The Most Common Questions Patients Have About Dialysis

The kidneys are vital organs in the human body. Their functions are those of secreting hormones, cleaning your blood, absorbing minerals and producing urine among others. They are absolutely necessary to maintain the body’s toxin levels at normal levels, they help regulate blood pressure and even stimulate the production of red blood cells.

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As you can probably guess, the kidneys have a lot of responsibility and are organs that work under constant stress. It is expected that when organs such as these stop working like they are supposed to, the consequences are dire, as the body loses its ability to regulate the toxins that are normally cleansed by the kidneys and you begin to feel sick.

Kidney disease is the term utilized to refer to the condition by which the functions of kidneys are reduced in their efficiency or in some cases completely impaired. In cases like this, there are but a few options available for a patient to stay alive. One would be a kidney transplant, and the other would be to receive dialysis treatment. Dialysis is a treatment by which advanced machinery is used to help cover the slack left by kidneys unable to perform their functions and thus remove excess toxins from the patient’s body.

Today in Joe Cosgrove’s blog, we want to talk about some of the most common questions and concerns raised by new patients to dialysis treatment, and by the family members who want to support them during their process.

What are the different types of dialysis?

There are three primary types of dialysis. Hemodialysis and hemofiltration work similarly because they are both concerned with the cleansing of the blood directly. Blood is removed and cleaned in a machine before being pumped back into the body. The difference between both of these methods is that one uses a dialyzer solution while the other uses pressure to separate substances through a permeable membrane.

The third type of dialysis is called peritoneal dialysis and is less efficient than the former methods. In peritoneal dialysis, the blood is not directly but indirectly cleansed by pumping dialyzer into the patient’s abdomen and then removing it after the waste material has transferred to the fluid. The process is repeated several times per session.

How does dialysis work?

Dialysis is a treatment that simulates the process done by the kidneys when they are healthy by removing excess toxins from the blood and keeps the body in balance. A machine is used to extract the blood of the patient (in the case of hemodialysis) and clean it before injecting it back in. Minor surgery is necessary to create a vascular access. Vascular access is a place where the needles and tubes can be easily connected every time the patient needs to undergo the procedure. An access can be created by joining an artery and a vein together into a blood vessel called a fistula or by placing a narrow plastic tube in a large vein near the chest or neck.

In peritoneal dialysis, the blood is actually cleaned inside the body. The doctor places a catheter in the patient’s abdomen so the peritoneal cavity can be filled with fluid and thus excess toxins from the blood can be extracted from blood vessels in the abdomen that come in contact with the dialyzer that is later removed.

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Is it possible to travel?

Traveling is absolutely possible, but it requires a bit more planning that you may be used to. Dialysis can be done by the patient him or herself while traveling with no real risk. There are also many centers around the country and even worldwide that can accommodate your needs while traveling and give you all the care you need. It is imperative to plan properly and to have everything planned well in advance so you can receive the treatment you need.

Does my diet have to change?

The food you eat will depend on many factors like your current health, the stage of your particular kidney disease and the recommendations of your doctor depending on their evaluation of your specific situation. Salt, in general, is to be avoided in large quantities; the same goes for foods that contain too much phosphorus. Anything that can affect your blood pressure has to be eaten in moderation, and it is recommended to eat fewer proteins than usual, especially if you eat lots of meats and animal products.

How often do I have to undergo the treatment?

The frequency of dialysis sessions you require depends mainly on the current state of your kidneys. Some patients with a more advanced condition may require more sessions than someone whose kidneys are still performing partially. Normally, hemodialysis takes places about 3 times a week while visiting the clinic and peritoneal dialysis is usually done at home, several times during the day. As we have mentioned before, one method is more effective than the other, and that is why it requires fewer sessions.

 

Two of the most important dialysis procedures

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As we have seen in previous articles, one of the most important terms in medicine, more specifically in the renal system is dialysis. This is one of the most significant procedures for those people with kidney problems, which gives to them the possibility of having a better health quality and the opportunity for living a more normal life. In other words, thanks to this medical process, people with kidney failures can have a new chance for passing better days.

In this post, we will talk about the two principal dialysis types: the peritoneal dialysis and the Hemodialysis. Before talking about these two vital medical procedures, it is important to have a better context about what a dialysis is and why it is important for those persons with kidney issues. In addition, it is significant to show some other alternatives for the treatment of kidney diseases.

Dialysis and other treatments

We can define dialysis as the medical procedure for cleaning the blood of those people with kidney failures. Put differently, it is the artificial way for eliminating waste and other components in the blood in those persons that have problems in their renal system with the impossibility for removing all these elements by themselves. Usually, the people who need dialysis are the ones with critical renal failures. For those that do not have chronic issues, there are different and less traumatic treatments.

It is important to say, as we have mentioned in this blog, that the renal system is in charge of keeping the right levels of water and minerals in the blood. Through this vital part of the body, elements like potassium, sodium, calcium, chloride, magnesium, phosphorus and sulfate are metabolized, maintaining the required levels of these minerals for the correct performance of the human body. When kidneys and other components of this system are not working correctly for doing this, then a medical treatment is needed. If it is critical, a dialysis procedure will be required.

Having clear what a dialysis is and when it is needed, then we can talk about other renal treatments. Sometimes, when the kidney failure is not so critical, there are medicines that let the renal system to keep the adequate mineral and water levels in the blood. Another alternative is a surgery. One of the best solutions for those persons with kidney failures is a transplant, giving to the affected the possibility of having a normal working in its renal system. However, this is a more complex alternative, due to the high demand of kidneys in the world.

Hemodialysis

Under this procedure, the patient or the affected is connected into a medical dispositive called dialyzer. This mechanism cleans the blood after receiving it from the body. Here, the blood is purified, removing from it all those wasting elements which can not be eliminated by the renal system of the patient. After the blood is cleaned, it is introduced in the body, giving into it the right levels of water and minerals. In other words, through a hemodialysis, the blood is extracted for being filtered and purified in a dialyzer, then it is returned to the body.

Usually, the hemodialysis process is executed in hospitals or medical institutions, but there is the possibility of doing it at home. Some clinics give this alternative to their patients, but it requires a specialized person that understands and know how to make this procedure. It is important to say that a dialysis is usually an outpatient process and can take a few hours to be accomplished.

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Peritoneal dialysis

With a Peritoneal dialysis, the patient can clean its blood through a medical element called dialysate. Basically, with this process, it is introduced glucose through the peritoneal cavity with a tiny tube, so the peritoneal membrane works as a filter, cleaning the blood and purifying it.

This procedure is designed for being applied between 4 or 5 times in a day and for some experts, it is less efficient than an hemodialysis. The Peritoneal dialysis is used not only for cleaning the blood from toxins and other elements, but also for removing excessive fluids and to correct electrolyte problems.

However, this procedure can bring some issues to the patient, like high blood sugar levels, abdominal infections, hernias, abdomen bleeding, or catheter blocking. In other words, the Peritoneal dialysis is an excellent alternative, but for being a medical procedure where a tube is introduced into the peritoneal cavity, some problems may occur.

We have seen in this article two of the principal alternatives for treating kidney issues with dialysis, but there are other processes like the Hemofiltration, the Hemodiafiltration, the Intestinal dialysis or the Pediatric dialysis, which are excellent options depending on the patient and the condition of its renal system. In addition, it is important to say that for those situations where the renal failure is not chronic, other alternatives must be considered, like medicines or surgeries.

Related: Everything You Need to Know About Pediatric Dialysis by Joe Cosgrove

What You Need To Know About Types Of Dialysis

The word dialysis comes from the Greek and means dissolution, as it is a process in which excess waste material, toxins, and water are removed from the blood in order to help the liver maintain its functions within the body. As we already know and have discussed previously here on Joe Cosgrove’s blog, the kidneys perform an important and exhausting task maintaining the balance of bodily fluids, minerals and all the acidic byproducts of metabolism that cannot be excreted through respiration. This importance is what makes a procedure like dialysis as necessary and integral to maintaining the health of patients with acute kidney failure in order to improve their quality of life and wait until they receive a transplant if that is their case.

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Dialysis comes in different types and sometimes patients have a say into which kind of treatment is best for them, considering their own particular medical and personal factors. It is important to understand that no matter which type of treatment you use, your lifestyle will somehow be affected by the procedure, so it is a matter of finding what is best for you and best suits your daily activities.

There are five different types of dialysis, three of them are considered primary treatments (hemodialysis, peritoneal dialysis, and hemofiltration) and the other two are what are known as secondary methods (hemodiafiltration and intestinal dialysis).

Hemodialysis

Hemodialysis is a process of dialysis in which blood is extracted from the body and passed through a machine that cleans it before returning it back into the patient.

The process begins by extracting the blood through a catheter, an arteriovenous fistula or an AV graft. Out of those three extraction methods, the fistula is the preferred procedure because of their lower infection rates; their higher rates of blood flow and lower occurrences of thrombosis. From there, the blood is pumped into a machine where it mixes with a substance called dialysate. Both the blood and the dialysate meet inside the dialyzer where the toxins of the blood are filtered through diffusion. Diffusion in a molecular process in which particles go from areas of high concentration into areas of lower concentration; think about adding milk to your coffee and how the milk slowly begins to mix into the substance giving the tan color a latte is known for. Diffusion happens through a semipermeable membrane and then the used dialysate is flushed through one side and the clean blood is injected again into the body.

The process happens over and over during the whole session, with the blood being pumped into the body to help it extract more waste material to be filtered inside the dialysis machine. An entire session of hemodialysis can last anywhere from 3 to 4 hours in order to be effective and it is repeated about 3 times a week. With the exception of the needles going inside the veins, the procedure is painless but some other side effects including nausea, headaches, fatigue and low blood pressure can be present if the fluids are removed from the body too quickly, and while the patient gets used to the treatment. Most complications with dialysis are very rare, but considering the circulatory system is being constantly exposed to treatment, it is possible for some patients to face some complications with infections depending on the extraction method being used.

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Peritoneal Dialysis

Peritoneal Dialysis is a process in which the cleaning process of dialysis takes place inside the body of the patient as opposed to using an external machine to complete the procedure. Just like in other processes like hemodialysis in which an artificial membrane is used to filter the blood, here the membrane used is the peritoneum itself.

Using a catheter, a sterile solution of dialysate is inserted into the abdominal cavity where it will mix with body fluids and become saturated with waste material by diffusion. Later, this liquid is removed out of the abdominal cavity, thus helping the body get rid of excess toxins. The process is repeated four or five times everyday. Peritoneal Dialysis is gentler but not as effective as hemodialysis and because of that it must be repeated daily, usually by patients themselves that have been properly taught on how to go about the procedure. Complications in peritoneal dialysis may arise when the body retains more fluid than in should after the procedure or if too much of it is removed. Pain and discomfort as expected if the dialysate is too cold or inserted too quickly into the abdomen. Continuous Ambulatory Peritoneal Dialysis can be done during the day as the person goes about their daily life while Automated Peritoneal Dialysis uses a machine that makes the fluid exchange as you sleep at night, leaving a reduced amount of the solution inside the body during the day.

Understanding the different processes is of great importance for you to take charge of your health and make the best decisions concerning your condition along with your physician.