If the kidneys are not functioning, dialysis has to take over. It uses a machine to filter and purify the blood, keeping your electrolytes and fluids in balance.

By eliminating waste and extra fluid from your body, the kidneys filter your whole body's blood. And when you urinate, this waste is transported to the bladder and removed.

The National Renal Foundation states that end-stage kidney failure happens when the kidneys only operate at 10 to 15 per cent of their normal capacity.

Why is dialysis used?

Healthy kidneys prevent extra water, waste, and other contaminants from building up in your body. Additionally, they assist in regulating blood chemical levels and blood pressure. These substances could contain salt and potassium. Your kidneys activate even a type of vitamin D that enhances calcium absorption.

Dialysis can assist in keeping the body functioning as normally as possible when your kidneys cannot carry out these tasks due to illness or damage. Salts and other waste materials will build up in the blood without dialysis, poisoning the body and harming other organs.

Dialysis, however, does not treat renal disease or other issues that affect the kidneys. To address these issues, other therapies can be required.

What are the different types of dialysis?

There are three different types of dialysis.

Hemodialysis 

The most popular form of dialysis is hemodialysis. In this, waste and surplus fluid from the blood are removed using an artificial kidney (hemodialyzer). The prosthetic kidney removes the blood from the body and filters it. A dialysis machine is then used to return the purified blood to the body.

Your doctor will undertake surgery to create a point of entry (vascular access) into your blood arteries so that blood may pass to the artificial kidney. The three different entry points are as follows:

Arteriovenous fistula (AV). This kind joins a vein with an artery. It is the recommended choice.

Graft AV. A looping tube is this type.

Access catheter for the veins. This might be placed into your neck's deep vein.

Both the AV graft and fistula are made to be used with long-term dialysis. Two to three months following surgery, patients with AV fistulas are recovered and prepared to start hemodialysis. In two to three weeks, recipients of AV grafts are ready. Catheters are made to be used just temporarily.

Three times a week, hemodialysis procedures are typically three to five hours long. Hemodialysis therapy can, however, also be carried out in shorter, more frequent sessions.

Most hemodialysis procedures are completed at a hospital, medical office, or dialysis facility. Your body size, the amount of waste in your body, and your present health status all influence how long the therapy will take.

Your doctor may decide that you are prepared to perform your dialysis treatments at home once you have been receiving hemodialysis for a considerable time. People who require long-term treatment are more likely to choose this choice.

Peritoneal dialysis

A peritoneal dialysis (PD) catheter is surgically implanted into your belly during peritoneal dialysis. The peritoneum, a membrane in your belly, is helped to filter your blood by the catheter. Dialysate, a unique liquid used in therapy, enters the peritoneum. Waste is absorbed by dialysate. Your abdomen is purged of waste when the dialysate removes it from the bloodstream.

This procedure must be performed four to six times daily and takes a few hours. However, the fluid exchange can be done whether you're awake or asleep.

Peritoneal dialysis comes in a variety of forms. Principally, these are:

Continual peritoneal dialysis in the community (CAPD). Your abdomen is repeatedly filled and drained throughout the day if you have CAPD. This technique must be used when awake and doesn't require a machine.

Continual peritoneal dialysis cycling (CCPD). The fluid is cycled in and out of your abdomen by CCPD using a machine. Usually, it's done while you're sleeping at night.

Peritoneal dialysis on demand (IPD). Even though it is occasionally done at home, this treatment is mostly done at a hospital. The method is the same as CCPD's; however, it takes longer.

Continuous renal replacement therapy (CRRT)

People with acute renal failure are primarily treated with this medication in the critical care unit. Hemofiltration is yet another name for it. Blood is transferred using a machine and tubing. The water and garbage are subsequently removed using a filter. Along with fresh fluid, blood is reintroduced to the body. This treatment is generally carried out from 12 to 24 hours a day.

Are there any risks associated with dialysis?

While all three forms of dialysis can save your life, they also carry certain risks.

The dangers of hemodialysis include the following:

• Anaemia, or not having enough red blood cells, lowers blood pressure.
• cramping in the muscles, trouble sleeping, itching
• high potassium levels in the blood
• Bacteremia, also known as bloodstream infection, sepsis, an inflammation of the membrane surrounding the heart, and pericarditis.
• Irregular heartbeat and rapid cardiac death, which the main reason for death in dialysis patients

The dangers of peritoneal dialysis

An increased risk of infections at the catheter site in the abdominal cavity is linked to peritoneal dialysis. For instance, a person may develop peritonitis after having a catheter implanted. An infection of the membrane lining the abdominal wall is peritonitis.

Other dangers consist of:

weakening of the abdominal muscles, weight gain, hernia fever, and high blood sugar as a result of the dialysate's dextrose content

Risks connected to CRRT

The following are some of the dangers of CRRT:

• infection\shypothermia
• reduced blood pressure
• alterations in electrolytes
• Bleeds prevented quick renal recovery.
• bone deterioration anaphylaxis
• While undergoing dialysis, let the medical professional administering the procedure know if you experience these symptoms again.

People who receive long-term dialysis treatments risk contracting amyloidosis and other illnesses. The illness can develop when amyloid proteins produced in bone marrow accumulate in organs like the kidneys, liver, and heart. Typically, this results in oedema, stiffness, and joint pain.

Following a diagnosis of chronic kidney failure, some persons may also experience depression. Call 911 or your local emergency number if you're experiencing thoughts of self-harm or suicide, which are signs of depression. If you're struggling with depression and a persistent ailment, the National Alliance on Mental Illness can also offer you servicesAre there any alternatives to dialysis?

Dialysis is costly and time-consuming. Not everyone chooses it, particularly if they are facing severe, acute renal failure.

Other treatment options could help control your symptoms if you decide against getting dialysis. Anaemia management is one of these possibilities. The body naturally produces the hormone erythropoietin (EPO) when the kidneys function normally. You can receive an EPO injection once a week to help with a kidney that isn't working properly.

Keeping your blood pressure under control helps slow the decline of your kidney. To prevent dehydration, consume fluids. Before taking anti-inflammatory medications, such as ibuprofen (Advil) and diclofenac, consult your physician (Solaraze, Voltaren).

For certain people, a kidney transplant is an additional option. There is a long-term commitment involved. Ask your doctor if a transplant is a correct action for you. A kidney transplant may not be an option for you if you:

heavily drink alcohol and smoke

are overweight and have an untreated mental illness

How do I prepare for dialysis? 

Your doctor will surgically insert a tube or other device to obtain access to your bloodstream before your first dialysis session. Usually, this is a quick procedure. You ought to be allowed to go back on the same day.

It's ideal for dressing comfortably during your dialysis sessions. Additionally, adhere to your doctor's advice. Among them could be a period of fasting before the procedure.

What types of dialysis can be done at home?

Peritoneal dialysis and hemodialysis can both be done at home. Hemodialysis requires a companion, whereas one person can do peritoneal dialysis. You can hire a dialysis nurse or use a friend or family member as a partner.

You will receive full instruction from a medical practitioner before beginning either treatment.

What’s the long-term outlook for someone who requires dialysis?

Kidney disease is not always irreversible. Until your kidneys can heal and function normally, dialysis might temporarily perform the same role as kidneys. The kidneys, however, very seldom recover from chronic renal disease. If you have this ailment, you will need to undergo dialysis for the rest of your life or until a kidney transplant is an option. It's also necessary to alter your way of life. A dietician should be part of your nephrologist's (kidney specialist)