The kidneys are bean-shaped organs that play a vital role in keeping the human body functioning properly. It has many functions and the most important is waste removal. If the kidneys fail, it can put your life in danger. This is where kidney dialysis comes in.
The kidneys are located on either side of your spine, in the upper abdominal cavity. The right kidney is situated at a slightly lower level than the left because of the space occupied by the liver above it.
The function of the kidneys
The kidneys filter out waste, maintain body fluid levels, regulate acidity levels in the body, and aid in the formation of red blood cells.
Filtering out wastes and toxins: The kidneys filter out urea, excess salt, and toxins from the blood. Urea is one of the waste products created during cell metabolism. The wastes are passed out of the body through urine.
Regulating body fluid levels: The kidneys monitor and react to all changes in the body fluid level throughout the day. If the fluid level rises, they pass out more urine, if the fluid level falls, the kidneys pass out less urine.
Red blood cells creation: When the kidneys do not get enough oxygen, they signal the bone marrow to produce more RBC, by sending out a hormone called erythropoietin.
When your kidneys stop functioning properly, it affects all the above-mentioned functions, but mainly removal of body wastes and maintenance of proper fluid levels in the body. Most people can get along very well if even one of the kidneys does its job. However, if both the kidneys fail, it is time to look for an alternative plan—a way to take over the function of removing waste.
Kidney dialysis is the artificial process of cleaning out the blood. There are two common types of kidney dialysis—hemodialysis and peritoneal dialysis. In hemodialysis, the filtering of blood is done using an external machine. In peritoneal dialysis, the blood purification process is done inside the body.
A machine called hemodialyzer is used to filter wastes from the blood. Doctors use a few methods to create pathways in and out of your bloodstream. There are three main methods used for this—fistula, graft, and catheter.
Fistula: A vein and an artery are joined together, just beneath the skin in your arm. This procedure, also called A-V Fistula, provides access to your bloodstream. This surgery is minor, but it can take six weeks to heal, and you have to wait for that long before you start the dialysis process. The fistula can be used for many years, to perform hemodialysis.
Graft: A plastic tube is used in this process, to join a vein and an artery under your skin. This is called an A-V Graft, and it takes just 2 weeks to recover from the surgery. This does not last as long as fistula, and you may need a new graft after a few years.
Catheter: This is a temporary access method, for those who need to start dialysis immediately. A flexible tube is inserted either into your neck, next to your groin, or below your collarbone. This tube does not last long and needs to be replaced.
Hemodialysis is mostly performed at a kidney dialysis center. Sometimes, a patient might be permitted to set up a home dialysis facility and do it themselves after proper training.
Generally, you need to go to a medical center for your hemodialysis. You can sit back in a chair while the medical staff takes care of the procedure. Needles are inserted into the fistula, graft, or catheter, in order to pump out and pump in the blood.
The blood is pumped out of your system to the hemodialysis unit, which then filters out the waste and toxins from the blood. The purified blood is then pumped back into your system.
In this type of kidney dialysis, the patient plays a major role in the overall process. In peritoneal dialysis, the doctor inserts a catheter into your abdomen. You’re responsible for keeping this pathway clean and free of infection.
The catheter is used to fill your abdominal area with a filtering liquid contained in a plastic bag. The liquid then stays in your abdomen, filtering out wastes until the next dialysis session. Moreover, you first drain this liquid out of your body into the plastic bag that contained the dialysate.
The catheter should then be cleaned and you should fill your peritoneal cavity with dialysate from a new bag. You have to roll up this bag and insert it into your underwear until the next cleaning session. You have to repeat this process four or five times each day. This method is called Continuous Ambulatory Peritoneal Dialysis (CAPD).
There is an alternative method called Automated Peritoneal Dialysis (APD) that uses a machine called a Cycler. Here, the machine is loaded with five or six bags of the dialysate. The machine works at night, automatically draining out the old fluid, and exchanging a new bag of dialysate for it.
Which method to choose?
Your doctor will advise you on which procedure is best for you. This will depend on various factors like:
- How advanced is your condition?
- Will you be able to take care of yourself in a home hemodialysis setup?
- Will you be able to strictly follow the instructions in the CAPD method to stay free of infections and other complications?
- Will the Cycler and the APD method work for you?
- Is hemodialysis in a medical center the right choice for your current situation?
If your condition is advanced, you may be advised to go for the routine, two to three times a week. Perform hemodialysis in a proper medical center. Here, trained medical staff monitor your blood pressure and other factors during the procedure and make required adjustments in the kidney dialysis process.
Kidney dialysis has helped keep patients alive, long after both their kidneys stopped functioning. This procedure can keep you alive and lets you get back to your normal life until you have a kidney replacement.
Even for patients who have been unable to find a kidney donor, kidney dialysis has helped them live for another 10 years and in some cases, even longer.