Dialysis and Renal Care

When kidneys fail, your body may have difficulty filtering your blood and keeping your body chemically balanced. Dialysis is a treatment process that cleans the body of unwanted toxins, waste products and excess fluids. Dialysis can take the place of some kidney function and, along with medication and proper care, help people live longer.

The session covers

• Haemodialysis
• Peritoneal Dialysis
• Vascular Access in Dialysis
• Membrane Function
• Membrane Biology
• Dialysis Solutions
• Palliative Care for CKD/ESRD
• Conservative Management of Advanced CKD (Vs. Dialysis)
• Clinical Studies in Renal Transplantation
• Transplantation: Basic Science and Immune Tolerance
• Epidemiology, Outcomes and Health Services Research in Dialysis
• Complications of Dialysis
• Extracorporeal Dialysis: Techniques and Adequacy
• Quality of Life in Dialysis

Who needs dialysis?

When a person with chronic kidney disease (CKD) reaches end stage renal disease (ESRD), also known as kidney failure or stage 5 CKD, the kidneys are no longer functioning to filter and clean the blood the way healthy kidneys normally would. Without treatment, life-threatening waste and toxins will build up in the body. At this point, dialysis treatment or a kidney transplant is needed to prolong life.

Doctors use a number of kidney function tests when determining kidney health. Early diagnosis of CKD and regular monitoring can help you keep kidney function for as long as possible—and allow you and your doctor to plan for ESRD treatment when necessary.

How does dialysis work?

Dialysis works by filtering toxins, waste and fluid from the blood through a semipermeable membrane. There are different methods of dialysis that filter blood in different ways.

Dialysis treatment is prescribed by your doctor. Together, you and your doctor will discuss treatment options and determine what's right for you. If you decide to go on dialysis, your doctor will prescribe your treatment amount and frequency based on your unique health needs. It's important to complete your dialysis treatment exactly as prescribed to feel your best.

Types of dialysis

There are 2 main kinds of dialysis—and several kidney failure treatment options—to discuss with your doctor. Depending on which type of dialysis you choose, you may also have options for treating in a center or at home.

Peritoneal dialysis—uses the blood vessels in the lining of your abdomen—the body's natural filter—along with a special solution via a peritoneal catheter to filter blood. With this method, blood never leaves the body. At-home peritoneal dialysis can be done with a machine or manually at home, at work or even while traveling.

Hemodialysis—filters the blood with a machine called a dialyzer. Once you are connected to the dialyzer via your hemodialysis access, blood flows into the machine, gets filtered and is returned to the body. There is a choice in where you do hemodialysis and who performs the treatment. In-center hemodialysis is done at the center by a team of medical professionals. At-home hemodialysis can be performed in the comfort of your own home with or without a care partner, depending on your therapy choice.

Which type of dialysis is best?

In many cases, you'll be able to choose which type of dialysis you want to have.

The 2 techniques are equally effective for most people, but each has its own advantages and drawbacks.

For example:

haemodialysis means you'll have 4 treatment-free days a week, but the treatment sessions last longer and you may need to visit hospital each time

peritoneal dialysis can be done quite easily at home and can sometimes be done while you sleep, but it needs to be done every day

If you're able to choose the type of dialysis you prefer, your care team will discuss the pros and cons of each option with you to help you make a decision.

Read more about the advantages and disadvantages of both types of dialysis.

Side effects of dialysis

Haemodialysis can cause itchy skin and muscle cramps. Peritoneal dialysis can put you at risk of developing peritonitis, an infection of the thin membrane that surrounds your abdomen.

Both types of dialysis can make you feel exhausted.

Read more about the possible side effects of dialysis.

Life on dialysis

Many people on dialysis have a good quality of life.

If you're otherwise well, you should be able to:

Continue working or studying

Drive

Exercise

Go swimming

Go on holiday

Most people can remain on dialysis for many years, although the treatment can only partially compensate for the loss of kidney function.

Having kidneys that don't work properly can place a significant strain on the body.

Sadly, this means that people can die while on dialysis if they don't have a kidney transplant, particularly elderly people and those with other health problems.

Someone who starts dialysis in their late 20s can expect to live for up to 20 years or longer, but adults over 75 may only survive for 2 to 3 years.

But survival rates of people on dialysis have improved over the past decade and are expected to continue improving in the future.

Dialysis facts

• Dialysis can substitute many normal functions of healthy kidneys.
• Dialysis empowers people with kidney failure to live full, productive lives.
• There are 2 types of kidney dialysis: hemodialysis and peritoneal dialysis.
• More and more people are choosing at-home dialysis, which can offer greater flexibility and better outcomes.
• Many people switch dialysis types to fit a changing lifestyle at some point during long-term treatment.
• The best dialysis option for you is the one that best fits your lifestyle and health needs.

Resources for Dialysis Patients

1. Aging with Dignity
2. Alliance for Home Dialysis
3. Alliance for Paired Donation
4. American Association of Kidney Patients (AAKP)
5. American Kidney Fund (AKF)
6. BenefitsCheckUpRx
7. CaregiverStress
8. Cleveland Clinic Foundation Renal Diet Cookbooks
9. DaVita Diet Helper
10. DaVita Patient Citizens (DPC)
11. Dialysis Facility Compare (from the Medicare web site)
12. Dialysisfinder™  Travel help for patients/social workers
13. Dialysis Units in the USA™ (from Nephron Information Center)
14. Disabled Living Foundation (DLF)
15. European Kidney Patients’ Federation CEAPIR
16. Financial Assistance for Living Donors
17. Green Dialysis
18. HealthWell Foundation
19. Help Hope Live
20. Home Dialysis Central
21. Home Dialyzors United web site
22. Jewish Kidney & Transplant Support Center
23. Kidney Care Partners
24. Kidney Community Emergency Response
25. Kidney End-of-life Coalition
26. Kidney Options™
27. Kidney Patient's Guide (UK site)
28. Kidney Patient News
29. Kidney School™
30. Kidney & Urology Foundation of America, Inc.
31. Life Options Rehabilitation Program
32. Living Kidney Donor Network
33. Living Kidney Donor Search
34. Living Kidney Donor Search Tools and Tips
35. National Association of Professional Home Care
36. National Donor Memorial
37. National Family Caregivers Association (NFCA)
38. National Kidney Federation (UK site)
39. National Kidney Foundation (USA)
40. K/DOQI™ Educational Materials
41. National Patient Safety Agency (UK site)
42. National Patient Safety Foundation
43. Nephron Information Center
44. NIDDK Publications On-line - Easy-to-read publication: Eat Right to Feel Right on Hemodialysis
45. Nocturnal Home Haemodialysis
46. Patient Access Network Foundation - medication assistance
47. Patient Education Institute
48. PatientsLikeMe
49. Quackwatch
50. Renal Family Cookbook
51. Healthy Life Info
52. renalinfo.com
53. Renal Nutrition Resouces (from NKF - CRN)
54. Renal Support Network (Southern California)
55. Restless Legs Syndrome Foundation (RLS)
56. S.L.E. Lupus Foundation
57. Small Comforts Foundation
58. Supportive Care Coalition
59. Transplant Living