Kidney Dialysis
Kidney Dialysis
Kidney dialysis is a life-saving treatment for individuals with kidney failure (end-stage renal disease or ESRD). When kidneys can no longer filter waste and excess fluids from the blood, dialysis performs this function artificially. This guide explores the types of dialysis, how they work, their benefits, risks, and the latest advancements in treatment.
Types of Kidney Dialysis
A. Hemodialysis (HD)
How It Works:
Vascular Access – A surgeon creates an access point, usually a:
- Fistula (connection of an artery and vein, preferred for long-term use).
- Graft (synthetic tube connecting artery and vein if veins are weak).
- Central Venous Catheter (temporary tube in the neck/chest for emergencies).
Blood Filtration – Blood flows from the body into the dialyzer, where:
- Waste and excess fluids are removed.
- Cleaned blood returns to the body.
Frequency – Typically done 3 times a week, each session lasting 3-5 hours.
Pros:
- Highly effective at removing waste.
- Performed at dialysis centers with medical supervision.
Cons:
- Requires strict schedule.
- Risk of infections, low blood pressure, and muscle cramps.
B. Peritoneal Dialysis (PD)
Types of PD:
Continuous Ambulatory Peritoneal Dialysis (CAPD)
- Done manually 4-5 times a day while awake.
- Each exchange takes 30-40 minutes.
Automated Peritoneal Dialysis (APD / Cycler PD)
- Uses a machine (cycler) to perform exchanges overnight.
How It Works:
- Catheter Placement – A soft tube is surgically placed in the abdomen.
- Dialysate Infusion – Sterile fluid flows into the peritoneal cavity.
- Dwell Time – Waste and excess fluids pass into the dialysate over 4-6 hours.
- Drainage – Used fluid is drained and replaced with fresh solution.
Pros & Cons:
Pros:
- More flexible, can be done at home.
- Fewer dietary restrictions than hemodialysis.
Cons:
- Risk of peritonitis (abdominal infection).
- Requires strict hygiene to prevent infections.
Innovations in Dialysis Technology
- Wearable Artificial Kidneys – Portable devices allowing continuous dialysis.
- Bioartificial Kidneys – Implantable devices combining synthetic and living kidney cells.
- Nocturnal Hemodialysis – Slower, overnight dialysis for better toxin removal.
- Telemedicine & Remote Monitoring – Digital tools to track dialysis patients at home.
Risks & Side Effects of Dialysis
- Low blood pressure (especially in HD).
- Muscle cramps & fatigue.
- Infections (catheter-related in PD, fistula infections in HD).
- Anemia & bone disease (due to reduced kidney hormone production).
Life Expectancy & Quality of Life on Dialysis
- Average life expectancy on dialysis is 5-10 years, but some live 20+ years with proper care.
- Quality of life varies—PD offers more freedom, while HD may cause fatigue after sessions.
- Kidney transplant remains the best long-term solution for eligible patients.
Dietary Guidelines for Dialysis Patients
- Limit potassium (bananas, potatoes).
- Reduce phosphorus (dairy, nuts).
- Control fluids (excess intake causes swelling).
- High-protein diet (to compensate for protein loss during dialysis).