Dialysis
You undoubtedly hear dialysis whenever the topic of end-stage kidney disease or kidney failure arises. But what does it entail, and why does it help kidney failure? This article provides you with a simplified introduction to dialysis.
What is dialysis?
Dialysis is a treatment for kidney failure that removes toxins and waste from the body and helps maintain its fluid balance by filtering blood across a membrane, which mimics a healthy kidney.
Who needs dialysis?
Dialysis is typically recommended when you have symptoms that indicate stage 5 of chronic kidney disease (CKD), otherwise known as kidney failure or end-stage kidney disease. At this stage, the kidney function declines so much that toxins start building up to high levels, and fluid balance becomes a problem, resulting in fluid overload.
Dialysis can help reduce the symptoms of CKD and prevent a potentially fatal build-up of toxins and fluid in the body.
Types of dialysis
There are two main types of dialysis: Haemodialysis (HD) and Peritoneal Dialysis (PD).
Haemodialysis
With haemodialysis, blood is removed from your body and filtered through a dialyzer, often referred to as an artificial kidney, and returned to the body in a continuous process. The process usually takes around 3-5 hours and is typically performed at least 3 times per week. In Singapore, haemodialysis is usually performed in dialysis centres.
Learn more about haemodialysis here.
Peritoneal Dialysis
With peritoneal dialysis, blood is cleaned inside your body’s abdominal lining (peritoneal membrane) with the aid of a special sterile dialysis fluid which flows into and out of your abdomen. Peritoneal dialysis is typically done daily and in one of two ways:
- Continuous Ambulatory Peritoneal Dialysis, which is done during the day in 3-4 short sessions
- Automated Peritoneal Dialysis, which is performed once for the entire night
Learn more about Peritoneal Dialysis (PD) here.
When choosing the type of dialysis, it is important to consider multiple factors such as your living situation, lifestyle, and pre-existing health conditions. The decision will be taken together by you and your healthcare team, who will explain the options suited to you. The selected treatment type can be re-evaluated and changed later if required.
Before starting dialysis: Dialysis Access
Before you start any type of dialysis, a surgical procedure called dialysis access surgery is performed. This procedure creates access to the bloodstream for HD or the peritoneal cavity for PD.
For haemodialysis, you will have an arteriovenous fistula (AV fistula), an arteriovenous graft (AV graft) or a catheter to allow easier access to the bloodstream. Learn more about the different types of haemodialysis access here.
For peritoneal dialysis, you will have a permanent catheter through your belly into the peritoneum for easy access to the peritoneal cavity.
Preparing for your first dialysis session
Apart from the steps your healthcare team will take to prepare your body for treatment, it is vital that you prepare yourself mentally.
- Talk to your family and friends so that you have a support network if required.
- Plan your daily schedule in such a way that you set aside enough time for treatment. This time required may vary based on the type of dialysis. If you are undergoing haemodialysis (HD), consider whether you want to plan some relaxing activities for the treatment duration – load up your playlist or keep a favourite book handy.
- Choosing peritoneal dialysis (PD) means you will have to carry out dialysis independently. You will be trained by your healthcare team until you are comfortable and confident to perform dialysis on your own at home.
Regardless of dialysis type, remember that the change in routine will take getting used to and that keeping a positive outlook is essential.
Life expectancy on dialysis
Life expectancy on dialysis depends on many factors, including any other long-term conditions that you may have, whether you can undergo a kidney transplant, and how efficient dialysis is for you.
The average life expectancy for patients on dialysis is more than ten years.
Talk to your healthcare team to understand your specific condition. It is also important that you keep to your treatment plan and dialysis schedule, as well as follow the advice of your healthcare team.