Dialysis
Kidney & its functions
The kidneys are a pair of bean-shaped organs, each about the size of a fist, located on either side of the spine, just below the rib cage on the upper and back sides of the abdomen. Extremely vital for our life, the kidneys perform numerous vital functions in the body to maintain our overall health.
They prevent excess water and waste from accumulating in the body by flushing them out in the form of urine as well as regulating the levels of chemicals in the blood such as sodium, potassium, and calcium.
The kidneys also produce hormones that help control blood pressure and stimulate the production of red blood cells. As a result, the kidneys may become susceptible to various conditions or diseases with all the crucial functions they perform and the toxins they encounter.
What is dialysis?
Dialysis is a procedure to remove excess water and waste products from the blood when the kidneys stop functioning that involves cleaning the blood by diverting it to a machine.
It is artificial filtering and purifying of the blood which helps in keeping the fluids and electrolytes in balance when the damaged kidneys cannot perform their functions.
This substitution for the natural functioning of the kidneys is also called renal replacement therapy (RRT). Dialysis is recommended for those patients whose kidneys have failed or are close to failing.
Patients with late-stage kidney failure, whose kidneys are performing at around only 10-15% of their normal function, need regular dialysis or until a donor’s kidney is found.
However, dialysis cannot cure kidney diseases or other problems affecting them. The purpose is to prevent the accumulation of waste products in the blood from reaching hazardous levels.
Types of Dialysis
Kidney failure can be treated with different types of dialysis:
1. Intermittent Hemodialysis (IHD)
2. Peritoneal Dialysis (PD)
3. Continuous Renal Replacement Therapies (CRRT)
Intermittent Hemodialysis (IHD)
Haemodialysis is a procedure that uses a dialysis machine to draw out the blood from the body and let the blood circulate outside the body to be filtered.
The blood is cleaned through a special filter called a dialyzer or an artificial kidney which removes excess salt, fluids, and wastes. It works just like the kidneys, as the filter removes waste products from the blood.
The filtered blood goes back to the body after going through the dialyzer. To draw out the blood from the body and return the filtered blood to the body, minor surgery is needed to make an access or entrance into the bloodstream.
This surgery is usually done in the arm and enlarges the blood vessels for the insertion of a fistula, graft, or catheter. Haemodialysis is usually done 3 times a week, with each session lasting 3-4 hours.
The duration of treatment depends on the condition of the kidneys between treatments. Haemodialysis can be done in a hospital, a dialysis facility, or at home. The doctor and patient can decide the best location, based on the patient’s health condition.
For patients who have dialysis at home, a caretaker is recommended who is willing to help with the haemodialysis and knows exactly what to do and what not to do. The home environment must be suitable for haemodialysis procedures.
We, at Yashoda, provide a homecare facility through our expertly trained medical staff who are skilled and compassionate enough to provide you with the best treatment in the comfort of your home. Our doctor will let you know when you should start treatment. They will also explain which type might work best.
Peritoneal Dialysis (PD)
Peritoneal dialysis is another procedure to remove waste products from the blood when the kidneys can no longer function adequately. It uses the lining of the abdominal cavity to filter the blood inside the body.
During the procedure, a cleansing fluid called dialysate is run through a catheter or tube into a part of the abdomen called the peritoneal cavity. The dialysate fluid stays in the abdomen for some time, which usually lasts from 4-6 hours.
The dialysate helps filter extra fluid and waste products in the blood from tiny blood vessels in the lining of the abdominal cavity. After the blood is filtered, the fluid is drained through the catheter into a sterile collection bag and discarded.
Minor surgery near the navel is needed for this treatment to allow the insertion of a tube or catheter to fill in and drain the dialysate out of the abdomen.
This process of filling and draining the dialysate from the body is called an exchange. Peritoneal dialysis can be carried out at home and even while travelling.
It is especially convenient for patients who are working or attending school. It allows for more flexibility in the schedule as it can also be carried out at night with a machine. The doctor will determine the best methods for the patient, considering their medical condition and personal preferences.
Continuous Renal Replacement Therapies (CRRT)
Continuous Renal Replacement Therapy (CRRT) is a slow and continuous procedure that lasts 24 hours in an Intensive Care Unit (ICU). It is useful for patients with acute kidney failure and is recommended for those patients whose bodies cannot tolerate conventional intermittent haemodialysis;
CRRT is more tolerable due to the slower process of fluid removal and leads to fewer complications including a lower risk of hypotension. The filter removes wastes from the patient’s blood when the kidneys aren’t functioning properly. Following a healthy diet, particularly eating foods with low sodium and phosphorus, is good for kidneys. It is also critical to take medications as prescribed by the doctor to get the best possible results.
The procedure requires special anticoagulation called citrate to prevent the blood from coagulating or clotting. Patients receiving dialysis treatment are more vulnerable to getting an infection, which can deteriorate their overall health.
Therefore, it is important to take precautions before, during, and after dialysis to improve the results of your treatment, as well as to maintain your overall health.
Following a healthy diet, particularly eating foods low in sodium and phosphorus, is good for
the kidneys. It is also critical to take medications as prescribed by the doctor to get the best
possible results.
Meet the nephrologists at Yashoda Hospital & Research Centre, Nehru Nagar, Ghaziabad:
Dr Ravinder Singh Bhadoria
He is the senior consultant at the Nephrology & Kidney Transplantation Unit at Yashoda Hospital & Research Centre, Nehru Nagar, Ghaziabad. A dedicated nephrologist, he is highly trained, having worked with the best nephrologists at various hospitals throughout the country.
With more than 15 years of experience in nephrology, he holds expertise in managing critically-ill nephrology patients, general nephrology patients, and patients with CKD Stage V and renal transplantation.
