A treatment that does some of the things done by healthy kidneys, dialysis is needed when your kidneys can no longer take care of your body’s needs. Although many people don’t need the full 100 percent of their kidneys’ abilities, serious health problems result when they have less than 25 percent renal function. (Learn more, too, by watching these videos and writing down your questions before your appointment.)
Total or nearly total and/or permanent kidney failure is called end-stage renal disease (ESRD). When this happens, your body fills with extra water and waste in a condition called “uremia.” Your hands and feet may swell, and you may feel tired and weak because your body needs clean blood to function properly. Untreated uremia may lead to seizures or coma – and will ultimately result in death. If your kidneys stop working completely, you will need to consider dialysis or a kidney transplant.
Like healthy kidneys, dialysis keeps your body in balance by:
- removing waste, salt and extra water in the body
- keeping a safe level of certain chemicals in your blood
- helping to control blood pressure
Dialysis can be provided in a hospital, dialysis unit, or even in the home, but this must be discussed with the physician. In some cases, dialysis is only needed for a short time until the kidneys get better (acute kidney failure). In chronic or end stage kidney failure, kidneys do not recover completely and dialysis is needed for life. In some cases, you may be a candidate for a kidney transplant, in which case you will be placed on a waiting list.
Two Types
Hemodialysis
In hemodialysis, an artificial kidney (hemodialyzer) is used to remove waste and extra chemicals and/or fluids from the blood. In order to get blood to an artificial kidney, we must make an entrance into your blood vessels through minor surgery in your arm or leg. If your blood vessels are not adequate for this procedure, we may use a soft plastic tube to join an artery and a vein under your skin, i.e., a graft. Occasionally, a narrow plastic tube (catheter) must be inserted into a large vein in your neck (temporary access for long-term treatment).
Peritoneal
In peritoneal dialysis, your blood is cleaned inside the body. In order to accomplish this, our surgeon will place a plastic tube called a catheter into your abdomen (belly) for access. During the treatment, this area (called the peritoneal cavity) is slowly filled with “dialysate” (a blood-cleansing solution) through the catheter, while blood stays in the arteries and veins that line the area. Extra fluid and toxins are removed from your blood and into the dialysate. After a period of time, this solution is drained and replaced with fresh fluid. There are many ways of handling this type of dialysis, but two major ones are most common:
- Continuous Ambulatory Peritoneal Dialysis (CAPD) – This is the only type done without machines and can be done on your own four or five times a day while at home or at work. By putting a bag of dialysate (about two quarters) into your peritoneal cavity through the catheter, the dialysate stays there for about four or five hours before it is drained back and thrown away (called an “exchange”). Each time an exchange is performed, you use a new bag of dialysate. This enables normal activities while the dialysate is in your peritoneal cavity.
- Continuous Cycling Peritoneal Dialysis (CCPD) – This type is usually performed at home using a machine called a “cycler.” Similar to the CAPD, a number of cycles (exchanges) occur and each cycle lasts about 1-1/2 hours. Using this method, exchanges are usually performed throughout the night while sleeping.
Contact us for more information regarding our work with dialysis patients.