Dialysis is a process that substitutes for kidney function when the normal operation of
the kidneys is interrupted. In a healthy body, the kidneys serve to regulate fluid levels in the body, filter waste products and control urination. Dialysis performs these functions when the kidneys fail due to disease or injury and the resultant buildup of waste products in the body threatens to cause illness.

Since the kidneys are essential organs, when kidney failure occurs the patient requires
dialysis. There are many reasons for kidney failure. These include diabetes, hypertension
and polycystic kidney disease. The kidneys may also shut down after a heart attack or severe injury or as a result of surgery.

There are two major types of dialysis:
Hemodialysis
This is a procedure in which a dialysis machine is used to filter the blood. Hemodialysis is administered by health care professionals in a hospital or dialysis. It takes less time and is undergone less frequently than peritoneal dialysis. Because hemodialysis is administered to patients in a group setting, there may be the advantage of emotional support. With hemodialysis there is a risk of low blood pressure, blood clot or infection, but because it is performed by medical professionals, there are
medical safeguards in place.

Peritoneal Dialysis
In this process, the body's own tissues are used to flush waste from the abdominal cavity through the use of injected fluid.Peritoneal dialysis is self-administered by the patient through a catheter that remains in the abdomen. It may be performed in any clean location in the home or during travel. It may also be possible for peritoneal dialysis to be administered during sleep.This procedure has the advantage of requiring fewer dietary and fluid restrictions and it does not make use of needles. Peritoneal dialysis, however, is difficult for some patients to administer and carries a risk of peritonitis, a serious abdominal infection.

Both are good, choice usually depends on personal lifestyle of the patient and certain medical conditions like congestive heart failure, vascular access complications, diabetes etc.Hemodialysis is usually performed at a dialysis centre as compared to peritoneal dialysis which can be safely done at home .CAPD is usually preferred in children as they have small vessels which are difficult to cannulate and repeated needling is painful and difficult in them. Fluid intake can be more liberal in CAPD.

During dialysis, blood is removed from a vein in the patient's arm or leg, circulated through a filtering machine, and returned to the body through an artery. Since veins tend to have weak blood flow, the doctor often connects one of the patient's arteries to the vein being used for dialysis. This increases blood flow and strengthens the vein. The artery-to vein connection, known as arteriovenous connection or AV, can be created either through the use of a graft, or artificial tube, or through the creation of a fistula, a direct surgical connection of one blood vessel to another.

Though fistulas take 2 to 6 weeks to mature, while grafts are ready for use in only two to
six weeks, doctors prefer to use fistulas which are stronger than grafts and have a lower
risk of infection. The use of a graft, however, is indicated when the patient has small,
blocked or scarred veins.

While dialysis is a safe procedure, there are various complications and risks associated
with it. Some are uncomfortable but not serious, such as itching, sleep problems, joint
pain and muscle cramps. Others are more dangerous, such as elevated or low blood pressure, infection at the site, pericarditis, anaemia, and elevated potassium levels.

Yes. It is extremely important for the patient and health care professionals involved to
avoid possible infection by hand washing, the use of surgical masks and antiseptic wipes, and inspection of supplies to ensure cleanliness. It is also necessary for the patient to eat a special diet high in protein and low in potassium and phosphorus, and to monitor fluid intake carefully.

Yes There are several circumstances in which dialysis is only needed for a certain period of time until kidney function returns. If dialysis is being used for kidney failure, however, it will be employed permanently or until the patient receives a kidney transplant.

The only effective treatment for kidney failure other than hemodialysis or peritoneal dialysis is for the patient to receive a kidney transplant.

Yes, they can travel and whenever they need to travel they should make prior arrangements for dialysis to wherever they are travelling.

No, most patients are very comfortable on dialysis; they can watch TV or read a book or work on a laptop.

Patients on adequate dialysis can lead a close to normal life.

No, dialysis does not cure kidney disease. It does the work which the kidneys should be doing.

Like healthy kidneys, dialysis keeps your body in balance. It removes waste, salt and extra water,keeps a safe level of certain chemicals in your blood, such as potassium, sodium and bicarbonate and helps to control blood pressure. A session of hemodialysis usually takes 4 hours three times a week whereas peritoneal dialysis is a continuous process.

It should be brought to the notice of your doctor.

A high protein diet should be taken while on dialysis taking care to avoid high potassium food.Most diabetics do not require any anti diabetic medication on dialysis but blood sugars should be monitored regularly (blood sugar between 150 -200 gm/dl is considered desirable).If your sugars are high or low you would need to consult your doctor.

While on dialysis you should watch your diet. In case of any breathing trouble you should contact your doctor as you may require urgent dialysis. Care of the vascular access should be ensured as advised by your physician.

Yes, this can lead to fluid overload and breathing problems. It can also increase your serum potassium level which can lead to serious cardiac complications. Therefore skipping dialysis can be life threatening.

Putting on weight between dialysis is usual. It is because all food that is consumed by you has some water/ fluid which is not excreted by the diseased kidneys. The amount of weight gain should not be more than 2.5 – 3 kg between two sessions of hemodialysis.