Healthy kidneys filter waste and excess fluid from your blood in the form of urine. They also produce hormones that aid your body functioning.
When your kidneys lose functioning, dialysis is required to perform the function of the kidneys externally through a machine. You can consult our dialysis specialist in Ahmedabad, Dr Ravi Bhadania to know more about the procedure required for you.
There are two different types of dialysis –
- hemodialysis and
- peritoneal dialysis
When do you need dialysis?
When only 10-15 percent of kidney functioning remains and it can no longer eliminate waste and unwanted fluid from the body, dialysis is required. Alfa Kidney Care, your dialysis centre in Ahmedabad can help you diagnose when you need to start dialysis.
How does hemodialysis work?
In Hemodialysis, the blood is pumped out from your body through a flexible tube inserted into the vein; this tube is called a catheter. To insert this tube, your nephrologist will make a small incision under local Anesthesia. The catheter feeds your blood into an artificial kidney called a dialyzer. The filtered blood is returned to the patient through the catheter.
How does the dialyzer clean my blood?
The artificial kidney or dialyzer has two compartments separated by a membrane. One part contains your blood and the other contains a washing fluid called dialysate. Important blood components like proteins and blood cells are too big to pass through the membrane and are not filtered out while waste products and toxins pass through the membrane. The dialysate then washes away these wastes, and the blood returning to your body is cleaned.
Where is hemodialysis done?
Hemodialysis is usually done at the hospital or a doctor’s clinic or a dialysis centre. You can get your Hemodialysis done at our dialysis centre in Ahmedabad. Sometimes Hemodialysis can also be possible at homes. This decision is based on how severe your doctor thinks your condition is plus your age, weight and personal wishes.
How long does a hemodialysis treatment last?
The length of treatment at a Dialysis centre lasts for 3-5 hours at a time and is performed twice/thrice a week. Shorter more frequent sessions can also be done, depending on how much fluid your body retains between treatments. Patients who choose to have their Hemodialysis treatment at home need to do it more frequently, 4-7 times a week, and for shorter duration of hours.
Can I have hemodialysis at home?
Home dialysis is prescribed for patients who have a stable condition and are not suffering from other condition that might pose a risk when performing it at home. A suitable caregiver is also required who knows exactly what to do.
Do I need to eat a special diet?
Yes. Patients who are prescribed dialysis are prescribed a diet higher in protein. This is because protein waste and unfiltered protein in the blood due to kidney malfunction is removed by the dialyzer. However protein is needed by the body to function and you need more of it as compensation. You are also told to limit the amount of potassium, phosphorus and sodium in your diet. If you have diabetes, you will have more diet restrictions. Your nephrologist doctor and dietician will help you out on this.
Can dialysis cure my kidney disease?
If yours is a case of sudden or acute kidney failure, dialysis may be required to support your kidney for a short period before it can resume its functioning again. However, in the case of chronic kidney disease, dialysis is required lifelong till you stay healthy unless you can receive a kidney transplant.
Will I be uncomfortable on hemodialysis?
When you begin hemodialysis, the needles put in your fistula or graft may be uncomfortable. Most patients get used to this in time. Your dialysis care team will make sure you are as comfortable as possible during your treatment.
Symptoms like cramps, headaches, nausea or dizziness are not common, but if you do have any of them, ask your dialysis care team if any of the following steps could help you:
- Slow down your fluid removal, which could increase your dialysis time.
- Increase the amount of sodium in your dialysate.
- Check your high blood pressure medications.
- Adjust your dry weight, or target weight.
- Cool the dialysate a little.
- Use a special medication to help prevent low blood pressure during dialysis.
Is reusing my dialyzer during each treatment safe?
Dialyzer remains functional after more than a single-use and Dialysis centers routinely disinfect and clean the dialysis station. There are set guidelines for this process that are followed. Before each treatment, the dialysis personnel will check if the Dialyzer is functioning properly.
When the dialyzer no longer works well, it will be replaced with a new one. However, if you feel uncomfortable reusing your dialyzer, you can request the centre and they will provide you with a new one for each treatment.
Can dialysis patients travel?
Yes, travelling is possible. There are dialysis centers in every part of the county and even in foreign nations.
Before you travel, you must make an appointment for dialysis treatments at another center.
Can dialysis patients continue to work?
Yes. Many dialysis patients continue to work or return 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 change your duties.
How does peritoneal dialysis work?
The peritoneum is a semi-permeable membrane in your abdomen that has the natural ability to filter out materials. A surgical incision is made to your stomach and a catheter is inserted. A sterile dialysate is run through a tube to your abdominal cavity. It is left there for some time for the fluid to absorb the waste products. Then it drains away through another tube and is discarded.
This exchange or cycle is performed 4-6 times during a day and saves you frequent visits to the dialysis clinic.
Types of peritoneal dialysis:
- Continuous Ambulatory Peritoneal Dialysis (CAPD)
- Automated Peritoneal Dialysis (APD)
The method of treatment for both is the same. The only difference is in the number of times and the way the treatment is administered.
- CAPD is a continuous method where the abdomen is filled and drained 3-4 times a day. It is an entirely machine-free method and must be performed when you are awake. It enables you to go about your normal routine of the day while the dialysis happens.
The fluid exchange takes about 30-40 minutes. Raising the fluid bag to shoulder length lets gravity pull the fluid into your abdomen.
Your doctor will train you in the method of using this mode of dialysis so that you can administer the treatment yourself without hassle.
- APD differs from CAPD as it uses a machine to cycle the fluid in and out of your abdomen. This is usually done at night when you sleep. This session can last 10-12 hours.
What kind of peritoneal dialysis is best?
Your doctor will help you choose the better method for you depending on your level of comfort, your activity levels and your medical condition.
What are the pros and cons about being on peritoneal dialysis?
- Some doctors feel that CAPD and APD have several benefits when compared to hemodialysis.
- With continuous dialysis, you can control extra fluid more easily, and this may reduce stress on the heart and blood vessels.
- You are able to eat more and use fewer medications.
- You can do more of your daily activities and it is easier to work or travel.
- However, there are some people for whom peritoneal dialysis may not be appropriate. The abdomen or belly of some people, particularly those who are morbidly obese or those with multiple prior abdominal surgeries, may make peritoneal dialysis treatments difficult or impossible.
- Peritonitis (infection of abdomen) is an occasional complication although should be infrequent with appropriate precautions.
- Peritoneal dialysis is an effective form of dialysis, has been proven to be as good as hemodialysis.
- Peritoneal dialysis is not for everyone. People must receive training and be able to perform correctly each of the steps of the treatment. A trained helper may also be used.