Dialysis or dialysis: what procedures are needed?

Definition

What is dialysis?

Dialysis or commonly referred to as dialysis is a procedure performed to get rid of harmful wastes in the body. Normally, this process is carried out naturally by the kidneys.

The kidneys will filter the blood and separate harmful substances and excess fluids from the body to be excreted through urine. However, the damaged kidney cannot perform its main function, so a machine-shaped assist device is needed.

There are two main types of dialysis, namely:

• hemodialysis, blood will be circulated through a machine to be cleaned, and
• peritoneal dialysis, dialysis assisted by the peritoneal membrane in the stomach to filter the blood.

What is the function of dialysis?

Generally, dialysis is performed for patients with kidney disease, namely chronic kidney failure. Chronic renal failure is a condition when the kidneys have decreased function below normal limits.

If you have chronic kidney failure, your kidneys are no longer able to filter waste, unable to control the amount of water, salt levels, and calcium in your blood.

As a result, unnecessary metabolic waste substances will remain in the body and endanger your condition. At this stage, the kidneys are only working about 10% of what they should be.

Dialysis procedures are performed to replace kidney function that can no longer work. However, keep in mind that dialysis cannot cure kidney disease or other conditions that affect how the kidneys work.

Therefore, treatment from doctors to treat kidney disease is still needed. In addition, this procedure will also need to be done for the rest of your life, unless you have a kidney transplant.

Procedure

How is the dialysis process?

Before dialysis begins, the doctor will perform a series of kidney examinations first. This aims to see if you need dialysis or not.

After that, your body weight will be weighed, as well as shortly after the procedure. That way, your doctor can measure how much excess fluid is being drawn from your blood.

Generally, there are two things that doctors usually measure, namely creatinine levels and urea levels in your blood. If these two components are above normal levels, your doctor will recommend you to undergo dialysis.

Preparation for dialysis also depends on which dialysis you will need. For example, patients who need hemodialysis will undergo minor surgery on their arm.

Surgery is performed to create a path for the needle needed to connect the blood circulation to the machine.

Meanwhile, peritoneal dialysis will be performed with the help of a small tube (catheter) that is attached to the body. That way, the tube will help drain the compounds that clean the blood into and out of the body.

Most dialysis procedures are painless. However, you may feel uncomfortable when the needle is inserted. You may also feel dizzy or have headaches and cramps.

This condition will usually disappear after treatment from a doctor is carried out. Dialysis also sometimes causes feelings of sadness or depression due to lifestyle changes.

If you feel bothered by this, consult a urologist to get the right solution.

How long does dialysis take?

The dialysis process is usually carried out in a hospital and lasts 3-5 hours. Depending on your medical condition and needs, you may need to come for the procedure several times a week.

In some cases, dialysis for temporary or acute kidney failure can be stopped when the kidneys are functioning again. However, this does not apply to chronic renal failure patients.

If you have end-stage chronic renal failure, it will usually require a kidney transplant. Unfortunately, finding a suitable donor kidney is not easy, so you will need to keep on dialysis until a suitable donor kidney becomes available.

There are times when the patient also has a condition that is not suitable for major surgery. If this happens, dialysis may be the only treatment option for kidney disease to stay alive.

Preparation

What are the preparations that need to be done before dialysis?

Generally, dialysis is used as a temporary treatment measure in young patients while waiting their turn for a kidney transplant. However, this procedure can also be permanent when a kidney transplant is no longer possible.

If you or other family members need to be on dialysis, be aware of the following preparations to do.

Prepare mentally

The words dialysis may sound scary to some people in Indonesia. As a result, most of them feel reluctant and afraid to undergo dialysis.

Try to provide yourself with support from family and friends. Don't forget to find as much information as possible about the dialysis process.

Apart from preparing for your physical condition, your mental health is equally important. The reason is, there are several challenges that will be passed when starting the dialysis process as follows.

• Feel healthy and don't want to be patient.
• Always feel sick and don't want to have a quality life.
• Often feel afraid and worried due to not understanding the dialysis process.
• Feel angry at the doctor who did not immediately diagnose the condition.
• Do not want to feel pityed by others and afraid of being considered "handicapped".

Therefore, mental preparation is important enough so that some of the points above do not happen to you and worsen your health condition.

Find out where to dialysis

You may think dialysis can be done at any hospital that has dialysis facilities. However, try to find a location for dialysis treatment at the hospital closest to your home.

This is done so that you don't have to feel unnecessary fatigue. The reason is, chronic kidney failure patients who undergo dialysis are usually more sensitive because they feel many things in their body.

Finding the nearest hospital can help you avoid feeling lazy, bored, and bored.

Bring snacks and wear loose clothing

When you come to the hospital for dialysis, wear loose clothes. In addition, you can also bring snacks or foods that your doctor likes and, most importantly, allows.

This method is quite effective because while you are waiting for the treatment, you can snack on while filling your energy. Dialysis patients sometimes tire easily and do not have enough energy after dialysis. Therefore, snacks and food are here to add to this lost energy.

Side effects

Dialysis is generally a safe procedure. However, there are risks and side effects that accompany this form of kidney failure treatment.

One of the common side effects of dialysis is fatigue. Here are some of the symptoms you may experience while on dialysis.

Shivering

One of the symptoms experienced by kidney failure patients undergoing dialysis is a feeling of chills. In fact, sometimes this side effect can also be accompanied by fever which is caused by an increase in body temperature.

There is no definite cause why this condition occurs, whether it is due to certain conditions, a weak immune system, or infection with pathogens and bacteria.

You don't need to worry because like any medical procedure, fever and chills during dialysis can be treated in several ways. Here's how to deal with fever accompanied by chills after the cause is known.

• Infusion of fluids is carried out when body temperature increases.
• Examination of dialysis tools, materials, and methods to detect the cause of contamination.
• Administration of antibiotics if chills are caused by a bacterial infection.

Dizziness and feeling tired

Dizziness and feeling tired may often be felt by kidney disease patients on dialysis. Symptoms related to low blood pressure can be caused by several things, including excess fluid in the body.

If you notice any of these symptoms, tell the doctors and nurses right away. The doctor may adjust the dialysis timing and frequency. In addition, they will also recommend limiting your intake of fluids and foods that are high in salt.

Nausea and vomiting

Nausea and vomiting that occurs after you undergo dialysis may occur due to a buildup of toxins in the blood (uremia). If you experience this, consult your doctor to get the right treatment.

Dry and itchy skin

Most patients on dialysis also experience dry, itchy skin. This condition can be caused by a variety of factors, including inappropriate dialysis frequency or skin allergies.

Dry and itchy skin can also be caused by the uncontrolled content of phosphorus in the blood. Therefore, you may want to avoid lotions with added fragrances as they can irritate sensitive skin.

Apart from the three symptoms above, there are a number of other side effects that you may feel during dialysis treatments, namely:

• muscle cramps due to fluid being drained at the end of a dialysis session, as well
• restless leg syndrome (RLS) because the nerves and muscles of the leg feel uncomfortable.

If you experience unpleasant symptoms while undergoing dialysis, immediately contact your doctor to get the right solution.

Complications

What happens if you are late for dialysis?

If you suffer from chronic kidney disease and are late on dialysis, of course this can cause serious problems. Here are some of the disorders that can occur when you are late on dialysis.

• The levels of urea and creatinine increase due to the buildup of waste in the blood.
• The kidneys cannot filter the blood properly, which can cause shortness of breath.
• Kidney function slowly weakens.
• More kidney tissue and other organ cells are damaged because they cannot work on their own.
• Symptoms and the risk of complications such as heart failure get worse due to increased blood potassium levels.
• Kidney function stops completely which can cause death.

What if dialysis is stopped completely?

The decision to stop dialysis is a decision that needs to be made by doctors and patients. If you are on dialysis because of acute kidney failure, recovery may be possible and dialysis will be stopped.

If you are on dialysis because of chronic kidney failure, stopping dialysis may not be the right choice. The reason is, dialysis that is stopped suddenly can increase the severity of the disease which can lead to death.

People with end-stage kidney disease who don't have dialysis or a kidney transplant can develop uremia syndrome. Uremia syndrome is a condition when toxins build up in the blood and when left untreated they can be life-threatening.

Here are some symptoms you need to watch out for as a result of kidney failure medication being stopped completely.

• Loss of appetite.
• Sleep most of the day.
• Feeling restless and confused about recognizing a familiar face.
• Respiratory pattern changes, can be gasping or too slow.
• Changes in skin color and temperature.

However, the decision to discontinue dialysis rests with both the patient and the doctor. If you decide you are no longer receiving dialysis treatment, your doctor may recommend palliative care aimed at improving the patient's quality of life.

Palliative care may be considered as an alternative to kidney failure treatment besides dialysis. This method is usually recommended for the elderly whose condition is no longer able to undergo dialysis.