Kidney is a vital organ in humans. Kidney functions include removing waste products from the body through urination, regulating blood pressure, balancing body fluids and production of red blood cells. Damage to kidney or kidney diseases can definitely change a person’s life. Common kidney disease such as chronic kidney disease accounts for more than 800 million people around the world. 10% of the population worldwide is affected by some form of kidney disease. Up until now, there seems to be no sign that the number of people diagnosed with kidney problems is going to decline soon. In fact, the number of people with kidney issues keep on rising year by year.
If you ask a doctor, you would know that most kidney diseases end up with receiving therapy such as dialysis and haemodialysis. The term ‘dialysis’ and ‘haemodialysis’ are always used interchangeably and may be confusing for some people. Dialysis is a form of renal replacement therapy whereas haemodialysis is part of dialysis. Dialysis helps to provide patients with what a healthy kidney could offer. This means that dialysis takes the role of the kidney to replace the kidney function of removing excess water, solutes and toxins from the body. Dialysis machine is considered as an artificial equipment replacing the partial function of the kidney.
Dialysis is divided into two types which is haemodialysis and peritoneal dialysis. In haemodialysis, the blood is cleaned outside the body using a dialysis machine before the blood is returned back to the body. The blood is filtered through a dialyzer located in the dialysis machine. Initially, needles will be placed into the arm (or leg or neck, depending on how easy for access). The inserted needles are attached to a soft tube connected to the dialysis machine. Before the needles are inserted, vascular access is needed. Vascular access is the entrance for the blood to flow in and out of the body to the dialysis machine. There are three types of vascular access which is AV fistula, AV graft and catheter. Minor surgery is needed to provide this vascular access. Type of vascular access is usually discussed with doctors. The frequency of haemodialysis procedure depends on the severity of the kidney diseases. Most people need 3 sessions of haemodialysis in a week with each session last around 4 hours.
In peritoneal dialysis, the treatment emphasises on the use of the lining (peritoneum) of the abdomen to filter blood inside the body. Surgeons will place a catheter (a tube) inside the abdomen weeks before peritoneal dialysis. Treatment is initiated when the dialysis solution flows through the catheter. When the dialysis solution bag is emptied, the catheter is then capped. A person can continue with their daily routine as usual. After a few hours, the solution and waste are drained out. This drains into a collection bag which the patient or caretaker must empty. Peritoneal dialysis is often done everyday by the patient themselves.
Haemodialysis may be considered to only be possible to be done in a dialysis centre. However, haemodialysis can be done either in the centre or at home. In-centre haemodialysis have trained staff to perform the procedure. Most people enjoy in-centre haemodialysis as they are able to socialise with others. However, in-centre haemodialysis may not be suitable for those wanting to have privacy and the rules here are stricter. Some people may find in-centre haemodialysis can cause a great amount of travelling time and schedules that can be cost and time restrictive. Home haemodialysis offers a person flexibility to perform dialysis at the ease of their own comfort. Machine used for home haemodialysis is small. This is convenient for those at home to perform it by themselves. Home haemodialysis also lowers the chance for muscle cramps and blood pressure issues that are common in standard in-centre haemodialysis. Although home haemodialysis may seem to be promising, it is not an easy procedure in reality. This is because household members or those taking care of the patient have to undergo training on how to perform haemodialysis safely and to instil skills. Training itself may take hours a day for everyday and may be from 3 to 8 weeks.
To decide on which dialysis or haemodialysis suits best, healthcare providers will make recommendations and are usually discussed together with patients. Each dialysis or haemodialysis has its own pros and cons. For example, home haemodialysis and peritoneal dialysis may be convenient but there is also high risk for infection if it is not done carefully. Should there be any concern regarding the therapy, it should always be addressed to your healthcare provider. Both haemodialysis and peritoneal dialysis may cause side effects. Common side effects include fatigue, low blood pressure, itchy skin, muscle cramps, insomnia, weight gain, dry mouth and anxiety. If unwanted side effects occur, do let your healthcare provider know as they can provide support or treatment to help ease these side effects. It is true to be living with haemodialysis or peritoneal dialysis is hard but rest assured that these are the best treatment available to help compensate for what a kidney should do for you.