Kidney and Dialysis: A Comprehensive Guide

Understanding Kidney Function

The kidneys play a crucial role in maintaining overall health by:

• Filtering waste products and excess fluids from the blood.
• Regulating blood pressure.
• Producing essential hormones.
• Removing waste through urine.

When kidney function is impaired due to conditions like Chronic Kidney Disease (CKD), the body’s balance is disrupted, leading to severe health issues.

When Does Kidney Failure Occur?

Kidney failure happens when:

• 85–90% of renal function is lost.
• Glomerular Filtration Rate (GFR) drops below 15.
• Kidney function becomes insufficient to sustain life.

Chronic Kidney Disease and Dialysis

CKD progresses over time, and when kidney function diminishes significantly, treatments like dialysis become necessary. Dialysis replaces some kidney functions, such as waste removal and fluid regulation.

Types of Dialysis

1. Hemodialysis

• Procedure: Blood is removed from the body, filtered through an artificial kidney (dialyzer), and returned to the body.
• Frequency: Typically 3 times a week, with each session lasting 3–5 hours.
• Location: Performed in hospitals, dialysis centers, or at home with proper training.

2. Peritoneal Dialysis

• Procedure: The abdominal lining (peritoneum) filters the blood using a dialysis solution.
• Methods:
  • Automated Peritoneal Dialysis (APD): Uses a machine (cycler) overnight.
  • Continuous Ambulatory Peritoneal Dialysis (CAPD): Done manually several times a day.
• Location: Usually done at home.

When is Dialysis Needed?

1. Acute Kidney Injury (AKI)

• Sudden loss of kidney function.
• Requires temporary dialysis support.

2. End-Stage Kidney Disease (ESKD)

• Occurs when kidneys function at only 10–15% capacity.
• Requires lifelong dialysis unless a kidney transplant is performed.

How Dialysis Helps

Dialysis helps by:

• Removing waste and excess fluid.
• Maintaining healthy blood mineral levels.
• Regulating blood pressure.

Side Effects of Dialysis

Hemodialysis Side Effects:

• Vascular access obstruction.
• Muscle cramps.
• Low blood pressure.
• Fatigue or nausea.
• Blood loss.

Peritoneal Dialysis Side Effects:

• Increased risk of hernia.
• Weight gain.
• Infection at the catheter site.

Common Side Effects:

• Itchy skin.
• Infections (blood, skin, or peritoneal).

Hemodialysis vs. Peritoneal Dialysis Comparison

Frequently Asked Questions (FAQs)

1. What is Dialysis?

   • Dialysis is a treatment that removes excess fluid and waste when kidneys fail. It partially replaces kidney functions.

2. What Stage Requires Dialysis?

   • Required for:
     • Acute Kidney Injury (AKI): Temporary support.
     • End-Stage Kidney Disease (ESKD): When kidney function drops below 15% (eGFR < 15 mL/min).

3. What is Hemodialysis?

   • A process where blood is filtered outside the body using a machine (dialyzer) and returned through a vascular access site.

4. What is Peritoneal Dialysis?

   • Blood is filtered inside the body using the peritoneum as a natural filter, with cleansing fluid (dialysate) absorbing waste.

5. How Long Can Someone Live on Dialysis?

   • Life expectancy varies but can range from 2–10 years. Some live much longer with proper care.

Dietary Considerations During Dialysis

Patients undergoing dialysis should:

• Limit phosphorus, potassium, and sodium intake.
• Control fluid consumption to prevent overload.

Managing Kidney Health with Expert Guidance

Early intervention and proper management improve life expectancy and quality of life for CKD patients.

Dr. Sandip Bhurke, a renowned nephrologist and kidney specialist in South Mumbai, offers personalized care for CKD patients. With his expertise, patients can navigate dialysis treatment effectively and look forward to a healthier future.