The kidneys function as a filtration plant in the body, they filter the blood by removing waste and excess fluid from the body. The waste is sent to the bladder and is ultimately removed through the urine. Dialysis is a treatment that filters and purifies the blood using a machine when the normal kidney function has failed. Properly functioning kidneys prevent extra water, waste, and other impurities from accumulating in the body. They also help control blood pressure and regulate the levels of fluids, electrolytes and chemical elements in the blood such as sodium, potassium and they even activate a form of vitamin D that improves the absorption of calcium 

Why dialysis is done

When the proper functioning of the kidney is impaired due to disease or injury, dialysis is required to keep the body functioning normally. Without dialysis, salts and other waste products will accumulate in the blood and cause damage to other organs. .

What are the different types of dialysis?

Hemodialysis:  It’s the most common type of dialysis where a hemodialyzer is used to filter blood. The filtered blood is returned back to body using the dialysis machine. The process usually takes 3-5 hours depending on the patient requirement. Hemodialysis is normally performed at a dialysis centre or hospital.  

Peritoneal dialysis: Peritoneal dialysis involves surgery to implant a peritoneal dialysis catheter into the abdomen. The catheter helps filter the blood through the peritoneum, a membrane in the abdomen. During treatment, a special fluid called dialysate flows into the peritoneum. The dialysate absorbs waste. Once the dialysate draws waste out of the bloodstream, it’s drained from the abdomen. There are several types of Peritoneal Dialysis, the main being: Continuous Ambulatory Peritoneal Dialysis (CAPD), Continuous Cycling Peritoneal Dialysis (CCPD), Intermittent Peritoneal Dialysis (IPD)   

Continuous renal replacement therapy (CRRT): This therapy is used primarily in the intensive care unit for people with acute kidney failure. It’s also known as hemofiltration. A machine passes the blood through tubing. A filter then removes waste products and water. The blood is returned to the body, along with replacement fluid. This procedure is performed daily for 12 to 24 hours a day.  

Preparations for Dialysis

Before the first dialysis session, the doctor surgically implants a tube or device to gain access to the bloodstream. It is advisable to wear comfortable clothing during dialysis treatments and also follow all the doctor’s instructions. These may include fasting for a certain amount of time before the treatment.

What are the risks associated with Dialysis

There are a few risks few risks involved in all forms of dialysis, the nephrologist will make the patient aware of the method and associated risks. These can include : Low blood pressure, anemia, muscle cramping, difficulty sleeping, itching, high blood potassium levels, pericarditis,, sepsis, bacteremia,, irregular heartbeat, sudden cardiac death. Increased risk of in and around the catheter site in the abdomen in case of Peritoneal Dialysis. In case of CRRT the risks can be that of infection, low BP, electrolyte imbalance, bleeding etc 

There is a risk of developing other medical conditions, including amyloidosis for patients who undergo long term dialysis. This disease can occur when amyloid proteins produced in bone marrow build up in organs such as the kidneys, liver, and heart. This usually causes joint pain, stiffness, and swelling.

Future of Dialysis Patients

In chronic kidney disease, the chances of kidneys getting better are very rare. And, the patient has to undergo dialysis permanently or until a kidney transplant is an option. In most cases, patients are able to live near normal lives with dialysis. 

Not all kidney disorders are permanent. Dialysis can temporarily serve the same function as kidneys until the kidneys repair themselves and begin to work on their own again. Even in these cases however, certain lifestyle changes are required. Patient should limit the intake of intake of potassium, phosphorus, and sodium while on hemodialysis. This includes sodium from vegetable juice and sports drinks. Patient may need to keep a record of how much liquid he/she consumes. Having too much fluid in the body can cause problems. Some hidden sources of liquids include fruits and vegetables, such as lettuce and celery. 

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