Are your kidneys functioning normally as they should? If not, this might lead you to kidney failure or End-Stage Renal Disease (ESRD), where the only options you are left with are either dialysis or a kidney transplant. Dialysis is a painless treatment, but each treatment has its drawbacks. Let’s learn about dialysis, its types, how it works, and its procedure in this article.

Charnock Hospital’s Dialysis department is equipped with modern facilities that promise you the best dialysis experience by following International protocols and safety standards. We have full-time consultants, Nephrologists, and expert hemodialysis technicians to offer you advanced nephro care. Book an appointment now to get the expert care you need.

What is dialysis?

Dialysis, a life-saving treatment, is chosen when the kidneys fail to function normally. In kidney failure, your kidneys stop purifying the blood causing the excess wastes and toxins to accumulate. Dialysis works as a replacement for your kidneys separating the toxins and excess water from the blood.

What are the types of dialysis?

The two types of dialysis are:

• Hemodialysis
• Peritoneal dialysis. 

These dialysis methods perform the same functions as the kidneys: removing impurities from the blood and regulating blood pressure.

What is hemodialysis?

In hemodialysis, a machine takes over the role of a healthy kidney to remove impurities such as wastes, excess salts, and fluids from the blood. 

How does hemodialysis work?

In Hemodialysis, blood is removed from your body, filtered through a dialyzer, and returned as purified blood to your body. Duration of this takes up to 3 to 5 hours and can be done weekly thrice in a hospital or a dialysis center.

Before initiating hemodialysis, a minor surgical procedure is done by your surgeon for easy access to the bloodstream. 

• Arteriovenous fistula (AV fistula): This surgical procedure connects an artery and vein in your arm.
• Arteriovenous graft (AV graft): The surgeon uses a graft (tube) to connect the artery and vein if they are shorter.

These minor surgical procedures help the connected artery and vein to expand, making the dialysis process easier by fastening the blood flow in and out of the body.

The technician provides you with instructions to prevent infections in your fistulas. Also, he or she will demonstrate how to do hemodialysis, if you prefer to do it at home. At home, hemodialysis has to be done four to seven times a week for a few hours. You can do it at night while sleeping too.

In hemodialysis, the machine works as follows:

• A needle in one arm of yours will remove the blood.
• This blood is collected in the dialyzer (artificial kidney), where the impurities are separated into a dialysis solution, a liquid containing water, salt, and other additives that act as a cleanser.
• The filtered blood is returned through another arm into your body.
• The machine also monitors your blood pressure to adjust the blood flow in and out of your body.

Hemodialysis might cause some side effects, which are subjective to the individual. People might experience low blood pressure during or after the procedure. Some common side effects are nausea, dizziness, chest pain, headache, itchy skin, muscle cramps, etc.

Some people might see complications with hemodialysis such as infections at the fistula site, obstructed blood flow due to a blood clot, etc. There are few chances of a needle disconnecting from your arm, or a tube coming off from the machine. In this case, a system detects the blood leak caused and alerts you or the dialysis technician. Then to prevent your blood loss, the machine stops temporarily until it is fixed by someone.

What is peritoneal dialysis?

In peritoneal dialysis, a machine takes over a healthy kidney to remove impurities such as wastes, excess salts, and fluids from the blood. This process is similar to hemodialysis, but the site of dialysis is the peritoneum (abdominal lining).

How does peritoneal dialysis work?

Peritoneal dialysis works by filtering the blood with a dialysis solution, through the tiny blood vessels of the peritoneum. This solution is a cleansing liquid that contains water, salts, and other additives. There are two ways to do peritoneal dialysis at home:

• Automated peritoneal dialysis 
• Continuous ambulatory peritoneal dialysis (CAPD) 

Three weeks before initiating peritoneal dialysis, a minor surgical procedure is performed by a surgeon where he inserts a catheter (tube) into your belly and the peritoneal cavity. This stays there permanently. The dialysis technician will demonstrate how to do it at home and to prevent infections at the catheter site.

In peritoneal dialysis:

• The catheter is connected to one end of a Y-shaped tube. This tube leads to a dialysis solution bag. This solution flows through the tube and catheter into the peritoneal cavity.
• When the dialysis solution bag gets empty after 10 minutes, disconnect the tube and catheter. Close the catheter.
• Perform your routine activities, while the solution in the peritoneum absorbs wastes and extra fluids in your body. This process can take up to 60 to 90 minutes.
• Use the other end of the Y-shaped tube to drain the fluid into a clear bag by removing the cap from the catheter.
• Follow these steps four times a day. 

During peritoneal dialysis, the abdomen fills with dialysis solution, so avoid doing any physical activity. Otherwise, you can exercise normally. It’s better to get expert advice on physical activity.

In automated peritoneal dialysis, a machine known as a cycler forces the fluid in and out of the body while you sleep. Accumulation of excess fluid in the belly can make you feel bloated. This can be uncomfortable, but the treatment doesn’t cause any pain. 

Infections at the catheter site, peritonitis (inflammation of the peritoneum), fever, abdominal pain, nausea and vomiting, hernia, weight gain, etc. are some common complications of peritoneal dialysis.

The outcome for someone on dialysis varies based on their age, cause of kidney failure, health status, and other factors. You can replace the dialysis with getting a kidney transplant, which will carry on its normal functions.

Dialysis will not stop you from leading an active life, performing regular activities, and enjoying traveling. If you want to travel, discuss it with your medical professional, so he or she will arrange for you to get dialysis at a center in a new location. If you are doing self-dialysis, remember to carry dialysis solution pouches and the portable home dialysis machine, if needed.