Understanding Dialysis: Types - How It Works

Kidneys play a very important role in keeping our bodies healthy by filtering waste, maintaining electrolyte balance, and managing fluid levels. When kidneys fail to perform these functions due to chronic kidney disease (CKD) or acute kidney injury, dialysis becomes a crucial life-saving treatment.

For patients facing kidney failure, dialysis takes over the role of the kidneys, ensuring the body continues to function correctly. This article explores dialysis in detail, helping patients and non-medical individuals understand the process, its types, and how it improves the quality of life for those with kidney-related issues.

What Is Dialysis?

Dialysis is a medical procedure replicating some of the kidney's essential functions, primarily waste removal and fluid balance. It is used when the kidneys can no longer perform adequately, usually in end-stage renal disease (ESRD) cases or severe kidney damage.

The primary goal of dialysis is to keep the body's internal environment stable by:

• Filtering waste products like urea and creatinine from the blood.
• Balancing electrolytes (e.g., sodium, potassium, and calcium).
• Controlling fluid levels to prevent swelling, high blood pressure, and heart complications.
  

Types of Dialysis

Here are two main types of dialysis. Both serve the same purpose but differ in their methods and settings:

• Hemodialysis (HD)

Hemodialysis is the most common form of dialysis. It consists of using a machine to filter the blood outside the body. Patients who undergo hemodialysis often feel fatigued after sessions due to the significant amount of waste and fluid removal in a short period. Here's how it works:

• Process: The patient gets connected to a dialysis machine through vascular access (usually in the arm). The machine pumps the blood through a special dialyzer filter, which removes waste, extra salt, and water. The cleaned blood is then returned to the body.
• Frequency: Hemodialysis is performed thrice a week, each lasting 3-5 hours.
• Setting: Hemodialysis can be performed in a hospital or a dialysis center and, sometimes, with proper training at home.
  
• Peritoneal Dialysis (PD)

Peritoneal dialysis uses the lining of the abdomen, called the peritoneum, to filter the blood. Patients on peritoneal dialysis must be diligent about hygiene to avoid infections, particularly peritonitis, a severe complication in which the peritoneum becomes inflamed. Here's how it works:

• Process: A catheter introduces a special fluid into the abdominal cavity. The peritoneum is a natural filter, allowing waste and excess fluid to move from the blood into the dialysis fluid. After a few hours, the used fluid is drained and replaced with fresh fluid.
• Frequency: PD is usually done daily, with fluid exchanges occurring manually or automatically using a machine (called a cycler) while the patient sleeps.
• Setting: Peritoneal dialysis is primarily done at home, offering patients more flexibility and independence compared to hemodialysis.
  

When Is Dialysis Needed?

Dialysis becomes necessary when the kidneys lose about 85-90% of their function, which often occurs in the later stages of chronic kidney disease. It is also used in cases of acute kidney failure, where kidney function drops rapidly due to injury or illness, and other treatments fail to reverse the damage.

Patients with conditions like diabetes, high blood pressure, and glomerulonephritis are at a higher risk of kidney failure and may require dialysis as part of their long-term care.

Life on Dialysis

Dialysis, while life-saving, significantly alters a patient's lifestyle. Here's what patients and families should know about living with dialysis:

• Dietary Changes: Patients on dialysis often need to follow a special diet that limits sodium, potassium, phosphorus, and fluid intake. Protein intake is also regulated, as excess can strain the kidneys.
• Medication: Patients may need to take medications to control blood pressure, manage anemia, and prevent bone disease.
• Emotional Impact: Living with dialysis can be mentally and emotionally challenging. Many patients struggle with feelings of dependency, frustration, and anxiety about their future health. Support from family, friends, and healthcare providers is crucial.
• Work and Activities: While dialysis requires time and energy, many patients continue to lead active lives, including working and participating in social activities. Proper planning allows patients to balance dialysis with other aspects of life.
  

Choosing Between Hemodialysis and Peritoneal Dialysis

Both dialysis options have proven effective, and the ideal choice should be determined through discussions with your healthcare team, considering your individual health condition, lifestyle, and personal preferences.

The factors influencing the choice between hemodialysis and peritoneal dialysis are:

• Patient Lifestyle: Peritoneal dialysis offers more flexibility, particularly for those who prefer or need to dialyze at home. On the other hand, hemodialysis is typically done in a clinical setting, though home options exist.
• Medical Conditions: Some patients may not be suitable for peritoneal dialysis due to previous abdominal surgeries or other medical conditions.
• Personal Preference: Some patients prefer the routine and support of a clinic-based treatment, while others value home-based dialysis's independence and control.
  

Potential Complications

While dialysis is essential for patients with kidney failure, it is not without risks. Some potential complications include:

• Infections: Due to the use of catheters, hemodialysis patients are at risk of bloodstream infections, while peritoneal dialysis patients face a risk of peritonitis.
• Low Blood Pressure: Rapid removal of fluids during dialysis can lead to hypotension, causing dizziness, nausea, and fainting.
• Muscle Cramps: Some patients experience painful muscle cramps during dialysis due to fluid and electrolyte imbalances.
• Anemia: Since the kidneys produce red blood cells, patients on dialysis often experience anemia and may require treatments like erythropoiesis-stimulating agents or iron supplements.

Sterling Hospital is Your Partner in Better Health Across Gujarat

At Sterling Hospital, we provide you with the utmost care and comfort throughout your journey to healthy kidneys. If you are looking for the best kidney specialist in Ahmedabad and Vadodara, we've got you. With considerable years of experience, we have built a team of the best nephrologists in these regions to provide you with premium treatment and the best results. Safeguard your kidney health and contact Sterling Hospital to schedule a consultation and embark on a journey towards a healthier life.