumulate when the kidneys are not functioning adequately. Too much wastes in the body causes a patient to vomit, itchy on their skin, poor in appetite and many other health problems.
While dialysis cleans your blood and removes extra fluid, the kidneys have other functions that can not be replaced by dialysis, such as production of important hormones(e.g, erythropoietin), so there are many drugs that kidney dialysis patients will be prescribed.
When should patients start dialysis?
Patients usually need dialysis when waste levels become so high in their body that they begin to feel very sick from them. The wastes build up in their body slowly. Patients will be tested for several blood chemical levels so that whether dialysis should start will be decided. Doctors will use a urine test, the “creatinine clearance”, to measure the level of kidney functions. The urine will be saved in a special container. Levels of wastes in blood and urine will be compared, and the result—creatinine clearance rate, which give an idea how well the kidneys are working. Usually, dialysis is needed when creatinine clearance rate is 10 to 12cc/m.
Other indicators will also be tested to determine if there is need to start dialysis. If a patient has blood potassium level above 6.5mmol/l, which can cause arrhythmia or other cardiac problems, or if the patient is complaining of problems of lungs, legs, heart and stomach, dialysis may be indicated even if creatinine clearance rate has fallen under 12cc/minute level.
What types of dialysis are there?
There are two main types of dialysis, including hemodialysis, including:
Each of the two types of dialysis has their advantages and disadvantages. The patients can choose the type of dialysis that best matches them after careful communication with the doctors. You may click the link to learn about each of the two types in detail.
Once I am on dialysis, will my kidneys get better?
The chance that the kidneys will get better depends on what caused your kidney failure. Kidney failure is divided into two major categories, acute kidney failure and chronic kidney failure. Acute kidney is usually temporary. Chronic kidney failure means gradual deterioration of the kidneys which usually doesn’t heal.
In acute kidney failure, when kidney function is lost due to a sudden cause, kidney function usually can recover. But when kidney damage is not timely or properly treated and progress over a number of years, as it is in chronic kidney failure, kidneys will also not get better. When chronic kidney failure progresses into end-stage kidney disease, dialysis is an approach for relieving kidney failure complications, but doesn’t improve or repair the failed kidneys, so kidneys don’t get better after dialysis treatment and people have their dialysis intervention shortened over time.
What are the side effects of dialysis?
Kidney dialysis has the benefits in treatment of end-stage kidney failure, however, there are some side effects the patients should know and learn to prevent properly under instructions of a doctor. The following introduce some of the common side effects of kidney dialysis:
Decreased blood pressure
Dialysis patients are at risk of sudden drop in blood pressure, especially if one has Diabetes. The side effects associated with low blood pressure are nausea, vomiting, difficulty breathing and cramping in the stomach.
Red blood cell volume in dialysis patients is usually lower than normal, which is mainly due to reduced levels of erythropoietin, a hormone normally produced by the kidneys to regulate red blood cell production.
This can be detected through normal blood tests conducted on dialysis patients. A variety of vital electrolytes that control a number of bodily process, including potassium, phosphorus, sodium, calcium, etc. Management of electrolytes requires proper dietary adjustments as well as changes of dialyzate based on the individualized condition.
Dialysis patients are generally more susceptible to infections, and the risk is even higher in people with Diabetes. The access point should be kept clean and any sign of infections, such as redness, itching or other problems should be watched for during dialysis treatment.
Patients on hemodialysis for more than five years become vulnerable to amyloidosis. Amyloidosis occurs because hemodialysis doesn’t remove a protein called beta-2 microglobin from the blood, which is a large molecular toxin in blood. Blood purification application can help reduce discharge the toxin thus reducing onset of Amyloidosis.
What if I stop dialysis?
Dialysis is not a cure for kidney failure. Dialysis helps to discharge toxins and excess fluid out of the body, which will help people to live longer. With or without dialysis, the kidneys will continue to fall. If people who are on maintenance dialysis stop it, toxins and fluid can quickly build up in the body, and without management of electrolytes, the result can be fatal. If people seek for alternative treatment, it should be as early as possible.
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