Dialysis - Overview and Management

Overview

What is dialysis?

Dialysis is a treatment for people whose kidneys are failing. When there a kidney failure, kidneys don’t filter blood the way they should. As a result, wastes and toxins build up in the bloodstream. Dialysis does the work of the kidneys, removing waste products and excess fluid from the blood.

Who needs Dialysis?

Dialysis may be necessary for those with kidney failure or end-stage renal disease (ESRD). Kidney damage leading to disease can result from injuries or conditions like high blood pressure, diabetes, or lupus. In some cases, the cause of kidney problems is unknown. Kidney failure may be a chronic issue or a sudden onset after severe illness or injury, with the latter potentially reversible.

Kidney disease progresses through five stages. Stage 5 indicates end-stage renal disease or kidney failure, where kidney function is significantly reduced. At this stage, dialysis or a kidney transplant may be required for survival. Some individuals undergo dialysis while awaiting a transplant.

What do kidneys do?

Kidneys, part of the urinary system, are two bean-shaped organs located below the ribcage on each side of the spine. Their primary function is to filter toxins from the blood, returning clean, nutrient-rich blood to the bloodstream. Waste and excess water create urine, which travels from the kidneys to the bladder. Additionally, kidneys play a role in regulating blood pressure.

Procedure Details

What are the types of dialysis?

There are two ways to get dialysis:

• Hemodialysis

• Peritoneal dialysis

Hemodialysis

Hemodialysis uses a machine to remove blood, filter it through an artificial kidney (dialyzer), and return the cleaned blood to the body. This typically takes 3-5 hours and may occur in a hospital or dialysis center three times a week.

Alternatively, hemodialysis can be performed at home. At-home treatments may be needed 4-7 times a week, with each session lasting for a shorter duration. Some individuals opt for nocturnal hemodialysis while sleeping.

Peritoneal dialysis

Peritoneal dialysis utilizes tiny blood vessels within the abdominal lining (peritoneum) to filter blood with the assistance of a cleansing solution. This solution is a specialized liquid containing water, salt, and additional additives.

Administered at home, peritoneal dialysis offers two treatment methods:

• Automated peritoneal dialysis employs a machine known as a cycler.

• Continuous ambulatory peritoneal dialysis (CAPD) is performed manually.

Recovery and Outlook

What’s the outlook (prognosis) for someone on dialysis?

Individuals on dialysis can potentially live for 10 to 20 years. The outlook depends on age, overall health, the cause of kidney failure, and additional factors. Receiving a kidney transplant allows for the discontinuation of dialysis once the new kidney functions properly.

Will I have activity restrictions while I’m on dialysis?

Many individuals on dialysis maintain active lives, working, raising families, and traveling. Healthcare providers can assist in arranging dialysis at a new location when traveling. For those on self-dialysis, dialysis solution bags and the portable home dialysis machine (if necessary) can be taken along.

Individuals using peritoneal dialysis may need to temporarily limit exercise or certain physical activities when the abdomen is filled with dialysis solution. Otherwise, exercise is generally acceptable for those on dialysis. Consulting with a healthcare provider about specific activities or sports is recommended.

A note from our specialist

Dialysis is a lifesaving treatment for individuals with kidney failure or end-stage renal disease (ESRD). This treatment may be continued indefinitely or until a kidney transplant becomes available. Several types of dialysis exist, with some preferring at-home dialysis and others opting for treatment at a hospital or dialysis center. Please discuss dialysis options with our doctors to determine the most suitable treatment for each individual.