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Hemodialysis Treatment For Kidney Failure Explained
Permanent and advanced kidney failure is most likely to be treated using a procedure called hemodialysis. This process was first introduced as a practical way to treat kidney failure in the 1960s.
Since that time, much has been learned about how to improve the effectiveness of hemodialysis and make it safer for patients
The function of the kidneys in your body is to clean your blood. They do this by removing wastes, minerals, and excess fluids. In addition, they make several crucial hormones which serve to keep your blood and your bones healthy.
Kidney failure leads to waste buildup within your body.
Your body is likely to retain water, your blood pressure will rise, and you may become deficient in red blood cells.
These are the reasons for dialysis treatment; it replaces the function of healthy kidneys.
How Does Hemodialysis Work?
Hemodialysis works in much the same way as your own kidneys. Blood is pumped through a filter that removes waste products. The clean blood is then returned to your body.
This maintains proper blood pressure, as well as keeping the balance of minerals such as sodium and potassium.
One of the inconveniences of this treatment is the need to follow a strict schedule. You can expect a full treatment to take up 10-15 hours of your week.
Most patients follow a 3 day a week schedule, with each session lasting from 3-5 hours or more.
We have even come to the point where dialysis machines are small enough for home use.
Though it has come a long way since its introduction, it is still a complex process, and requires the coordinated efforts of a full team of health care professionals. This includes the nephrologist, the dialysis nurse and technicians, a nutritionist, and a social worker.
Because of the nature of treatment, the most important members of the health care team are you and your family.
When you and your family learn as much as possible about the dialysis treatment, its strengths, weaknesses, and shortcomings, you will get superior results, meaning you can lead an active and fulfilling life.
Home dialysis is gaining in popularity, and there are several centers in America where you can learn to perform hemodialysis treatment from home.
In addition to yourself, a friend or family member will also be required to take the training. This training lasts from 4-6 weeks. Home dialysis treatment provides you with more flexibility, but it is still critical to maintain a strict schedule when doing home dialysis.
Dialysis Equipment and Procedures
There is no doubt that your first visit to a dialysis center will leave you with an impression of complexity and discomfort.
This is normal, but in time you will become used to the mix or new people and the large hemodialysis machines. Here is what you can expect in terms of equipment:
The Dialysis Machine — Machines have come a long way and the current machines are roughly the size of a small washing machine or dryer.
The machine is used to pump blood, clean waste products from the blood, and return the blood to your body.
In addition, it also monitors the flow of blood to and from your body, as well as monitoring your blood pressure.
The Dialyzer — The dialyzer is attached to the dialysis machine and is often referred to as the artificial kidney, as this is where your blood is actually cleaned. It is a large canister that contains thousands of fibers, around which your blood flows. The fibers allow the wastes and fluids in your blood to pass through into the dialysis fluid, which washes them away.
Do not be concerned if the dialysis center reuses your dialyzer.
This is considered to be safe, so long as the dialyzer is cleaned between each use. Just check that it is clean, disinfected, tested and marked with your name prior to use.
The Dialysis Solution — This is the solution that helps remove the waste and fluid from your blood. It is also known as dialysate. In addition to cleaning your blood it can also contain bicarbonate, which is used to neutralize the often acidic nature of kidney failure patients.
The specific concentration of dialysis solution is determined by your nephrologist.
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Dialysis patients typically have their blood tested once a month to determine if the dialysis treatments are removing sufficient waste products. There are two formulas, the URR or Kt/V, which can be used to test the waste concentration of your blood. Both tests measure the amount of blood urea nitrogen to determine if your dialysis is removing enough waste products from your blood.
Other Conditions Related to Kidney Failure
Because your kidneys do more than just remove waste from your bloodstream, there are other conditions you will be prone to. These include anemia and other bone, nerve and skin conditions.
Some common symptoms of kidney failure are bone and joint problems, itching, excessive tiredness, and a condition known as restless legs.
Here is a brief description of the more common problems associated with kidney failure:
Anemia and Erythropoietin (EPO) – Anemia occurs when there are not enough red blood cells in the blood. Because the red cells carry oxygen to all of the bodies organs, anemia sufferers are often chronically tired and pale.
Those with kidney disease are prone to anemia because the kidneys are responsible for producing the hormone erythropoietin (EPO), which stimulates the production of red blood cells in bone marrow.
Without enough EPO, the bone marrow red blood cell production is compromised and it will not produce enough. EPO is available by prescription and is often given to dialysis patients.
Renal Osteodystrophy — This is a bone disease related to kidney failure. It affects roughly 90 percent of all dialysis patients. It causes weak brittle bones and symptoms include bones that break easily, bone and joint pain, and bone deformation (especially in children).
It is believed that it occurs due to the increased phosphate levels of kidney failure patients, combined with the kidneys inability to convert vitamin D into a usable form.
Itching (Pruritus) — Itching is a common complaint of dialysis patients, especially during and just after dialysis treatment. It is believed that there are several mechanisms that cause this itching, though a sure treatment has not been found.
Some believe that the itching is related to wastes that remain in the blood because current dialysis processes cannot remove them.
Others feel that the itching may be related to high parathyroid hormone (PTH) levels.
Parathyroid glands are associated with the control of calcium and phosphorus in the blood. Removal of the parathyroid glands has provided some patients with relief.
Other patients have found relief through the use of phosphate binders, EPO shots, ultraviolet light exposure, and even over the counter antihistamines can provide relief. No matter what, it is important to care for dry skin to lessen itching.
Sleep Disorders — Sleep disorders are common in dialysis patients, with many patients complaining of insomnia. Some dialysis patients contract sleep apnea, which is a disturbance of breathing during sleep.
This can lead to extreme tiredness, headaches, and depression.
Sleep apnea treatments that work for dialysis patients are no different than those that work for other sleep apnea sufferers and include losing weight and changing sleeping position.
Far more dialysis patients have trouble sleeping because of restless legs.
Restless Leg Syndrome — Restless legs occurrs when the lower limbs twitch and jerk during sleep, often waking the sleeper. They are caused by nerve damage and chemical imbalances.
Moderate exercise during the day has been found to help with restless legs, as does avoiding caffeine, alcohol, and nicotine. Warm baths and massages have provided some patients with relief.
In extreme cases, a benzodiazepine such as Valium or Librium may be prescribed, but this is discouraged due to the addictive nature of this class of drugs.
While it can be difficult to accommodate yourself to the new requirements and symptoms of your hemodialysis treatment, it is good to know that this treatment is available to those with life threatening kidney disease.
While life might never be the same as before the dialysis, you can certainly still live a very active and fulfilling life, especially if you understand the dialysis process and how it effects your body.
Additional Patient Resources:
- Hemodialysis and Viral Hepatitis
- National Kidney Foundation
- American Association of Kidney Patients
- Renal Support Network
- National Institute of Diabetes and Digestive and Kidney Diseases
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