Charlotte, NC
Bibhusan Basnet, MD
Gauri Adhikari, MD
Dialysis is a crucial medical procedure that has transformed the lives of millions of individuals suffering from kidney disease. In this comprehensive article, we will delve into the world of renal treatment, exploring its various types, the process involved, its significance, and the impact it has on the lives of patients. Whether you’re a patient seeking information or simply curious about this life-saving treatment, this article will provide you with a deep understanding of renal treatment.
Dialysis is like a superhero when your kidneys cannot work as they should. Think of your kidneys as the body’s natural filter, removing waste and excess fluids from your blood. When they’re not working well, harmful substances can build up in your body, making you feel unwell. Renal treatment is an artificial filter, taking over the job your kidneys can’t do. It’s like having a helping hand to keep your body balanced and healthy when your kidneys need a little extra support. There are mainly two types of renal treatment. One of them is hemodialysis, and the other one is peritoneal dialysis. But which renal treatment is better for you? Remember, the ideal form of renal treatment for you depends on your preferences and health. Your doctor will assist you in making the best decision possible for you.
Hemodialysis is a treatment where blood is cleaned using a renal treatment machine and a specific filter called an artificial kidney or a dialyzer. The cleaned blood then travels back to your body through tubes from the machine connected to your vessels.
1. What needs to be done before starting hemodialysis?
Before starting hemodialysis, you need to create a port for your blood to flow in and out of your body to the renal treatment machine. Therefore, your doctor will order a minor surgery to get vascular access through your blood vessels. The port, in simple terms, is called a fistula. These fistula are usually made on your arms.
2. How will your blood flow from your body to the renal treatment machine?
Initially, when you reach the center, nurses will take your vitals to ensure they have your baseline information. Then, the nurse or the renal treatment technician will insert two needles into your arm through the fistula. Your blood will flow from one needle to the renal treatment machine, and then from the machine, the other needle will flow the cleaned blood back to your body. After setting up the flow rate, the renal treatment machine monitors your blood pressure (High Blood Pressure) and regulates how rapidly your blood passes through the filter, removing bodily fluids.
3. Can you do hemodialysis at home?
Hemodialysis was traditionally done at the renal treatment center, but these days, it can be done in the comfort of your home. You have to train yourself and someone else for emergency situations when you cannot do it. However, you must get your doctor’s appointment monthly to ensure your kidney numbers are good. That will, additionally, allow your doctor to decide the frequency of your renal treatment.
4. How long will you have to stay there attached to the machine?
Usually, each hemodialysis session lasts about three to four hours and is done three times a week. If you do it at home, you might need it four to six times weekly. It can be done at any time of the day or night. However, the time you need for renal treatment and the frequency depends on various factors:
5. Do you need to change your diet?
When you have reached a dialysis stage due to kidney failure, you must be strict with your diet, with limitations over certain foods rich in potassium and phosphorus, like bananas, beans, avocados, and whole wheat. You must also avoid taking high sodium-containing foods like canned and processed foods. But, if you are having home dialysis and your sessions are regular, you might be less strict with your diet. However, that may not apply to all.
6. Can you travel when you are having hemodialysis?
There are no restrictions to travel just because you are having hemodialysis. You can have your hemodialysis at any center, so you can feel free to travel, given that the city you are visiting has a renal treatment center. If you are on home hemodialysis, there are certain machines these days that are small enough to carry. You have to ensure someone is available to help you with each session.
7. Can you work while you are on hemodialysis?
One can always choose to work while having renal treatment, but you have to schedule your work around your renal treatment time. There is a little bit more flexibility when it comes to work and home renal treatment.
Peritoneal dialysis is one type of renal treatment treatment similar to hemodialysis for kidney failure. It uses a fluid that is introduced into your belly, and that helps to remove the toxin from your blood.
A few weeks before beginning peritoneal renal treatment, a surgeon will insert a soft tube into your abdomen known as a catheter. This is a minor surgery where only the area where your catheter gets inserted will be numbed. This catheter will transport fluid in and out of your belly. Additionally, you will get your initial peritoneal renal treatment sessions in the center to get used to the process. After the initial stage of training, you will get to do it on your own, and once you are confident, you can start doing it at home.
→ To begin with, you will use the catheter to fill your belly with the dialysate fluid. The fluid is rich in sugar, which will help to pull the fluid and waste from your blood. The tissue called the peritoneum, which covers most of your organs, will act as a filter
→ The dialysate will stay in your belly for a certain period, lasting four to six hours. During this time, the toxins will accumulate in the fluid.
→ After four to six hours, you will have to drain the fluid and refill it with fresh dialysate. This is called exchange, which will be determined by your doctor as to how many times you are supposed to do it in each session.
Depending on who will do the exchange process, there are two types of peritoneal dialysis:
1. Continuous Ambulatory Peritoneal Dialysis (CAPD)
In this type, you will use the force of gravity to do the exchange process.
Procedure:
During this process, you will attach the catheter in your belly to the dialysate fluid in a plastic bag. The bag will be hung in a stand and kept at the level of your shoulder. Gravity will pull the liquid into your belly. While that happens, you can walk around and do all your chores, ensuring you do not pull the catheter. Once the bag is empty, it is discarded. The dialysate will stay in your belly between the exchanges.
Usually, this is done at the beginning of the day so that the fluid can be drained at the end of the day, and you refill it one last time before you go to bed. In the morning, you will have to start the same process. In 24 hours, this procedure is often carried out three to five times, and each session lasts between 30 and 40 minutes.
2. Automated Peritoneal Dialysis
A device known as a cycler fills and empties your abdomen three to five times throughout an automated peritoneal dialysis treatment.
Procedure:
You start the day with a new solution that the machine will fill in your belly. Then, you let that fluid stay there all day while you do your work. At night, you attach your catheters to the machine and program it to do three to five cycles. For this purpose, one bag of solution for each exchange is connected to the three to five bags of dialysis solution that go into the cycler.
