If you have kidney disease, you must make certain decisions about the coming treatment. If you choose so, alternatives are basically three hemodialysis, peritoneal dialysis, and kidney transplantation. Each one has advantages and disadvantages. It is also possible for you to decide not to submit to any kind of treatment. If you know your choices, you can decide wisely with the help of your doctor about what is best for you. Whatever treatment you choose, you must make some changes in your life, such as diet and the way to plan your daily activities.
The first aspect you should consider is the status of your kidney disease is. Knowing this is so important for your doctor in order to determine the kind of treatment that best fits your health situation. Renal disease has five stages. First is kidney damage, for example, when there is protein in the urine of patients (with a filter of 90 or higher on the scale of glomerular filtration rate GFR). The second stage is kidney damage with a mild decrease (with a slight GFR decrease between 60 and 89). The third is the moderate GFR decrease; specifically, between 30 and 59. The fourth stage is a severe GFR reduction: between 15 and 29. Finally, the last stage is kidney failure, which occurs when the kidneys are not able to adequately filter toxins and other waste substances from the blood stream.
The numbers in the GFR is a way to know about how much kidney function remains for a particular patient. There are different techniques to calculate the glomerular filtration rate. These techniques generally make use of an endogenous or added substance that filters almost completely and then is almost not reabsorbed or excreted at tubular level. GFR can be determined by injecting insulin in the blood plasma, by measuring the rate of creatinine clearance, using the Cockcroft-Gault, using the MDRD formula, or the Starling Leonardo equation.
It is very important that a proper diagnosis of the current condition of your renal system is made before choosing any option.
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If the GFR is below 30, your doctor should tell you about the possibilities in the dialysis treatment, and you would have a little time to take a decision. However, if the index is below 15, it is advisable to start any treatment as soon as possible, because the risk of dying is actually imminent.
Now, the first way for treating renal failure is kidney transplantation, and its great advantage is that you don’t have to undergo long and constant dialysis sessions. The downside is that, on the one hand, it is difficult to find donors and, on the other hand, sometimes it is even harder for the patient’s body to assimilate the transplanted organ. The latter usually happens because the patient’s antibody levels may be very high, so the body considers that the transplanted organ must be removed, and then triggers the immune system to attack it with all its cellular system artillery.
Another method of treating kidney failure is, of course, dialysis. There are two types of dialysis: hemodialysis and peritoneal dialysis.
Many doctors help their patients to choose treatments from a series of simple criteria: the medical affection, the lifestyle that the patient will have after it, the daily care (diet, for instance), the type of medication (and its side effects) and the treatment plan, which is different in both cases.
Hemodialysis removes wastes and the excess of fluid from the blood stream. During this process, blood is pumped through tubes to a dialysis machine and takes it through a special filter called a dialyzer, and then the machine gradually returns the blood to the patient. Each session lasts three to five hours and must be performed at least three times a week.
This treatment can be done at home (see the picture below) or in a specialized center, usually a hospital. If the dialysis session will be done at home you need to have the right equipment and enough space for it, as well as access to water and electricity. It is crucial to have an assistant for each session, which can be a nurse or a trained member of your family.
Peritoneal dialysis is not developed outside the body. For this treatment, the inner membrane of the abdomen (peritoneum) is used as a natural filter. This process requires a dialysate circulation fluid flowing through the abdomen through a catheter. This catheter is inserted into the body through a simple surgery. After several hours, the introduced cleaning solution is drained and a new amount must be introduced. This exchange usually lasts about half an hour.
This treatment is carried out at home. It is a way to treat kidney failure for those who need more independence than those patients who prefer hemodialysis.