Dialysis - Symptoms, Risk factors and Treatment

The kidneys are one of the essential organs that work day and night to keep your body healthy and functional. They excrete out waste and excess water that are harmful to our bodies. If they do not work well, toxins will build up, hence causing damage to us. Therefore, we must take proper care of them, since their functioning plays a role in our survival and quality of life.

Dialysis performs the role of a kidney that is unable to function well. According to experts, dialysis is done when the kidney is working at only 10 to 15% of its normal function. 

In dialysis, your blood is filtered through a machine to get rid of toxins and waste products. It keeps your fluid and electrolytes in balance as your kidneys do. 

Types of Dialysis

Dialysis performs the job of your kidneys. There are two types of dialysis named hemodialysis and peritoneal dialysis. 

Hemodialysis 

In hemodialysis, your blood is put into a machine that filters it, takes out the toxins, and puts the blood back into your body. It is done in dialysis clinics or hospitals. 

Peritoneal dialysis 

In peritoneal dialysis, your blood is cleaned inside your body. Fluid is put into your abdomen that absorbs the waste from the small vessels of your abdominal cavity. After it filters it out, the fluid is thrown outside. This type of dialysis can be done at home. 

Risks associated with Dialysis

Risks associated with hemodialysis are;

• Hypotension- Low Blood Pressure
• Anemia, or Not Having Enough Red Blood Cells
• Muscle Cramping
• Difficulty Sleeping
• Itching
• High Blood Potassium Levels
• Pericarditis, an Inflammation of the Membrane Around the Heart
• Sepsis
• Bacteremia, or a Bloodstream Infection
• Irregular Heartbeat

sudden cardiac death, the leading cause of death in people undergoing dialysis

Risk factors associated with peritoneal dialysis are;

• Abdominal muscle weakening
• High blood sugar due to the dextrose in the dialysate
• Weight gain
• Hernia
• Fever
• Stomach pain
• Increased risk of infections 
• Peritonitis- infection of the abdominal cavity

How does Dialysis work?

Hemodialysis

For hemodialysis, you need to get a small surgery- a little cut that helps create access to the bloodstream. It can be done through a fistula, graft, or catheter. 

Fistula- also known as AV fistula or arteriovenous fistula, is when an artery and vein are joined together under the skin. Before using for hemodialysis, the AV fistula needs around 6 weeks or longer to heal properly. After that, it can be used for many years. 

A graft- also known as AV graft, is when your artery and vein are connected through a plastic tube under your skin. It takes two weeks to heal before hemodialysis. Therefore dialysis can be done soon. However, the risk of infection is greater when using a graft. 

A catheter- also known as a central venous catheter, is inserted into the vein of your neck, next to the groin, or below your collarbone. This catheterization is meant for a short time and emergency dialysis only. 

During hemodialysis, the healthcare provider will place two needles in your arms where a fistula or graft is created and connect it with a dialyzer- a machine that performs dialysis. Your blood is filtered through the machine that works like a kidney- filter excess salt, fluid, and waste. The blood is sent back to the body through the second port. During the procedure, you can sit or lie back on a chair. 

Peritoneal Dialysis 

For peritoneal dialysis, a catheter is inserted into your belly near the navel, weeks before dialysis. After the area heals, your doctors will train you to perform peritoneal dialysis as you will be doing it on your own. Through the catheter, you will transfer special fluid into your abdominal cavity. The solution contains fluids, salts, and additives, that work as an absorbent and absorbs excess salt, waste, and fluids. After a few hours, you will drain out that fluid into a separate bag- a process known as an exchange. There are two types of peritoneal dialysis;

Continuous cycling peritoneal dialysis (CCPD)- peritoneal dialysis that uses a machine to do exchanges. 

Continuous ambulatory peritoneal dialysis (CAPD)- peritoneal dialysis in which you will do exchanges through the hand. 

Conclusion 

Dialysis is done when your kidneys are not functioning well. It is a process that filters out waste, salt, fluid, and toxins out from your body.