Kidney dialysis

Kidney dialysis is a medical procedure that substitutes the natural function of the kidneys when they are failing or have failed. This treatment is essential for individuals suffering from chronic kidney disease (CKD) or acute kidney injury (AKI), particularly when they reach the advanced stages known as end-stage renal disease (ESRD). Dialysis works by removing waste products, excess fluid, and salts from the blood, thereby helping to regulate blood pressure and maintain the balance of essential minerals such as potassium and sodium in the body.

Types of Kidney Dialysis

There are two main types of kidney dialysis: Hemodialysis and Peritoneal dialysis.

Hemodialysis

In hemodialysis, blood is filtered through a dialyzer, also known as an artificial kidney, outside the body. The process involves circulating the patient's blood through the machine, where it is cleaned before being returned to the body. This type of dialysis is typically performed three times a week, each session lasting around four hours, in a dialysis center or hospital. However, with the advent of portable machines, home hemodialysis is becoming an increasingly viable option.

Peritoneal Dialysis

Peritoneal dialysis utilizes the lining of the abdomen, or peritoneum, as a natural filter. A dialysis solution is introduced into the abdominal cavity through a catheter, where it absorbs waste products and excess fluids from the blood vessels in the peritoneal membrane. The solution is then drained and discarded. This type of dialysis can be performed at home, often overnight, making it a more flexible option for many patients.

Indications for Dialysis

Dialysis is recommended when a patient's kidneys can no longer perform their function well enough to keep the patient healthy. This situation is typically determined by a significant decline in the glomerular filtration rate (GFR), elevated levels of waste products such as urea and creatinine in the blood, or the occurrence of symptoms of severe kidney failure, which may include nausea, vomiting, fatigue, and swelling due to fluid retention.

Risks and Complications

While dialysis is a life-saving treatment, it is not without risks and complications. These may include infection, blood clots, low blood pressure, and the long-term complication of dialysis-related amyloidosis. Patients undergoing dialysis may also experience a decrease in quality of life due to the time-consuming nature of the treatment and its side effects.

Living with Dialysis

Adjusting to life on dialysis can be challenging for patients and their families. It requires significant lifestyle changes, including dietary restrictions, fluid intake limitations, and regular scheduling of dialysis sessions. Support from healthcare professionals, as well as from friends and family, is crucial in managing the physical and emotional challenges that come with this treatment.

Future Directions

Research is ongoing to improve dialysis technology and to find new treatments for kidney failure. This includes the development of more efficient and less invasive dialysis machines, as well as efforts to create a bioartificial kidney that could one day eliminate the need for dialysis.