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Dialysis
Dialysis also known as Kidney Dialysis or Hemodialysis is a process wherein a machine is used to purify blood in a person with chronic kidney disease or kidney failure, i.e, when the kidneys cannot function effectively on their own. In this procedure, blood is drawn out of the body through a dialysis access, and passed through the machine, or dialyzer, where it is filtered of waste substances such as urea and creatinine, and then returned to the body. Dialysis (Hemodialysis) also helps in the balancing of electrolytes and in the removal of extra fluid from the blood. This procedure helps in increasing the life expectancy of patients with kidney failure and helps them lead a normal life.
The following symptoms may indicate kidney disease or failure and in turn the requirement for kidney dialysis (hemodialysis).
- Vomiting or diarrhea
- Loss of appetite and weight loss
- Fatigue and nausea
- Blood in the urine
- Unusually high amounts of urination with pale urine or unusually low amounts with dark urine
- Itching and muscle cramps due to build up of phosphates
- Weakness, dizziness and low blood pressure due to anemia
- High blood potassium which may lead to abnormal heart rhythms and muscle paralysis
Kidney failure and the need for dialysis can be confirmed through the following tests and diagnostic procedures:
- Blood tests- various blood tests such as blood urea nitrogen test (BUN), GFR ( glomerular filtration rate), creatinine
- Abdominal ultrasound
- Kidney biopsy
- Urine tests
For the treatment to commence, a dialysis access is created on a person’s body to gain access to the blood for filtration. The access can be created using the following methods:
- Fistula- is a connection between an artery and a vein. It is created surgically and requires an adequate amount of time to form completely.
- Synthetic graft- a synthetic tube, or graft, is implanted under the skin to connect an artery to a vein. It acts as an artificial vein and is usually used when a person has small or blocked veins.
- Intravenous catheter- a catheter is a small flexible tube which is inserted in the arm and which can be used to draw blood. It is not used a permanent access, rather it is used only when a person is in a dire need for dialysis and there is not enough time for the formation of a more permanent access.
Once an access is created, two needles, which are connected to two tubes that are in turn connected to the dialyzer, are inserted through the access site. Blood is then extracted with the help of one of the tubes and passed through the dialyzer where it is then cleansed with the help of a cleansing liquid called dialysate. The clean blood is returned to the body through the second tube. The patient’s blood pressure and heart rate are monitored during the course of the treatment and once dialysis is completed, the needles are removed from the access site.
Fluid shifts during the procedure can cause various side effects such as low blood pressure and hypertension, muscle cramps, fatigue, headaches and nausea. Creation of access sites can also lead to infections or blockage if proper care is not taken. Sleep related problems and mood swings are common in patients undergoing Dialysis (Hemodialysis). It can also cause various forms of heart disease in the long run.
The patient needs to be closely monitored during and after the procedure for any sign of inadequate dialysis. The access site should be checked for infections and the patient and his caregivers should be educated to avoid the same. One should not carry heavy weights, sleep on, or restrict the access arm in any manner.
Dialysis from one of the best multi-speciality hospital: Apollo Hospitals Greams Road Chennai, Greams Lane, Chennai
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