If your kidneys cannot function due to illness or injury, dialysis can be a lifesaving treatment. Dialysis removes waste and excess fluids from your body, preventing serious health problems.
If you or a loved one requires dialysis, you likely have many questions. This article will explain what dialysis is, who needs it, how it works, and what to expect during treatment.
What Is Dialysis?
The kidneys are essential organs that filter waste products and excess fluid from the blood and produce urine. When the kidneys can no longer perform this function, waste builds up in the body, which can be harmful.
Dialysis is a treatment that helps individuals with kidney failure maintain a balance of fluids, electrolytes (such as sodium and potassium), and blood pressure. This is vital for staying healthy when the kidneys no longer function properly.
Who Needs Dialysis?
Dialysis is typically recommended when kidney function declines to a level that cannot keep the body healthy on its own. This can occur suddenly due to kidney injury or gradually over time in cases of chronic kidney disease (CKD).
CKD can eventually progress to end-stage renal disease (ESRD), the final stage of CKD, where the kidneys lose about 90% or more of their function. The medical community increasingly refers to ESRD as end-stage kidney disease (ESKD).
Dialysis may be a temporary or long-term solution. Some individuals only need it for a short period while their kidneys recover from an injury. However, most people with ESKD will need dialysis indefinitely unless they receive a kidney transplant. Without dialysis or a kidney transplant, individuals with ESKD cannot survive.
How Does Dialysis Work?
Dialysis takes over the kidney’s role in filtering the blood. It removes extra water, waste, and toxins from the body.
Types of Dialysis
There are two main types of dialysis: hemodialysis and peritoneal dialysis. Both remove waste and excess fluid but function differently. You and your doctor will determine which option best suits your needs.
Hemodialysis
Hemodialysis is the most common type of dialysis, using a machine to filter your blood outside your body.
Here is how it works:
Blood is drawn from your body and passed through a filter called a dialyzer, which acts as an artificial kidney.
Blood flows into tiny hollow fibers in the filter, while a special fluid called dialysis solution moves in the opposite direction outside the fibers.
Waste from the blood passes into the solution, which exits the body, and the cleaned blood returns to your body.
The dialysis machine monitors your blood pressure and regulates blood flow throughout the process.
Each session takes about four hours and typically occurs three times a week at a dialysis center or sometimes at home. Some centers offer nighttime treatments that take longer but happen while you sleep.
Peritoneal Dialysis
Peritoneal dialysis is an alternative for individuals with kidney failure. Instead of using a machine to filter the blood, this method uses the lining of your abdomen, called the peritoneum, as a natural filter.
Here is how it works:
A few weeks before starting treatment, a surgeon inserts a soft tube (catheter) into your abdomen.
During treatment, dialysis solution is introduced into your abdomen through this tube. The peritoneum filters waste from the blood, and the waste is absorbed by the solution.
After a few hours, the fluid containing waste and excess fluid is drained and replaced with fresh solution to continue the filtering process.
This process is repeated several times daily, depending on individual needs. The two main types of peritoneal dialysis are continuous ambulatory peritoneal dialysis (CAPD), performed manually several times daily, and automated peritoneal dialysis (APD), which uses a machine, often overnight.
Peritoneal dialysis can be done at home, work, or while traveling, provided the location is clean and private.
What to Expect During Hemodialysis
Hemodialysis involves a structured process at regularly scheduled intervals. Before starting, minor surgery is performed to create an access point (called an arteriovenous fistula) for the machine to connect to your bloodstream, often in your arm. For patients unable to have a fistula created, a catheter may be placed in a vein in the neck to allow connection to the bloodstream.
At the start of each session, a nurse or technician inserts two needles into your access point, connecting them to soft tubes that link to the dialysis machine.
Each session lasts about four hours, and most people go to a dialysis center three times a week. While the machine operates, you can read, watch TV, or sleep. Some individuals feel tired afterward, and side effects like low blood pressure, cramps, or headaches may occur. Your care team will monitor you closely to manage any discomfort.
Lifestyle and Other Changes Your Doctor May Recommend
Living with dialysis often requires adjustments, but with time and support, many people adapt well. Here are some changes your doctor may suggest:
- Dietary Adjustments: Since your kidneys can no longer filter certain nutrients, you may need to limit foods high in sodium, potassium, and phosphorus. Managing fluid intake is also important. Additionally, dialysis removes protein from your body, so increasing protein intake may be necessary.
- Medications: Some medications processed by the kidneys may need adjustments, and new ones might be prescribed to manage blood pressure, protect bones, or prevent anemia.
- Regular Check-Ups: Your health care team will monitor your condition with blood tests and other assessments to ensure dialysis is effective and your body is adjusting well.
- Time Management: Dialysis can consume several hours weekly, so planning around your treatment schedule is essential. While it may feel overwhelming initially, many individuals successfully balance treatment with work, family, and personal time.
Dialysis can be life-changing, but it does not have to limit your quality of life. With proper care and support, many individuals continue to work, travel, and enjoy time with family and friends. Your health care team will help you manage your treatment and maintain your well-being.
