How is dialysis done?
Dialysis is done by using a special fluid called dialysate. Dialysate, a mixture of pure water and chemicals, is carefully controlled to pull wastes out of your blood without removing substances your body needs.
A semipermeable membrane keeps the blood apart from the dialysate. This membrane lets the wastes and fluid in your blood flow through into the dialysate. Your blood cells and larger molecules, like protein that you need, cannot fit through the holes.
What is hemodialysis?
Hemodialysis, the most common treatment option for treating ESRD, is a way of cleaning your blood using a dialysis machine and a special filter called dialyzer. The dialyzer works as an artificial kidney, straining toxins and removing extra fluid that build up because of ESRD. However, the dialyzer does not completely replace your original kidney’s function. Remember, healthy kidneys work 24 hours a day, 7 days a week, while hemodialysis takes a few hours a day, 2-3 days a week.
What happens during hemodialysis?
During a dialysis treatment, two needles connected to hollow plastic tubes are inserted into your fistula or graft. Your blood is pumped out by the machine through one line to the dialyzer to be cleaned. Once cleaned, it is returned to your body through another plastic tube. Your nephrologist will prescribe the length of your treatment, usually four hours a day done three times a week, either Mon/Wed/Fri or Tues/Thurs/Sat, but may vary depending on your body size, laboratory results and medical condition. You will have the same morning or afternoon time for each treatment.
In the early stages of chronic kidney disease, you do not need dialysis. These stages can last for many years. But if your kidneys fail, you will need dialysis or a kidney transplant to keep you alive.
If I have kidney disease, how long will it be before I need to start dialysis?
Depending what stage your kidney disease is and how quickly it progresses, you may never need dialysis, or you may need dialysis right away. Dialysis is usually recommended when your kidney function is about 10-15% of normal, or about 25% if you have diabetic kidney disease, or if you have severe symptoms caused by your kidney disease, like shortness of breath, fatigue, muscle cramps, or nausea and vomiting. If you are not having symptoms, you may be able to wait a bit longer. Since chronic kidney disease often happens slowly, sometimes people do not even know how bad they feel until they start dialysis and begin to feel much better! It is important to start getting ready for dialysis or a transplant well in advance.
I am in Stage 4 kidney disease and can’t have a transplant. Can I do dialysis for the rest of my life?
Yes, dialysis is something you can do for the rest of your life. Some people have been on dialysis for 30 years or more without getting a transplant. How long you can live on dialysis, and how well you do, will depend on a number of things, including:
- How healthy you are, other than kidney disease
- How positive your attitude is (optimists live longer, depression can be treated)
- Whether you receive good quality medical care and dialysis
- How much you learn about dialysis and take an active role in your care.
Will I have to quit work when I start dialysis?
No. You dont have to quit work when you start dialysis.
Can I travel on dialysis?
Yes. With proper planning, you can travel while on dialysis. Start small—with day trips and quick weekend getaways. Then you can build up confidence and work up to longer vacations. Your center can forward a copy of your dialysis prescription and other records to the center you will visit.
If you do peritoneal dialysis, you can take your supplies with you, or have them shipped to your destination. Check with your PD nurse. Your PD nurse can help you learn safe ways to do your exchanges while camping or taking a driving trip.
Once I am on dialysis, will my kidneys get better?
The chances that your kidneys will get better depend on what caused your kidney failure. Kidney failure is divided into two general categories, acute and chronic. Acute (or sudden) kidney failure is often temporary. In chronic kidney failure, the kidneys normally do not heal.
In acute kidney failure, kidney function may recover with or without dialysis. But when the damage to your kidneys has been continuous and progressive over a number of years, as it is in chronic kidney disease, then the kidneys usually do not get better since the damage is considered irreversible. Hence, long-term dialysis is needed. While your kidneys will not get better once you are on dialysis, you may feel significantly better and live life to the fullest.
»data courtesy of Philippine Society of Nephrology«