Introduction:

 

The kidneys work by filtering your blood, removing waste and extra fluid that are then expelled from the body when you urinate.
If your kidneys are compromised due to disease or injury, dialysis can step in to help maintain bodily functions. Kidney failure arises when the kidneys are functioning at only 10% to 15% of their normal capacity. Without dialysis, harmful waste products like salts can build up in the blood and cause damage to other organs.


Here’s more about dialysis, its various types and associated risks.

 

Exploring Dialysis Techniques

 

When your kidneys falter, different dialysis methods like haemodialysis, peritoneal dialysis, and continuous renal replacement therapy (CRRT) come to rescue.

 

Understanding Hemodialysis

 

Hemodialysis uses a specialised filter called a hemodialyzer to cleanse the blood of waste and excess fluid.

 

Preparation for Hemodialysis

 

Before starting hemodialysis, a doctor performs a minor surgical procedure to create an access point in your blood vessels. This may require several months to heal completely.

 

Common access points include:

  • Arteriovenous (AV) fistula
  • AV graft
  • Vascular access catheter

 

AV fistulas and grafts are for long-term dialysis, while catheters are temporary solutions.

 

During Hemodialysis

 

During treatment, blood is drawn from your body and filtered through the hemodialyzer. The purified blood is then returned to your body using a dialysis machine.

 

Hemodialysis sessions last about 4 hours, up to 3 times per week, though shorter, more frequent sessions are also possible.

 

Initially, hemodialysis is often conducted in a hospital, doctor’s office, or dialysis centre. Treatment duration depends on factors like body size, waste levels, and overall health.

 

Post-Hemodialysis

 

After undergoing hemodialysis for an extended period, you may transition to performing dialysis at home, especially for long-term needs.

 

Understanding Peritoneal Dialysis

 

Peritoneal dialysis involves using a peritoneal dialysis (PD) catheter in your abdomen to filter blood through the peritoneum, a membrane in the abdomen.

 

Preparation for Peritoneal Dialysis

 

The PD catheter is implanted through surgery, typically scheduled about 3 weeks in advance. Before starting peritoneal dialysis, you receive training on catheter care and fluid exchanges.

 

During Peritoneal Dialysis

 

During treatment, special fluid called dialysate flows into the peritoneum, absorbing waste from the bloodstream. The used dialysate is then drained from the abdomen.

 

Peritoneal dialysis requires 3 to 5 daily exchanges, which can be done while sleeping, awake, or during daily activities.

 

Types of peritoneal dialysis include:

 

  • Continuous ambulatory peritoneal dialysis (CAPD): Involves multiple daily exchanges without a machine, done while awake.
  • Continuous cycling peritoneal dialysis (CCPD): Uses a machine to cycle fluid in and out of the abdomen, usually done during sleep.
  • Intermittent peritoneal dialysis (IPD): Conducted in the hospital or at home, similar to CCPD but with longer sessions.

 

Post-Peritoneal Dialysis

 

After peritoneal dialysis, it’s important to care for your exit site, catheter, and supplies to prevent infections.

 

Understanding CRRT (Continuous Renal Replacement Therapy)

 

CRRT, also known as hemofiltration, is predominantly used in intensive care units for individuals with acute kidney failure.

 

During CRRT, blood is circulated through tubing into a machine where a filter removes waste products and excess water. Replacement fluid is then added before returning the blood to the body. This process can last for 24 hours or longer.

 

Identifying Dialysis Risks

 

All types of dialysis carry inherent risks.

 

Hemodialysis Risks

 

Risks associated with hemodialysis include:

 

  • Low blood pressure (hypotension)
  • Anaemia
  • Muscle cramps
  • Difficulty sleeping
  • Itching
  • High blood potassium levels (hyperkalemia)
  • Pericarditis (inflammation around the heart)
  • Sepsis
  • Bacteremia (bloodstream infection)
  • Irregular heartbeat
  • Sudden cardiac arrest

 

Peritoneal Dialysis Risks

 

Peritoneal dialysis may increase the risk of infections around the catheter site, such as peritonitis.

 

Other risks include:

 

  • Abdominal muscle weakening
  • High blood sugar 
  • Weight gain from dextrose and excess fluids
  • Nausea or vomiting
  • Hernia
  • Fever
  • Stomach pain

 

CRRT Risks

 

Risks associated with CRRT (Continuous Renal Replacement Therapy) include:

 

  • Infection
  • Hypothermia
  • Low blood pressure (hypotension)
  • Electrolyte disturbances
  • Bleeding
  • Delayed renal recovery
  • Bone weakening

 

Additionally, long-term dialysis can lead to other medical conditions, such as amyloidosis.

 

Some individuals may experience depression or anxiety following a long-term kidney failure diagnosis. If you’re struggling with depressive thoughts, consider reaching out to a member of your care team or a mental health professional. To know more about kidney dialysis in Khanna.

 

Consulting a Specialist:

 

For those considering dialysis or experiencing symptoms like swelling (edema), particularly around your hands, ankles or face, peeing often , dry or itchy skin, poor appetite, must consult a qualified healthcare professional. Specialists like those at Jain Multispeciality Hospital, with decades of experience in treating kidney failure effectively & performing dialysis, can provide accurate diagnoses and personalised treatment plans.

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