Dialysis: Types, Procedure, Purpose, Complications, Side Effects

Kidneys are the vital organs of our human body performing various specialised functions, including controlling the volume of various body fluids, acid-base balance, electrolyte concentration and elimination of toxins from the body etc. In case of malfunctioning kidneys, the patient might face severe consequences such as chronic kidney disease (CKD). The only treatment for CKD is a kidney transplant or lifetime dialysis.

Dialysis is a medical procedure that aids in replacing the normal working of kidneys in people with non-functional kidneys. In this, the excess water, toxins, metabolic wastes and other solute substances are eliminated, and the blood is filtered. This technique is generally employed when 85-90% of the kidney function is lost.

Types of Dialysis

There are three major types of dialysis each of which are employed accordingly:

1. Hemodialysis

   1. In hemodialysis, a hemodialyser which is also known as an artificial kidney is utilised for the removal of excess fluids and waste from the body.
   2. The blood is passed through the hemodialyser outside the body, filtered and returned to the body via a dialysis machine. It is usually conducted a week thrice for 3 to 5 hours per session.
   3. The hemodialysis can be performed at a hospital, doctor’s clinic or dialysis centre. The duration of treatment might vary depending on the severity of the case.

2. Peritoneal dialysis (PD)

   1. The PD involves the implantation of a PD catheter into a patient's abdomen via surgery. The catheter tube aids the infiltration of blood through the peritoneum layer of the abdomen. During the process, dialysate flows through the peritoneum layer.
   2. This special fluid absorbs the waste and draws it out of the bloodstream. This process is required to be repeated several times a day.

3. Continuous renal replacement therapy (CRRT)

   1. The CRRT is utilised for patients with acute renal failure in the ICU. The machine passes the blood via tubing for filtration.
   2. The purified blood is returned to the body. This process is usually conducted on a daily basis for 12-24 hours, varying accordingly.

Dialysis is used to treat the following conditions:

1. Chronic Kidney Disease
2. Acute Kidney Injury
3. Nephritis
4. Nephrogenic Systemic Fibrosis
5. End Stage Kidney Disease

Reasons for Kidney Failure

Usually, kidney failure is a consequence of several other serious health disorders that damage the kidneys over the years. Kidney failure is an end-stage of chronic renal disease. The most common reasons contributing to renal inadequacy are:

1. Diabetes mellitus
2. Hypotension 
3. Inherited diseases (Polycystic kidney disorder)
4. Autoimmune diseases
5. Nephrotic syndrome
6. Age factor
7. Inappropriate drug administration
8. Urinary tract infections

Dialysis is a life-saving procedure. However, there are various risks associated with the process:

1. Abdominal muscle weakening
2. Hernia
3. Weight gain
4. Muscle cramps
5. Anaphylaxis
6. Weakening of bones
7. Peritonitis (Infection in peritoneum layer)
8. Irregular heartbeat

Usually, each hemodialysis treatment lasts about four hours and is done three times per week. Cost of each session ranges from about Rs.2500-Rs.5000.