What is Dialysis?
Chronic Kidney Disease (CKD) usually progresses to End-Stage Renal Disease (ESRD). When that happens, dialysis has to be done to remove the waste materials, salt, and water from the body that cannot be removed by any other means.
Hemodialysis
Dialysis can be done in two ways. Hemodialysis is when a shunt is placed in the forearm. It is surgically done at least three months ahead in anticipation of the hemodialysis. Hemodialysis is usually done three times a week and can last for as long as four hours at a time. Taking into account the travel time and waiting, half of the day has passed by the time all is said and done.
Peritoneal Dialysis
Peritoneal dialysis (PD) involves inserting a flexible tube thru the abdominal wall to instill the dialysis fluid that will absorb the waste materials from the abdominal cavity. The same catheter will also drain the waste fluid. Peritoneal dialysis can be done in two ways. Continuous Ambulatory Peritoneal Dialysis (CAPD) is done 3 to 4 times in 24 hours and lasting about 30-40 minutes each daily. It is ambulatory because the patient can resume their normal activities.
The other is the Automated Peritoneal Dialysis (APD). APD involves using a machine called a cycler that will put the dialysate inside the body and drain it. Not all patients are suited to do PD because it needs manual dexterity and the ability for the patient or someone else at home to do it.
There should also be extra planning when going out of town or out of the country to make sure that the dialysis can be done safely wherever they may go.
Dialysis Patients in the Emergency Room
I have seen many dialysis patients in the emergency room. As in any procedure, HD or PD have their own complications. The most common will be continuous bleeding from the HD dialysis site because the needles that are used are big. Since the bleeding site has a wide hole from the dialysis needle that was removed after the HD and under high pressure, massive blood loss can happen in a short period if it is not controlled.
If someone missed their dialysis, fluid could rapidly build up in the lungs, and they present in the emergency department with severe shortness of breath. Most situations will need urgent dialysis and may even need to have a breathing tube and hooked to a breathing machine if the condition is severe.
Infections are also a problem. Any material that is not native to the body is an invitation for an infection. It can be localized inside the stomach or body-wide. Either way, most need antibiotics and possible admission to the hospital. There are other complications like low blood pressure and passing out, and the ones mentioned here are just an example.
Diabetes is the most common cause of CKD and ESRD. Anyone with CKD can benefit from the following kidney-friendly tips from the Centers for Disease Control. Emphasis added by me.
- Keep your blood pressure below 140/90 mm Hg (or the target your doctor establishes for you).
- If you have diabetes, stay in your target blood sugar range as much as possible.
- Get active—physical activity helps control blood pressure and blood sugar levels.
- Lose weight if you’re overweight.
- Get tested for CKD regularly if you’re at risk.
- If you have CKD, meet with a dietician to create a kidney-healthy eating plan. The plan may need to change as you get older or if your health status changes.
- Take medications as instructed, and ask your doctor about blood pressure medicines called angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers, which may protect your kidneys in addition to lowering blood pressure.
- If you smoke, quit. Smoking can worsen kidney disease and interfere with medication that lowers blood pressure.
- Include a kidney doctor (nephrologist) on your health care team.
If numbers 1 to 4 sounds familiar, that is because they are the same things that are needed to prevent and maybe even reverse metabolic syndrome and Type 2 diabetes (T2D). The same metabolic syndrome that is associated with many other diseases.
The Earlier the Prevention, The Better
Why wait until the development of kidney disease or T2D to make a lifestyle change? Dialysis or any other illness is no picnic. The time for prevention is as early as possible. Don’t Get Sick.
Thanks for reading.
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Image Credits:
- Hemodialysis By GYassineMrabetTalk✉This W3C-unspecified vector image was created with Inkscape. – Own work from Image: Hemodialysis schematic.gif., CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=3411574
- Peritoneal Dialysis National Kidney and Urologic Diseases Information Clearinghouse, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, USA
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