What You Need To Know About Dialysis

Dialysis is a treatment and an artificial process that removes waste and extra fluid from the blood of patients whose kidneys cannot eliminate properly. Dialysis also helps to maintain the balance in the body by correcting the levels of various toxic substances in the blood. Without dialysis, all patients with terminal renal failure die as a result of the accumulation of toxins in the blood.

Dialysis is advised for patients who suffer from kidney disease, kidney failure or overload of fluids, potassium and acid.  It should be understood that dialysis does not cure kidney disease or other problems affecting the kidneys, but it can improve the quality of life of patients whose kidneys fail to work.  Some patients can even live a fairly normal life for many years with the help of this treatment.

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Generalities of Dialysis

There are two types of dialysis: hemodialysis and peritoneal dialysis. Regardless of the chosen method, the mission of each is very similar. Dialysis is designed to replace some of the functions of the kidney by filtering and purifying blood artificially. The treatment must eliminate the waste products and excess fluid, and balance the amount of electrolytes and other substances in the body. An effective dialysis requires a semi-permeable membrane, blood, dialysis fluid and a method to remove excess fluid.

During the dialysis, a semipermeable membrane separates the blood from the dialysis fluid. This membrane allows the passage of some substances but not others. It allows waste products, water, electrolytes, and other substances to pass from the blood into the dialysis fluid (and sometimes in the opposite direction) through a process called diffusion. The movement of waste and other substances depends on the permeability of the membrane, the size and the structure of these substances, the constitution of the dialysis fluid and the amount of blood in contact with the membrane.

The greater the amount of blood in contact with the membrane, the greater the efficiency of the dialysis treatment. In hemodialysis, the blood supply can be controlled by the dialysis machine.

In both dialysis methods, the dialysis fluid allows to eliminate the waste from the blood. Additionally, it contains several substances that help to correct imbalances that occur as a result of end-stage renal failure.

Liquid elimination is achieved in hemodialysis and peritoneal dialysis by distinct processes. In hemodialysis, the dialysis machine uses pressure to extract the liquid from the blood through the membrane, and this passes into the dialysis fluid. In peritoneal dialysis, the glucose present in the dialysis fluid is used. This causes the excess fluid to leave the blood and pass into the dialysis fluid to be eliminated periodically.

Associated Risks

While both dialysis treatments can help a patient’s condition and even save lives, there are risks associated with them as well.  Peritoneal dialysis is associated with an elevated risk of infections around the catheter site in the abdominal cavity, whereas hemodialysis is associated with risks such as low blood pressure, anemia, muscle cramping, difficulty sleeping, itching, depression, among others.

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How to Prepare

There are ways to help prepare patients for dialysis and have the right attitude during the treatment.  Here are some suggestions:

  • Study all that is related to your condition: Understand your condition and learn about the equipment used to treat you.
  • Be surrounded by supportive people:  Talk to your loved ones and friends about your need for dialysis and how you are feeling. Get support in order to help you feel prepared for dialysis.
  • Get informed to make the right decisions:  Discuss your treatment options with your nephrologist so you can work together and find the most appropriate therapy.
  • You are not alone: Talk to people who can identify with you. Other dialysis patients can help you understand everything there is to know, and help you prepare for the dialysis.
  • Follow a healthy diet:  A dietitian that has experience with renal patients will guide you through the creation of a food plan and recipes, and will help you renew your grocery shopping list. This new diet will include foods that are customized to your kidney’s needs.
  • Follow your treatment: Patients under dialysis treatment will often have to take a significant amount of medicines and following your planned schedule faithfully is really important.  

It is normal to have questions and concerns about the treatment but learning about dialysis can help a patient dissipate fears and take an active role in the process.   As we mentioned earlier, even though dialysis does not cure kidney disease, it does help patients live longer and better.  Following a healthy diet and going through the treatment faithfully can have a positive impact on results.

If you want to know more about renal health, read the article “Renal Compensation: Definition, importance and cares” by Joe Cosgrove by clicking here.

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Renal compensation: Definition, importance and cares

There are three key points to mention about the pH compensation performed by the kidneys. The first one is the importance of identifying the normal pH range in body fluids and the upper and lower limits compatible with human life. The second one is to understand the vital function of pH compensation in the body. The third one is knowing what kind of diet must be taken in order to experience a good health.

(Read also: Hormones Involved in Renal Compensation.)

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What is renal compensation? This renal function is the regulation of the measurement of acidity in a certain solution. Kidneys perform it in the blood for the proper functioning of the whole organism. Changes in pH are corrected through different mechanisms. When are those changes made by the kidneys? For example, when patients consume high-fat foods very often and do not drink the recommended amount of water, the pH level in the internal body fluids becomes very low, and it may become a future problem that affects cells, tissues and organs in the rest of the body systems. The importance of a good diet improves the regulation of pH in our body. It is because, in order to keep the pH in balance, the consumption of alkaline substances is needed. Those substances may be found in fruits, vegetables and low sugar food.

On the other hand, it is well known that poor diets and a stressful lifestyle may contribute to pH imbalance in all body fluids, and, subsequently, it negatively affects the immune system. A weak immune system means a body exposed to bacterial and viral infections. “The general lifestyle of the current society in reflected in the consultations of patients and their visits to emergency rooms with severe kidney problems. The main reason is the imbalance in the pH of blood”, affirms Joe Cosgrove, Chairman, President and CEO of Pentec Health. “Poor diet, stress, poor sleep habits, physical inactivity, alcohol and illegal drugs, self-medication and other harmful activities are direct and indirect causes of renal decompensation of pH in body fluids.”

PH is an abbreviation: hydrogen potential. As a chemical measure, it is used to determine the degree of acidity or alkalinity of substances. PH measurement is extremely useful for biological and chemical studies because the degree of alkalinity or acidity determines the possibility that certain chemical reactions are carried out or not. The pH scale ranges from zero to fourteen. Values under seven indicate acidity, and, over seven, alkalinity. The number seven is neutral: is the point of reference of the scale.

Kidneys perform vital functions in the body. Not only filtering the blood stream of hazardous substances, but the pH balance of the whole body through the blood supply depends on the kidneys. Every day, these wonderful organs filter about one hundred ninety liters of blood, eliminating about two liters of waste and excess water. Those wastes and water excess become urine, which is stored in the bladder and expelled when urinating through the ureters.

The mechanism of pH regulation in the kidneys develops as follows. Tubule cells of the kidney manufacture bicarbonate and hydrogen ions from carbon dioxide and water. The body re-absorbs the bicarbonate, which acts as a buffer, and it secretes hydrogen ions turning it into sodium. Each hydrogen ion lost in the urine becomes a bicarbonate ion, which will subsequently be available in the extracellular fluid, in order to effectively neutralize more hydrogen ions. In addition, kidney also eliminated substances by a process of acid formation of ammonium ions from ammonia, or by other acid neutralizers, such as phosphate. However, it is very important to remember that at the time of saturation, the body has to take more drastic measures to combat an acid pH. On one hand, if the blood does not have enough alkaline minerals to counter an excess of acids, the deposited acid remains in a huge variety of tissues until the organism can neutralize them. Some studies suggest that if this process is repeated often over long periods, the chances of getting cancer are much higher. A high level of acid in body fluids also affects cholesterol, because it adheres more quickly to the arteries, damaging artery walls and it facilitates the creation of plaque that leads to heart issues.

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What kind of food should be avoided then? In order to help the kidneys in their compensation function, processed foods, pre-packaged foods, alcoholic beverages, sodas, cold meats and canned foods are examples of what should be avoided in a healthy diet. If you have several of the following symptoms, it may be a sign that the pH level of your body is very high, and you should visit your doctor for guidance in the development of a healthy diet: Acne, low energy, hyperactivity, menstrual and premenstrual cramps, diarrhea, constipation, hot urine, smelly urine, headaches or difficulty for getting up every morning.

Be aware of these consequences of having hemodialysis

What are the side effects of a hemodialysis? Joe Cosgrove asks himself. What changes do people experience when they are treated with Hemodialysis? In fact, what can patients expect when the treatment starts and all the changes in the body start to appear? Let’s first take a look at what causes a body to receive a hemodialysis and what it does to the body.

Chronic kidney disease and acute kidney injury (also known as acute renal failure) cause the kidneys to lose their ability to filter and remove waste and extra fluid from the body. Hemodialysis is a process that uses a man-made membrane, known as a dialyzer to remove wastes, such as urea, from the blood; restore the proper balance of electrolytes in the blood and eliminate extra fluid from the body.

For hemodialysis, you are connected to a filter (dialyzer) by tubes attached to your blood vessels. Your blood is slowly pumped from your body into the dialyzer, where waste products and extra fluid are removed. The filtered blood is then pumped back into your body. There are different types of hemodialysis such as In-center hemodialysis where you go to a hospital or a dialysis center;  home hemodialysis which comes after you are trained and you do your dialysis treatments at home; daily home hemodialysis and nocturnal home hemodialysis.

Ok, but what are the real changes or consequences our body feels when it goes through hemodialysis treatments? Here they are:

  • Low blood pressure (hypotension). One of the most common side effects of a hemodialysis is a drop in blood pressure, particularly if you have diabetes. Low blood pressure in turn causes many other factors to change. For example, all this can come with shortness of breath, abdominal cramps, muscle cramps, nausea or vomiting. If the patient also suffers from diabetes, these problems will appear even faster.

  • Muscle cramps. If they occur, nobody knows why they occur during Hemodialysis, they usually happen in the last half of a dialysis session. The cramps can be stopped by adjusting the hemodialysis prescription and adjusting fluid and sodium intake between hemodialysis treatments.

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  • Sleep problems. People receiving hemodialysis often have trouble sleeping, sometimes because of breaks in breathing during sleep (sleep apnea) or because of aching, uncomfortable or restless legs. It is extremely common for dialysis patients to have sleep disturbances, which can affect daytime alertness, activity level, and overall well-being. There is a study done by Havva Tel, PhD; Hatice Tel, PhD; and Mehtap Esmek, RN called Quality of Sleep in Hemodialysis where they found that as age increased in patients, sleep quality decreased.  They also found that elderly men are more likely to have sleep problems. “Advanced age and long-term dialysis therapy directly affected patients experiencing sleep problems”.
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  • Anemia. Not having enough red blood cells in your blood (anemia) is a common complication of kidney failure and hemodialysis. When kidneys are diseased or damaged, they do not make enough EPO. As a result, the bone marrow makes fewer red blood cells, causing anemia. When blood has fewer red blood cells, it deprives the body of the oxygen it needs. In a hemodialysis treatment, a lot of blood is lost and recovered and this causes anemia as well. When kidneys fail and a hemodialysis takes place, nutrients such as iron, vitamin B12 and folic acid will start to scarce, causing anemia too because they are the nutrients responsible of making  red blood cells to make hemoglobin, the main oxygen-carrying protein in the red blood cells.

  • Bone diseases. Bone diseases come in a hemodialysis treatment because after you have had chronic kidney disease and you are doing the treatment, the body, more specifically the kidney, cannot process vitamin D, and in turn cannot absorb calcium. As a consequence, your bones may weaken. Also, calcium is released from the bones because the treatment and kidney failure causes overproduction of the parathyroid hormone.

  • High potassium levels (hyperkalemia). One of the functions the kidney has is to remove Potassium from the body and the blood.  If you eat more potassium than recommended, your potassium level may become too high. It can sound a little extreme, but it has been known that too much potassium can cause your heart to stop.

  • Depression. And of course, the last and silent disease. People do not like to be ill and especially from the kidney which gives you that line of defense.  Changes in mood are common in people with kidney failure and some people don’t emotionally react very well to the situation. The best idea is to talk with the health care team about options to treat depression.

It is good to know what will inevitably come from our health treatments. Sometimes avoiding these effects is not an option, but it is an option to be informed and adapt the best way possible.

Find out about advantages and disadvantages of a hemodialysis treatment in this article.