Dialysis is a blood-cleansing treatment used to remove toxic substances from your blood when your kidneys either fail, aka renal failure, or are too diseased to sufficiently perform their filtering task, aka chronic kidney disease. And dialysis may be used to remove drugs or poisons quickly as well.
Healthy kidneys not only function as waste removal for blood via filtration, but they also participate in:
- managing water level in your body
- making sure blood pH remains between 7.35-7.45
- maintaining balance of sodium, potassium, phosphorous, other minerals & vitamins
In addition, your kidneys release three vital hormones:
- renin ~ regulates blood pressure
- erythropoietin ~ stimulates bone marrow to make red blood cells
- calcitriol ~ helps maintain calcium for bones, chemical balance in body
Yet, dialysis can only replace these renal functions that a healthy kidney performs:
- helps control blood pressure
- removes waste, salt, extra water to prevent build up
- maintains safe level of potassium, sodium, bicarbonate
Hemodialysis and peritoneal dialysis are the two types of dialysis. Hemodialysis is the most common treatment method used and is typically done in a medical setting. Whereas, peritoneal dialysis is done at home.
With hemodialysis, your blood slowly flows through an artificial kidney that has a special filter to remove toxins, waste, chemicals and fluids. As your blood is cleaned it is returned to your body.
The length of time it takes for hemodialysis treatment varies because how long depends on stuff like:
- your size
- how well your kidneys work
- type of artificial kidney used
- how much waste needs to be removed
- how much fluid you retained since your last treatment
Generally, you can expect your hemodialysis treatment to last around four hours and you’ll likely need to do this about three times a week.
And because your body is continuously making waste and retaining fluid, you’ll be instructed to closely follow a hemodialysis diet.
Some hemodialysis treatments are being done at home as well. So, talk to your renal health care provider about whether this option is right for you.
Some of the potential treatment risks of hemodialysis are:
- cramps
- infection
- ischemia
- hypotension
- air embolism
- nausea, vomiting
- access site bleeding
- electrolyte imbalance
Peritoneal dialysis cleanses your blood without removing it from your body. So, you’ll have a renal dialysis blood cleaning from your inside rather than outside.
How peritoneal dialysis works is a catheter is surgically placed into your peritoneal cavity. Via the catheter, a cleansing liquid called dialysate is slowly introduced. Dialysate solution contains dextrose, a sugar, that has the property of pulling waste and extra fluid.
As blood flows through the arteries and veins that line your peritoneal cavity, extra fluid and waste products are drawn out through your peritoneum and into the dialysate. Then the kidney dialysis solution containing the waste and fluid is drained and discarded.
Continuous Ambulatory Peritoneal Dialysis (CAPD) and Continuous Cycling Peritoneal Dialysis (CCPD) are the two major types of peritoneal dialysis. CAPD is done without a machine and you can go about your life while the dialysis solution in your abdomen. CCPD treatment requires a machine and is done while you sleep.
And you’ll likely be instructed to consume a special peritoneal dialysis diet, which differs from the one for hemodialysis.
Risk of infection around your catheter site is the primary health concern while using either peritoneal dialysis treatment methods. You’ll be instructed to watch for signs like:
- fever
- nausea, vomiting
- redness, pain around catheter
- unusual color, cloudiness in used dialysis solution
Because your kidneys do more than just remove waste and extra fluid, you may experience other health issues. Some of the more common conditions caused by kidney disease or failure that dialysis may not prevent are:
- pallor
- pruritus
- anemia
- insomnia
- extreme tiredness
- restless legs syndrome
- bone, joint, nerve problems
- amyloidosis ~ common if on dialysis for over 5 years
Not all kidneys that fail is a permanent health condition. In some cases, kidney failure is acute and dialysis may only be needed until your kidneys get better. However, with chronic kidney disease or end stage kidney failure your kidneys won’t recover and you will need dialysis for the rest of your life.
