Dialysis - Everything you need to know

Dr Sanjeev Gulati *

Hemodialysis schematic : Simplified hemodialysis circuit. :: Pix - Wikipedia/YassineMrabet

Chronic kidney disease (CKD) is the irreversible deterioration of renal function that gradually progresses to end stage renal disease (ESRD). CKD has emerged as a serious public health problem. It ie believed 10- 13% people in general population have varying sages of CKD.

When is dialysis needed?

You need dialysis when you develop Stage 5 kidney disease or end stage kidney failure —usually by the time you have less than 10 % kidney function left. Prior to that u can manage with medicines under supervision of nephrologist.

What does dialysis do?

Like healthy kidneys, dialysis keeps your body in balance.

Dialysis does the following:
* removes waste, salt and extra water to prevent them from building up in the body
* keeps a safe level of certain chemicals in your blood, such as potassium, sodium and bicarbonate
* helps to control blood pressure

Will dialysis help cure the kidney disease?

No. Dialysis does some of the work of healthy kidneys, but it does not cure your kidney disease. You will need to have dialysis treatments for your whole life unless you are able to get a kidney transplant.

What are different types of Dialysis?

There are 2 types of dialysis hemodialysis or blood dialysis and peritoneal dialysis or water dialysis. Hemodialysis is performed by at specialized dialysis centres by trained technicians, whereas peritoneal dialysis can be done at home. While hemodialysis can be done 2-3 times week, peritoneal dialysis has to be done daily. Peritoneal dialysis is especially suitable for people living in remote areas or in those cities where hemodialysis is not available.

Is dialysis uncomfortable?

You may have some discomfort when the needles are put into your fistula or graft, but most patients have no other problems. The dialysis treatment itself is painless. However, some patients may have a drop in their blood pressure. If this happens, you may feel sick to your stomach, vomit, have a headache or cramps. With frequent treatments, those problems usually go away.

How long has dialysis been available?

Hemodialysis and peritoneal dialysis have been done since the mid 1940's. Dialysis, as a regular treatment, was begun in 1960 and is now a standard treatment all around the world. CAPD began in 1976. Thousands of patients have been helped by these treatments.

How long can you live on dialysis?

We do not yet know how long patients on dialysis will live. We think that some dialysis patients may live as long as people without kidney failure.Howevr on an average out of 100 people who start dialysis about 40 would be live after 5 years.As compared to this 70 out of 100 kidney transplant recipients would be alive after 5 years posttransplant.

Is dialysis expensive?

Yes. Dialysis costs a lot of money. However it is a life saving treatment and hence needs to be continues until one gets kidney transplant.Infcat kidney transplant works out cheaper than dialysis as the cost of kidney transplant is less than the amount of money a patient swould spend on dialysis in a year.

Dialysis centers are located in all major hospitals. The treatment is standardized. In case u are going to another city, you must make an appointment for dialysis treatments at another center before you go. The staff at your center may help you make the appointment.

Can dialysis patients continue to work?

Many dialysis patients can go back to work after they have gotten used to dialysis. If your job has a lot of physical labor (heavy lifting, digging, etc. ), you may need to get a different job.

What is new in Dialysis ?

A miniaturized dialysis machine that can be worn as a belt, the WAK concept allows patients with end stage renal failure the freedom to engage in daily activity while undergoing uninterrupted dialysis treatment. There are many benefits to the automated, wearable artificial kidney, or AWAK. Foremost is that rather than spending hours on a machine several times a week; much like a regular kidney, the AWAK functions continuously.

This will allow patients to go about their lives in a much more unaffected manner than presently available. Another is the efficiency of the device. Typically, dialysate, the fluid of pollutants and other chemicals removed from blood during dialysis, is simply disposed. The AWAK can reuse the fluid and proteins contained in the dialysate, reducing protein and eliminating water loss during the filtration process.

"Dialysis-on-the-go, made possible by AWAK's 'wearability' and automation, frees end-stage renal failure patients from the servitude that is demanded by the current dialytic regimentations," stated Robert and Lee in a Clinical and Experimental Nephrology article about the device. Certainly the device will improve the quality of life for many dialysis patients should it see widespread use.

A miniaturized dialysis machine that can be worn as a belt, the WAK concept allows patients with end stage renal failure the freedom to engage in daily activity while undergoing uninterrupted dialysis treatment. There are many benefits to the automated, wearable artificial kidney, or AWAK.

Foremost is that rather than spending hours on a machine several times a week; much like a regular kidney, the AWAK functions continuously. This will allow patients to go about their lives in a much more unaffected manner than presently available. Another is the efficiency of the device. Typically, dialysate, the fluid of pollutants and other chemicals removed from blood during dialysis, is simply disposed. The AWAK can reuse the fluid and proteins contained in the dialysate, reducing protein and eliminating water loss during the filtration process.

"Dialysis-on-the-go, made possible by AWAK's 'wearability' and automation, frees end-stage renal failure patients from the servitude that is demanded by the current dialytic regimentations," stated Robert and Lee in a Clinical and Experimental Nephrology article about the device. Certainly the device will improve the quality of life for many dialysis patients should it see widespread use.