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

How To Make The Transition To Your Life On Dialysis

Undergoing dialysis treatment is something that will definitely change your life. As we have mentioned here on numerous occasions at Joe Cosgrove’s blog, living with dialysis has a lot to do with adjusting to the new definition of what you consider normal in your daily routine and the way you look at life in general. With that being said, it doesn’t mean that everything you enjoy doing has to stop because of your treatment and that you simply have to adjust to a life that excludes you from things like traveling, eating anything you want and working like everyone else. Dialysis simply becomes part of who you are and the way you go about those activities that bring you joy is just a bit different, even more fulfilling at times.

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One of the biggest challenges of living with dialysis is probably one of the things that has to do the least with the treatment itself, and that is accepting it. Dialysis is a big word that conjures up images of sickness, needles, hospitals and pain; most of that has to do with a bad reputation that it has acquired over the years and just the ignorance sported by the general population when it comes to kidney disease. These types of treatment exist to make you better and every single day there are brilliant minds and large amounts of resources working hard at advancing this processes even more with the aid of cutting-edge technology in an attempt to give patients a better quality of life and a warmer acceptance of what living with dialysis means.

Today on our blog, we want to talk a little about the beginning of your life with dialysis and what you should expect in the first couple of months while you get used to it so you can make the best out of this challenging time in your life.

Understand the alternative

Dialysis is a relatively new treatment and before that, there was nothing that you could do for patients with kidney failure, something that pretty much meant that you were looking forward to an extreme decline of your health and most likely dying from your condition. Today dialysis can not only keep you alive, but it can do with while giving you a considerable quality of life as it becomes such a manageable part of you, that you will simply come to live with it seamlessly.

The dialyzer has limits

The machine that is helping you clean your blood during the dialysis treatment is not a magical device that can completely replace your kidneys. Kidneys are truly remarkable organs and are able to withstand a lot of damage before failing, they are truly irreparable and no machine exists that can do what they do as well as they do it. Understanding that is crucial for you to realize that while internally there isn’t much else you can do to help your kidneys other than undergoing the treatment, externally there is a lot you can do to compensate for the dialyzer shortcomings. Things like eating healthy, exercising and taking care of yourself so as to alleviate the stress your body has to go through are great ways to making sure that all your efforts are directed towards making the treatment work as well as it possibly can.

Find ways to make yourself comfortable

Yes, you are just lying down and reading or watching TV waiting for the treatment to be over, but as you are apparently relaxed and not doing much, your body is working overtime dealing with everything that is going on. Your blood is being extracted, cleaned and then pumped back into your body constantly during a session that may last up to four hours, this means that your body has to take all these in and push itself to compensate. It is very common to feel tired even if you think you did nothing during the day. Give your body time to get used to the changes.

Lean on your support network

Give the people in your life who care about you the opportunity to be there with you and to participate in whichever way you think it will make the process easier for you. Those around are also affected in their own way, so make sure you don’t neglect this support network and allow it to help you get through the tough times. People in the dialysis community are also very supportive of new members and will answer your questions and take you in if you need anything. You should take advantage of their experience and knowledge dealing with dialysis and even share with them the ways that you are making it work for yourself. Remember you are not alone in this and the condition can be a bonding experience with your family, friends and other loved ones.

Is dialysis always recommendable?

People who are currently on dialysis have different characteristics: although, as mentioned in previous articles by Joe Cosgrove, kidney failure may affect all kinds of people, adults aged 75 and older are seemingly the fastest growing group under the treatment. And while dialysis is, to some extent, the best possible solution to some stages of the condition, one question still lingers amongst patients: “How long can they expect to live?”

This has been a matter of study at Tufts University and other institutions. In a recent publication, the aforementioned institutions carried out a research regarding the topic and found that up to 95% of patients want to be given information about life expectancy. Such figure depicts the staggering growth of concern around dialysis and life expectancy: when compared to a similar study carried out in 2010, almost 90% of patients never really got to discuss the issue with their nephrologists.

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Now, universities alongside researchers, doctors, and physicians call for those who are not explaining prognosis to their patients to do so while addressing the topic by assessing the benefits and downsides of the treatment according to the patient’s expectations. Such premise has also been adopted by the Renal Physicians Association and the American Society of Nephrology but reality shows otherwise: such advice is being widely ignored in practice.

Several experts, in an attempt to address the topic of life expectancy versus dialysis, agreed upon the conclusions: older people on dialysis have a considerably shortened life expectancy compared with other people in such age group. This is substantially true when other diseases also accompany the condition: up to 33% of older people with severe kidney failure normally suffer from other illnesses such as hypertension, dementia, different heart diseases, diabetes, etc. Physicians agree that 70 to 75-year old patients on dialysis may expect to live 3.5 years on average, compared with almost 12.3 years for people of that age. For 76 to 79-year olds, the figures plummet to a drastic 3.1 years versus almost 9.1 years. As for 80-years old and older, the figures dropped to 2.5 versus 6.6, sometimes less. Nevertheless, it is important to point out that estimating such life expectancy depends upon a plethora of different factors, which is why there seems to not be a consensus regarding the applicability of these figures. Since some people may do it better and other may do it worse, it is hard to predict in a precise manner whether a specific patient will get to live such and such amount of time; however, it is unquestionable that the more conditions or diseases someone has, the less likely will their life expectancy be after starting dialysis.

Such circumstances become especially true in patients with ischemic heart diseases since the blood flow to the heart is reduced. In fact, physicians seem to agree upon the fact that that condition alone is enough to dismiss any potential benefit from dialysis in older patients.

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The research also concluded that older people who are unable to dress, go the toilet, bathe, eat on their own or get out bed in the morning are not likely to improve on dialysis. Such conditions raise the question about whether dialysis seems to be a wise choice in hopes of living more time; however, if someone seems to be relatively healthy, that is another matter entirely.

Since the likelihood of adding longevity to the elderly is, to some extent, still debatable, given the sheer array of circumstances that affect the chances of succeeding, another question seems to linger: “Can patients live longer on dialysis than on other types of supportive therapy?” Studies suggest that older people on dialysis will certainly live longer than those who dismiss the possibility of starting the treatment and choose instead to treat other pathologies like pain or nausea —which is commonly referred to as supportive therapy. According to a recent compilation of studies and reviews, patients who decided to start supportive therapy had a life expectancy of at least six months, which, compared with patients on dialysis, is far shorter. In general, the evidence supporting an advantage in the elderly on dialysis is somewhat weak, and there is definitely growing concerned amongst the scientific community that perhaps too many patients may be on dialysis without assured potential benefits. There has been a growing concern regarding overtreatment on older individuals, especially those who suffer from other diseases or depict the conditions mentioned above and are frail or have any sort of life-limiting conditions. Older patients and their families deserve to be given honest and precise information so that they can understand what they can expect when their primary physician recommends undergoing the treatment. Dialysis is without any question a very demanding and exhausting treatment; is, in fact, one whose potential benefits and burdens deserve careful assessment and consideration.