The kidneys are the purifiers of the body; they help in removing the waste from the body through the urine. In those suffering from kidney diseases, the function of the kidney is affected, and so their ability to clear out waste from the body is reduced and completely lost gradually. However, waste continues to form, and therefore, such patients have to undergo dialysis, where the blood is purified through an external device.

The frequency and duration of the dialysis would depend on how effectively the kidneys are still functioning and how much waste has been formed from the time of the previous dialysis session. The person s overall body mass index (BMI) and the water weight gained are also considered.

Once it is decided that a person s kidneys are damaged and dialysis is required, the person has to prepare for a long-term process. The following outlines what to expect before, during, and after the dialysis sessions. 

Before the session: 

Since most people prefer to get it done at a dialysis centre, it is preferable to plan for it, three treatments a week on an average, with each session lasting about 4 to 4 hours.

During the session: 

The blood flows through the dialysis device, which acts as an artificial kidney. The sequence of events are as follows:
The Weight is checked
Vital signs, including heart rate, blood pressure, breathing and pulse are checked.
The access areas are washed, and needles are used to connect these areas to the dialysis machine. Anesthesia may be used in the beginning to reduce the pain in this area.
The same access areas are used for each session, and over a period of time, buttonholes are formed which is like a small tunnel.
Though the session would last about 3 to 4 days, normal activities can be done, including reading, working on a laptop, watching television, or even sleeping.
Once the dialysis session is complete, the tube will be removed and a dressing is placed over the site.
After the session

The same site is used each time for the dialysis, so for the first couple of sessions, there could be discomfort. There could also be nausea, diarrhoea, cramping, and headaches.
The treatment needs to be adjusted based on symptoms, so please let the doctor know if you experience any symptoms.

Call the doctor if you are facing the following:

Bleeding from the access site
Inflammatory signs around the site
Persistent fever of over 104 degrees
Numbness or weakness in the arms
Confusion, drowsiness, or cognition problems
Though initially uncomfortable, once you get into the dialysis schedule, you will notice the difference of how cleansed you will feel after each session.

Undergoing Dialysis - What To Expect From It?

Every organ is important for the human body to perform its functions normally. Kidneys too are vital and are responsible for removing the excess fluid and toxins from the body. If the kidney is not functioning properly, then the patient is advised to undergo dialysis treatment. In some cases, the patient is advised to undergo a transplant. However, in any case, the patient has to follow a healthy diet, for the treatment and the medicines to work positively.

Suitable diet during dialysis
Most of the patients are not aware of the diet prescribed for dialysis. Though it is always advised to consult a dietician before following any diet for the condition, it is also advisable to gain some knowledge about what the dietician might suggest, so that one is not clueless about the treatment. In a majority of the cases, food containing potassium, phosphorus, low-fat cholesterol, and sodium is included in the diet of these patients. However, these are prescribed in a limited amount and vary from patient to patient.

Sodium: The sodium level of the dialysis patients needs to be controlled; and this can be done by eating food items that have a low sodium content, not more than 2,000 mg. Hence, the quantity of snacks, pudding, and chips are to be reduced in the diet chart.
Potassium: The level of potassium also needs to be kept in check to avoid further deterioration of the kidney. Bread, certain vegetables, and grains contain a high amount of potassium. Moreover, various salt substitutes contain potassium chloride instead of sodium chloride. Large intake of these foods may affect the kidney permanently. Hence, these are majorly excluded from the diet. The patients are advised to include tomatoes and bananas in their diet, though not on a daily basis.
Phosphorus: The patient is advised to avoid foods with high phosphorus. This includes milk and dairy products and grains. However, while on dialysis, meat is important as it gives enough protein despite being high on phosphorus. But, an abundance of meat in the diet may affect adversely. Hence, this is advised, but kept in control.
Cholesterol: To keep cholesterol amount in check during dialysis, the patient needs to cut down on fruits and vegetables and specific fat diets, while eating a sufficient amount of fish.
Protein: High protein food is necessary for a patient with a kidney disease. Meat is an excellent source of protein. Along with that, poultry, fish, and eggs are important, as well. Hence, all this is included in the diet.
Fluids: Dialysis helps in removing the excessive waste fluids from the kidney. But, to keep the body hydrated, the patient is allowed liquid intake, but only up to a certain limit.
It is necessary to maintain a proper diet during dialysis, as it quickens the treatment as well as helps the patient recover quickly.

Undergoing Dialysis - What Should Be Your Diet?

When do kidneys need dialysis?

Kidneys are a pair of organs that are located on either side of the spine, each about a size of a fist. The kidneys help in purifying blood by removing toxins, waste materials and excess fluids from the human body. Disorders and dysfunctions of the kidney can lead to severe and often fatal consequences. When the kidneys stop functioning as they are supposed to, dialysis is performed to resume normal functioning in the body.

Dialysis is a type of treatment, which filters and purifies the blood with the aid of a machine. It is an artificial way of purifying blood. There are two types of dialysis, namely hemodialysis and peritoneal dialysis. Hemodialysis, the most common form of dialysis, which involves using a manmade kidney called a hemodialyzer, which removes toxins and waste materials from blood.

Peritoneal Dialysis, on the other hand, is a type of treatment which involves implanting a catheter in the stomach. During the procedure, a fluid called dialysate flows into the abdomen that absorbs all the waste material, which is consequently drained out of the body.

You may need a dialysis if:

- Your kidneys are dysfunctional
- When waste materials and toxins start to accumulate in the body
- In an event of an injury or accident to the kidney such as internal lacerations (wound caused by the tearing of a tissue)
- If the creatinine (a type of a chemical waste product) level falls to 10-12 cc/minute
- In an event where the kidneys aren't able to work properly leading to accumulation of toxins, irregular amounts of chemicals in the body and other dysfunctions

Weakening of the abdominal muscles and weight gain are some of the risks involved in dialysis. Dialysis is a temporary treatment and serves to function till the time the actual kidneys get repaired. In chronic cases of kidney disease, kidney transplant may perhaps be the last resort.



When Do Kidneys Need Dialysis?

No Blood, No needle, No visit to hospital, you can do yourself at home with water. A thin layer of transparent screen like structure hangs in front of the abdominal muscles known as peritoneum. This peritoneum protects the abdominal structures and the muscle. This can also be used for performing dialysis which is carried out when the functioning of kidney gets affected. In peritoneal dialysis a thin and soft catheter is placed in the person s belly one week before performing the procedure.

The catheter has numerous holes in order to facilitate the transformation of fluids. Dialysis solution is prepared in a bag and the tubing is connected to the catheter placed in the abdomen thereby, the fluids absorb the waste materials from the body. The fluid is allowed to stay in your body for a particular period of time which is commonly referred as dwell time and later the fluid is drained out.

There are two types of peritoneal dialysis, continuous ambulatory peritoneal dialysis and automated peritoneal dialysis. This is the simple form of dialysis which anybody can perform after a short training period and this can be done anywhere in clean private place like hotels, home and even in office.

Procedure followed during Peritoneal Dialysis
All you need to perform a peritoneal dialysis is catheter and transfer set, cycler, dialysis solution and safety precautions materials to stay away from getting infections.
Step 1 - Perform a sterile aseptic technique. Wear a glove and surgical mask before connecting the catheters and transfer set. Clamp the tubing and remove the catheter once the dialysis solution enters your abdomen
Step 2 - Allow the solution to remain in your abdomen for a particular period of dwell time
Step 3 - Drain the fluid from the abdominal cavity into the drain bag. You may feel a mild tugging sensation when adequate amount of fluid is drained.
Step 4 - After drain close or clamp the transfer set and later flush a fresh solution directly to drain bag so as to remove the air from the tubing.
Step 5 - Close your drain bag and open your transfer set and refill your belly with fresh solution.

Make sure you perform without giving way for infection and excess fluid and dextrose absorption.

Peritoneal Dialysis - Procedure to be Followed!

A diseased kidney is one that has lost its ability to carry out the filtration process in a proper manner. This process of filtration usually sends the waste and toxins out of the body in a routine manner. In such cases, a kidney disease manifests which requires a number of treatment measures. Dialysis is something that enters the treatment plan at a later stage as chronic early stage kidney disease can remain in the patient s body for many years. When the kidney function comes down to 15%, then most doctors recommend the start of dialysis which is basically a process that removes the excess waste and fluid from the blood. This can be a process that will leave the patient fatigued and in a mental state that is not exactly stable and positive at all times. It is common to see dialysis patients battling depression due to the chronic nature of the treatment as well as the low chances of recovery.

So, let us find out how dialysis patients can cope with depression.

    Professional Help: Depression is said to be like a common cold when it comes to mental diseases. The state of a person s body can very well affect the balance in his or her mind and lead to depression. Starting from pressing circumstances to hormonal changes as well as chronic ailments, depression can affect people due to a number of reasons. Dialysis patients who are undergoing depression must consult a professional specialist like a psychiatrist who will help the patient understand and cope with the situation with the use of therapy based counselling.
    Medication: The patient can also be given medication that will prevent the build up of unnecessary stress by blocking the production of those hormones that result in a negative state of mind. This medication must be prescribed after speaking the patient s nephrologist about what kind of medication will suit the patient specifically.
    Psychotherapy: Long term psychotherapy is also known as talk therapy that can help the psychiatrist or clinical psychologist in talking the patient through the problems. Besides giving the patient the scope and platform to air out the problems and reach solutions regarding normal day to day functioning despite the troubles, this kind of therapy also aims at equipping the patient with a better perspective and improved attitude.

While going through this kind of therapy and medication, it is important to keep a team of nephrologists and psychiatrists in the loop so that the patient may reach out at any time in order to avail help in the most trying situations. This will give a blanket of security to the patient as well.

3 Ways a Dialysis Patient can Cope with Depression

A dialysis diet is a special diet that is customized for patients who are or will be starting dialysis within a short period of time. Such a diet is prepared to reduce the waste and fluid levels that keep on accumulating between the dialysis sessions so that the patient remains healthy for the process to be carried out seamlessly.

What can you eat?
Eat foods which are rich in high-quality proteins (poultry, fish, lean meat and egg whites).

What can t you eat?
Eat less of foods which are rich in sodium and phosphorus.

Foods high in Sodium
1. Use minimum salt in preparing the dishes; this helps control BP and probable weight gain that might happen between the dialysis sessions.
2. Make use of spices, herbs and other salt-flavored enhancers.

Meat
1. Patients on dialysis need to include more of high-quality protein foods in their diet. This will help regulate blood protein levels. Eat about 10 ounces of foods rich in high-quality protein every day.
2. 1 egg,   cup of ricotta cheese,   cup of tuna.

Salads/Vegetables

The potassium content of vegetables can be alarming for a patient on dialysis. Eat 3 servings of vegetables that are low in potassium every day. These include broccoli, cauliflower, cabbage, carrots, garlic, cucumber, eggplant, celery, radishes, etc.
Avoid vegetables such as beets, potatoes (in any form- wafers or wedges), winter squash, cooked spinach, pumpkin, asparagus and avocado.
Note:

Although seeds, nuts, peanut butter, lentils, dried beans and peas are rich in protein, they are generally struck off from the diet plan because of their high phosphorus and potassium content.
You can have moderate amounts of grains, bread and cereals.
Try and not have brown bread and other whole grains as they are loaded with phosphorus.
Usually, 5-10 servings of these are considered sufficient for patients on dialysis.
Also, limit intake of milk and other dairy products.
  cup yoghurt or   a cup of milk is considered safe. Also, remember that all varieties of milk- skim, whole and low fat, have the same amount of phosphorus.
All fruits contain some amount of potassium. However, some of them contain more potassium than the others. Limit your intake of fruit juices.
Avoid or limit fruits like: 
Orange juice and oranges
Kiwis
Prune juice and prunes
Dried fruit and raisins
Melons
Bananas

Dialysis - What To Eat & What To Avoid?

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