Kidney Dialysis: Types, Risks & Outlook

Kidneys are your two reddish-brown bean-shaped blood-filtering organs. Each kidney is attached to a ureter, a tube that carries your excreted urine to the bladder. The kidney participates in the removal of toxins, various electrolyte concentrations, acid-base balance, fluid osmolality and control of the volume of various body fluids. 

Sometimes, the kidneys may not function due to chronic kidney disease, acute kidney failure or other kidney issues. Dialysis is a life-saving treatment that can take the place of the function of failing kidneys. It works by filtering your blood to help restore both electrolyte and fluid balances. 

There are also complications and risks to consider, as well as problems with treatment access. Talk with a doctor about the pros and cons of dialysis, and ask them which type might be best for your situation.

What is Kidney Dialysis?

By eliminating extra fluid and waste from your body, the kidneys filter your blood. When you urinate, the bladder receives this waste and excretes it.

When your kidneys can not perform well due to injury or disease, dialysis can help keep the body running using a machine. Kidney failure occurs when the kidneys perform only 10% to 15% of their typical function. Salts and other waste items build up in the blood without dialysis, which can harm other organs.

What are the Different Types of Kidney Dialysis?

Types of dialysis can include CRRT (continuous renal replacement therapy), peritoneal dialysis and hemodialysis. 

Hemodialysis

Hemodialysis is a form of dialysis that uses a filter called a hemodialyzer to remove extra fluid and waste from the blood. 

• Before hemodialysis 

To get access to your blood vessels, a doctor conducts a little surgical procedure. This is done in advance, as it might take several months to heal.

The 3 types of entrance points include:

• Vascular access catheter
• AV graft
• AV (Arteriovenous) fistula

Both the AV graft and AV fistula are designed for long-term dialysis treatments. Catheters are designed for temporary or short-term use.

• During hemodialysis

Your blood is drawn from your body during therapy and sent through the hemodialyzer to be purified. The body receives the filtered blood back after that with the aid of a dialysis machine.

Hemodialysis treatments last about four hours each, up to three times per week. You might also have hemodialysis treatment in shorter, more frequent sessions.

At first, most hemodialysis treatments are performed at a dialysis centre, doctor’s office or a hospital. The length of treatment depends on your current health, the amount of waste in your body and your body size. 

• After hemodialysis

After you have been on hemodialysis for an extended period, you might be ready to give yourself dialysis treatments at home. People who require long-term therapy frequently choose this alternative. 

Peritoneal Dialysis

Peritoneal dialysis uses a PD (peritoneal dialysis) catheter in your abdomen to filter your blood. The catheter filters blood through the peritoneum, a membrane in your abdomen. 

• Before peritoneal dialysis

A doctor performs surgery to implant the catheter. This usually happens about 3 weeks in advance.

You normally receive training from a dialysis nurse for a couple of weeks before dialysis to learn to perform the exchanges and care for the catheter site. 

• During peritoneal dialysis

Dialysate, a unique fluid used in therapy, enters the peritoneum. The dialysate absorbs waste. Once the dialysate draws waste out of the bloodstream, it is drained from your abdomen.

This process can take a few hours and needs to be repeated three to five times daily. But this fluid exchange can happen while you are awake or sleeping, and even during daily activities.

Types of peritoneal dialysis include:

• Continuous ambulatory peritoneal dialysis (CAPD): Your abdomen is filled and drained multiple times daily. This method doesn’t require a machine and must be performed while awake.
• Continuous cycling peritoneal dialysis (CCPD): To cycle the fluid in and out of your abdomen, CCPD employs a machine. Usually, it’s done when you’re sleeping at night.
• Intermittent peritoneal dialysis (IPD): This treatment is usually performed in the hospital, though you may perform it at home. Although it makes use of the same equipment as CCPD, the procedure takes longer.
• After peritoneal dialysis

After treatment, you will need to take care of your catheter, exit site, and other supplies to prevent infection.

Continuous Renal Replacement Therapy (CRRT) 

CRRT is used mainly in the intensive care unit for people with acute kidney failure. It is also known as hemofiltration.

A machine passes the blood through the tubing. After that, a filter eliminates waste and water. A machine returns the blood to the body, along with replacement fluid. This process is carried out for at least 24 hours at a time.

You Can Also Read: 10 kidney disease symptoms to watch out for 

What Risks are Associated With Kidney Dialysis?

All 3 forms of kidney dialysis can carry certain risks:- 

Risks Associated with Hemodialysis

• sudden cardiac arrest
• irregular heartbeat
• bacteremia (a bloodstream infection)
• sepsis
• pericarditis (an inflammation of the membrane around the heart)
• hyperkalemia (high blood potassium levels)
• itching
• difficulty sleeping
• muscle cramps
• anaemia
• hypotension (low blood pressure)

Risks Associated with Peritoneal Dialysis

Peritoneal dialysis might increase your risk of infections in or around the catheter site, like peritonitis. Other risks include:

• stomach pain
• fever
• hernia
• vomiting or nausea 
• weight gain from excess fluids and dextrose 
• Dialysate dextrose causes elevated blood sugar.
• abdominal muscle weakening

Risks Associated with CRRT

• anaphylaxis
• weakening of bones
• delayed renal recovery
• bleeding
• electrolyte disturbances
• hypotension (low blood pressure)
• hypothermia
• infection

Long-term dialysis patients run the danger of contracting other illnesses, such as amyloidosis.

After learning they have long-term renal failure, some patients experience anxiety or sadness. If you are having thoughts associated with depression, talk with a mental health professional or a member of your care team. 

You Can Also Read: Diet Chart for Kidney Patients

Are there any Alternatives to Kidney Dialysis?

Other treatment options might help manage your symptoms if you decide not to pursue dialysis.

One option is anaemia management. When the kidneys work correctly, the EPO (hormone erythropoietin) is produced naturally. You can receive an EPO injection once a week to help with a kidney that isn’t working properly.

You can decrease kidney degeneration by keeping your blood pressure in a healthy range. Drink fluids to avoid dehydration. Before using any anti-inflammatory medications, see a doctor.

A kidney transplant might be an option. Find out if a transplant is right for you by speaking with a doctor. A kidney transplant may not be an option for you if you:

• have an untreated mental health condition
• have obesity
• heavily use alcohol
• smoke

What is the Long-term Outlook for Kidney Dialysis?

Dialysis can temporarily serve the same function as kidneys until your kidneys repair themselves and begin to work on their own again.

But if you have chronic kidney disease, you usually go on dialysis permanently or until a kidney transplant becomes an option.

While on hemodialysis, you will need to limit your sodium, phosphorus and potassium intake. You might need to keep a record of how much liquid you consume. Problems might arise from having too much fluid in the body.

A kidney doctor (nephrologist) usually has a dietician on the team to help guide dietary choices.

Maintaining a regular dialysis schedule will help lessen your need for a kidney transplant.

If you are considering stopping dialysis, mention any concerns to a doctor.

While it is in your right to stop any treatment at any time, they might suggest you talk with a mental health professional before ending this life-saving treatment. If the condition causing kidney failure has not been corrected, stopping dialysis will eventually lead to death.

Conclusion

Your kidneys perform many vital roles, including the removal of toxins. Sometimes, they may not function properly due to a disease or kidney failure. Kidney dialysis is a life-saving therapy but it also has risks and complications to consider, so it is always advisable to seek medical help from an experienced nephrologist. Timely care and help can ensure an appropriate diagnosis and treatment of your condition. 

At the CK Birla Hospital, we ensure patients get holistic medical support which includes treatment in a compassionate environment. This patient-centric approach not only helps patients heal better but also ensures they are aware of the preventive measures as well. In case you need to consult a nephrologist, reach out to us, or book a direct appointment with Dr. Umesh Gupta at the CK Birla Hospital.

FAQs

Is Kidney Dialysis Painful?

The dialysis treatment itself is painless. However, some patients might have a drop in their blood pressure that could lead to cramps, headaches, vomiting or nausea. However, if you take care to follow your fluid restrictions and kidney diet, these types of side effects can be avoided.

How Long Can a Kidney Patient Live on Dialysis?

Life expectancy on dialysis differs depending on how well you follow your treatment plan,  your other medical conditions and various other factors. The usual life expectancy on dialysis is 5 to 10 years. Many patients, nevertheless, have successfully maintained a 20- or 30-year dialysis regimen.