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Dialysis - Treatment, Procedure And Side Effects

What is the treatment?

A healthy kidney has the function of filtering around 1500 liters of blood every day. If the kidneys fail to work properly, waste can accumulate in the blood. This can lead to serious health issues, resulting in coma and even death.

When the kidneys cannot function properly, a person needs to undergo dialysis to keep his/her body in balance. Dialysis performs the of your kidneys until they are functional. The process of dialysis removes waste, salt as well as the extra water, thus preventing them from accumulating in your body. It also ensures to keep certain chemicals in the blood like sodium, bicarbonate, and potassium within optimal levels. Lastly, dialysis also helps in controlling the blood pressure.

Dialysis is mainly of two types; hemodialysis and peritoneal dialysis. In hemodialysis, a hemodialyzer (artificial kidney) is used for removing the waste and extra chemicals from the blood. The peritoneal dialysis involves a surgery where a catheter is implanted in the stomach area, and a fluid named dialysate flows into the abdomen. This fluid draws out the waste from your abdomen after which it is drained out.

A dialysis can be done in the dialysis unit of the hospital or at your home. The doctor decides on the location based on your preferences and the status of your condition.

How is the treatment done?

There are mainly two types of dialysis treatment that a patient can undergo:

  • Hemodialysis – This is the most common form of dialysis. The doctor creates an incision so that the blood can flow to the artificial kidney or the hemodialyzer. The entrance point is made by creating a small incision in the arm or the leg. It can also be done by joining one of the arteries to a vein under the skin in order to make a bigger blood vessel known as a fistula. This surgical entrance point allows a large amount of blood to flow from your body during the treatment. As a result, more blood is purified and filtered. This treatment usually lasts for three to five hours. A patient is generally required to undergo a hemodialysis thrice every week. This option generally works for people who require long-term treatment.
  • Peritoneal Dialysis – This treatment involves implantation of a catheter in the area around the belly through which the fluid is administered to your body. The dialysate fluid draws out the waste from the blood, and then the waste is drained from your abdomen. Peritoneal dialysis can be further classified into two types. One is the Continuous Ambulatory Peritoneal Dialysis, where the abdomen is filled and drained multiple times in a day. The other is the Continuous Cycler-Assisted Peritoneal Dialysis, where a machine is used for cycling the fluid in and out of the abdomen. It is generally done at night when the patient is sleeping.

Who is eligible for the treatment? (When is the treatment done?)

You may need to undergo dialysis in the following conditions:

  • If you are suffering from a chronic kidney disease, you may require dialysis treatment until the time you decide to go for a kidney transplant.
  • Some people opt for dialysis if they come across symptoms of kidney failure like swelling, fatigue, nausea or vomiting.
  • When the results of your lab tests show high levels of waste in your blood. The rise in the blood urea nitrogen level and the creatinine level are indicators of poor performance of the kidneys.

Who is not eligible for the treatment?

Dialysis is usually not recommended for the following people:

  • Those who have some major illness apart from a damaged kidney like a heart or a lung disease
  • Peripheral artery disease of the legs, where your arteries become narrower and decrease the blood flow to your legs

Are there any side effects?

Dialysis can have the following side effects:

  • Weakening of the abdominal muscles
  • Gaining weight
  • Muscle cramping
  • Difficulty in getting sleep
  • Itching
  • High blood sugar due to the presence of dextrose (sugar) in the fluid (dialysate)
  • Depression
  • Low blood pressure
  • Increase in the blood potassium levels
  • Pericarditis, a condition where the membrane around the heart gets inflamed
  • Amyloidosis, if you are undergoing a long-term dialysis treatment. In this condition, the amyloid proteins that are produced in the bone marrow builds up in the liver and the kidneys. It can cause swelling, joint pain, and stiffness.

What are the post-treatment guidelines?

Listed below are some of the post treatment guidelines of a dialysis patient:

  • You must be careful about what you are eating and drinking. Take the advice of your doctor regarding the amount of protein, salt, and fluid that you are supposed to consume.
  • Avoid smoking, drugs or the consumption of alcohol that can affect the condition of your kidneys
  • Check for redness, swelling or pus at the incision site that has been made. If you see any of these signs, consult the doctor.
  • Ensure that the bandage covering the catheter is dry and clean
  • The person who helps with your treatment must always wash their hands properly before helping

How long does it take to recover?

The recovery time after undergoing a dialysis varies from person to person. For some it can be 2 hours, for some it is 4 to 6 hours and for few, it takes almost 12 hours to recover completely after the treatment.

What is the price of the treatment in India?

The cost of getting a hemodialysis can vary from Rs. 12,000 to Rs. 15,000 per month. A peritoneal dialysis can cost between Rs. 18,000 to Rs. 20,000 per month.

Are the results of the treatment permanent?

Dialysis can improve the condition of your kidneys and the quality of your life if the damage is in the initial stages. After a few sessions, you can stop the treatment. In the case of a chronic disorder, there is a possibility that you may need to undergo dialysis for the rest of your life.

What are the alternatives to the treatment?

There are no alternatives to the treatment of dialysis.

Safety: Medium Effectiveness: High Timeliness: Medium Relative Risk: Medium Side Effects: High Recovery Time: Medium Price Range: Rs. 12,000 - Rs. 20,000

Popular Health Tips

Depression - How Dialysis Patients Can Manage It?

Dr. Sudeep Singh Sachdev 86% (10 ratings)
MBBS, DM - Nephrology, MD-General Medicine
Nephrologist, Delhi
Depression - How Dialysis Patients Can Manage It?
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.
2672 people found this helpful

Dialysis - What To Eat & What To Avoid?

Dr. Sunil Prakash 90% (30 ratings)
FISN, FISPD, MD - General Medicine, MBBS, DM
Nephrologist, Delhi
Dialysis - What To Eat & What To Avoid?
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
2579 people found this helpful

Undergoing Dialysis - What To Expect From It?

Dr. Prashant C Dheerendra 89% (28 ratings)
MBBS, MD - Internal Medicine, DM - Nephrology
Nephrologist, Bangalore
Undergoing Dialysis - What To Expect From It?
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.
3582 people found this helpful

Fistula For Dialysis!

Dr. Rahul. N.S 92% (89 ratings)
MBBS, MS - General Surgery, MCh - Vascular Surgery, F.V.E.S
Vascular Surgeon, Bangalore
Fistula For Dialysis!
An arteriovenous fistula or AV fistula is a connection between the artery and vein made by a vascular surgeon at the time of hemodialysis. Hemodialysis is a treatment for kidney failure that involves a machine called dialyzer to filter the blood and remove the toxins. In order to gain a safe and easy access to the blood system during hemodialysis, the AV fistula is essential. An AV fistula is placed in the upper arm and it causes extra pressure and extra blood to flow into the vein, thereby making it stronger and larger. Benefits of AV Fistula Lower complication rates Less prone to injection or blood clotting Enables greater blood flow Relatively less expensive to maintain with a longer lifespan Types of Fistula for Dialysis All AV fistulas are created from the native blood vessels of the body, without any synthetic materials. The surgical process is quick and simple and requires a maturation time, in order to enable an increase and thickening of vessel walls. Radial Cephalic Fistula This access involves a connection of the radial artery and cephalic vein. It is the hardest to create and has a lower blood flow than the other types. Typically the first choice for hemodialysis access, the radial cephalic fistula at the wrist is recommended. Brachial Cephalic Fistula It is the easiest fistula that can be created by connecting the upper arm cephalic vein to the brachial artery. This access allows for a higher blood flow since the blood vessels in this part of the body are relatively larger. Also, it is easier to cannulate or introduce a tube into the vein, with a larger possible selection of cannulation sites. Brachial Basilic Fistula This access is more complex to create and typically considered when multiple access procedures have failed previously. It requires the vein to be elevated and transposed in order to enable easy access. A mobilized vein from a deep location is connected to a superficial tunnel. How does the AV Fistula Work? Before surgery is done to insert the fistula, the surgeon may perform a vessel mapping test to analyze blood vessels and determine the best blood vessels to use. Once the surgery is performed, the fistula needs 2 to 3 months to mature and accustomed to the body before it can be used for hemodialysis. At the start of the dialysis, the patient or healthcare provider inserts two needles into the access. One needle referred to as the arterial needle carries the blood from the body to the dialyzer machine. The dialyzer performs the kidney s function to filter out the toxins and then it returns the filtered blood through another tube. The other venous needle carries the filtered blood back to the body.
1942 people found this helpful

Ultrapure Water for dialysis : What is it And How is it beneficial to patients?

Dr. Prashant C Dheerendra 89% (28 ratings)
MBBS, MD - Internal Medicine, DM - Nephrology
Nephrologist, Bangalore
Ultrapure Water for dialysis : What is it And How is it beneficial to patients?
Do you know that 100 litres of purified water are used for each dialysis session? This water needs to be of very high purity. Otherwise the patient can be harmed and can lead to serious infections and even heart disease. At Dharma Kidney Care we use "Ultrapure" water for dialysis which is one of the purest forms of water on the planet.
2 people found this helpful

Popular Questions & Answers

Hi, Patient creatine is 3.1 mg/dl and urea is 70 mg/dl and potassium is 5.3mmol/L and chloride serum is 110mmol/L, so will medicine work on this patient or dialysis is compulsory. Patient age 66 year and no blood sugar problem only he has high blood pleasure.

Dr. Kunal Raj Gandhi 89% (111 ratings)
MBBS, MD - General Medicine, DM - Nephrology
Nephrologist, Delhi
Hello, At present he can be managed conservatively with blood pressure medicines and diet restriction. It is necessary for him to be under regular follow up of a nephrologist.
2 people found this helpful

My Brother had kidney problem. His creatinine is now 10.5. He underwent first dialysis and creatinine went down to 6.3. But now, it again soar to 10.5. What next we should do to do his treatment?

Dr. Sunil Prakash 90% (30 ratings)
FISN, FISPD, MD - General Medicine, MBBS, DM
Nephrologist, Delhi
Possibly look for reversibility of kidney disease If it is irreversible then he may need kidney transplant or dialysis indefinitely.
3 people found this helpful

My father-in-law is a CKD patient and he is taking treatment from 2012 with creatinine-3.5 Urea-80. His current levels are: HB: 9.80 Blood sugar: 108.9 Urea: 150 Creatinine: 6.82 GFR: 8 Sodium: 140 Potassium: 4.5 Chloride: 101 Bicarbonates: 25 Urine Analysis: Protein: 30 Blood CA 25 ery/ul Dr. Suggested to go for HD and fix the fistula in hand so that dialysis can be done whenever needed instead of doing in the neck if any emergency. As of now he is not having any symptoms like swelling, nausea, vomiting, itching. He is taking diet food normally and water in take 500 ml per day and urine output is 750 ml per day. In this condition, kindly suggest how to handle the situation whether we need to start dialysis now or continue with medication. If the fistula fixed now, is there any minimum period to start the dialysis?

Dr. Bhagyesh Patel 96% (5161 ratings)
MS - General Surgery, FMAS.Laparoscopy
General Surgeon, Gandhinagar
Hello dear Warm welcome to I have evaluated your query for your father in law thoroughly.* Any dialysis decision depends upon the severity of the symptoms. As there are no other detrimental symptoms, I do not recommend for fistula at present, keep medications, dietary precautions, regular consultation with urologist.* Once fistula is fixed, he has to undergo minimum once a week dialysis without failure. Hope this clears your query. Wishing him fine recovery. Welcome for any further assistance. Regards take care.
1 person found this helpful

My father in law has problems in kidneys & doctor has advised for dialysis within a short time, but he is not willing to do? So, Sir, Please advise what to do.

Dr. Jatin Soni 93% (29682 ratings)
General Physician, Mumbai
We will have to make him understand that if he doesn’t do dialysis than his life will be at high risk
1 person found this helpful

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