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What is Dialysis and What are its Risks and Benefits?


I feel like a lot of us have heard the term “dialysis,” but we don’t know exactly what it entails. For those of you who are like me and would benefit from learning more about dialysis, what it is, and what those who get dialysis go through, this article is perfect. Let’s get right into it!

 

So, what is dialysis? “Dialysis is a type of treatment that helps your body remove extra fluid and waste products from your blood when the kidneys are not able to” [1]. So, clearly, dialysis is meant to help perform the function of the kidneys when they aren’t doing it themselves, but there are two specific situations in which dialysis is used. Acute kidney injury (AKI) is one condition in which dialysis is used. AKI is “a sudden episode of kidney failure or kidney damage that happens within a few hours or days” [1]. Dialysis is not the immediate treatment used when dealing with AKI, but it “may also be needed for a short time until the kidneys get better” [1]. The other condition in which dialysis is used is for kidney failure, which is very different from AKI. Kidney failure is “when 10-15% of your kidney function remains” [1]. Yes, this is completely as bad as it sounds. “At this stage, your kidneys are no longer able to keep you alive without some extra help. This is also known as end-stage kidney disease (ESKD). With kidney failure, dialysis is only able to do some of the work of healthy kidneys, but it is not a cure for kidney disease” [1]. When it comes down to it, having ESKD will mean sitting through a lot of dialysis treatments, but even then, your kidneys are too far gone for the dialysis to really fix anything. Basically, if you have ESKD, “you will need dialysis for the rest of your life or until you are able to get a kidney transplant” [1]. On top of that, there is a huge waiting list (I’m talking over 100,000 people just in the U.S.) for getting a kidney transplant. So, in reality, thousands of people will need to be on dialysis for a very long time, so let’s get into how dialysis works and the two types of dialysis treatments that so many individuals are experiencing across the globe.

 

Like I said before, dialysis is a treatment used to help perform the functions that your kidneys usually do when they are functioning normally. These functions include: “removing waste and extra fluids in your body to prevent them from building up in the body, keeping safe levels of minerals in your blood, such as potassium, sodium, calcium, and bicarbonate, [...] helping to regulate your blood pressure” [1]. All of these functions are important for the health of your entire body.

 

Now, there are two different types of dialysis treatments available. The first is called “hemodialysis (HD).” “In hemodialysis, a dialyzer (filtering machine) is used to remove waste and extra fluid from your blood, and then return the filtered blood into your body” [1]. So, your blood is taken out of your body, filtered in a machine, then put back into your body. “Before starting hemodialysis, a minor surgery is needed to create a vascular access site (opening into one of your blood vessels), usually in your arm” [1]. This is just so there is an easy access to obtain blood for all of your dialysis treatments. “Treatments usually last about four hours and are done three times per week,” but this differs depending on individuals’ needs [1]. The second type of dialysis treatment you can get is called “peritoneal dialysis (PD).” For this version of dialysis, “your belly area is slowly filled with dialysate (a cleansing fluid made from a mixture of water, salt, and other additives) through the catheter. As your blood flows naturally through the area, extra fluid and waste products are pulled out of the blood vessels and into the belly area by the dialysate [...]. After a few hours, the fluid mixture is drained from your belly using the same catheter and bag that was used at the beginning of the treatment” [1]. So, in this dialysis treatment, it’s almost like your body is acting as the dialyzer with the help of necessary equipment. Just like HD, PD also requires a minor surgery before starting treatment, but it’s not in the arm the way HD is; rather, the minor surgery happens in the belly so the catheter can be inserted where it needs to be to fulfill the treatment [1]. There are two common types of PD treatment: Continuous Ambulatory Peritoneal Dialysis (CAPD) and Automated Peritoneal Dialysis (APD) [1]. “The supplies and equipment needed, duration of each treatment (also known as an exchange), and number of treatments per day will differ depending on the type of PD you are using and your medical condition” [1].

 

Now, for both hemodialysis and peritoneal dialysis, these treatments can be done at home, and PD can be done virtually anywhere as long as you have the necessary supplies [1]. It is nice that dialysis can be done in multiple places, like dialysis centers, hospitals, and your own home, so individuals can choose where they feel most comfortable while getting their treatments done. In order for your dialysis treatment to be as effective as possible, there are some steps you can take like: following your set schedule for treatments, following your recommended diet plan and getting regular exercise to keep your strength up, and discussing any concerns about side effects youmay be experiencing with your doctor [1].

 

Speaking of side effects, there are a good amount that can come with getting dialysis treatments. Now, different side effects come with the different dialysis treatments, but they also share some side effects, too. For HD, side effects include: “blockage in your vascular access site (entrance point), muscle cramps, hypotension (low blood pressure), weakness, dizziness, or nausea, and blood loss” [1]. As for PD, side effects include: “hernia (weakness in your abdomen muscle, often presenting as a lump or swollen area) [and] weight gain” [1]. The side effects both treatments share include: “infection of the skin, blood, and/or peritoneum (belly area), [...] fatigue, [...] [and] pruritus- itchy skin that people with kidney disease may experience” [1]. People may experience additional side effects, and they may not even experience some of these side effects listed, but these are the most common individuals do experience when going through dialysis treatment.

 

Dialysis treatments can affect some people’s daily routine. Although dialysis is meant to help individuals feel better, “some people report feeling tired after dialysis, especially if they have been getting dialysis treatments for a long time” [1]. This can definitely take a toll on someone’s day-to-day every now and then, especially when they’re already taking a few hours out of their day to make time for their dialysis treatment. Mostly, just working around dialysis treatments, a new recommended diet, and any side effects from treatment (like fatigue) is what can take some getting used to.

 

I know what you’re all thinking: how much does it cost to get this treatment? This can be extremely expensive,”however, most people with kidney failure are eligible for Medicare when they start dialysis. This means the federal government pays 80 percent of all dialysis costs. Private health insurance or state Medicaid programs may also help with the costs” [1]. Considering “the average life expectancy on dialysis is 5-10 years” and some even have lived with dialysis treatments for up to 30 years, it’s good to know that these options exist for many who need this treatment [1].

 

I know this article is going to help so many more people understand what dialysis is and what comes with it, because I definitely learned a lot, myself. If you are concerned about your kidney health, talk to your doctor to make sure you’re doing everything you can to avoid kidney failure; however, you can have peace in knowing there are options that exist to help you if you’re ever in that position.

 

References:

1. Dialysis. National Kidney Foundation. (2023, February 27). Retrieved April 4, 2023, from https://www.kidney.org/atoz/content/dialysisinfo

 

 

Contributors:

Author: Lauryn Agron

Editor: Chadwick Huynh

Health scientist: Marjorie Sy

 

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