Dialysis

What is Dialysis, How is it Done? What are the Types of Dialysis?

The main function of the kidneys is to filter the blood, removing waste products and excess fluid from the body through urine. When the kidneys are unable to perform their functions, waste products and excess fluid in the blood are cleaned using dialysis.

You can find answers to all the questions you may have, such as how dialysis is performed, what types of dialysis exist, and nutrition for dialysis patients in this article.

At the Daviva Health Group Dialysis Unit; with its device infrastructure, hygiene protocols, and experienced specialist staff in the field of nephrology, we provide our patients with a treatment environment in the comfort of home.

What is Dialysis?

It is a treatment method that cleanses excess fluids and waste products that accumulate in the blood when the kidneys do not work sufficiently. Dialysis is used as the standard treatment for chronic kidney failure. However, it is also used in cases of sudden kidney disorders or situations such as drug overdose and poisoning. Dialysis also artificially replaces kidney function by balancing electrolyte levels in the blood, such as potassium and sodium.

Who Needs Dialysis? What are the Conditions Requiring Dialysis?

Chronic kidney failure

It is the irreversible loss of kidney function due to various reasons such as diabetes and high blood pressure. Chronic kidney failure may not show any symptoms in the early stages. Generally,

• Fatigue and weakness
• Increased or decreased urination
• Foamy urine
• Swelling in the legs, ankles, or feet
• Dry skin and itching
• Nausea and loss of appetite are among the most common symptoms of chronic kidney failure.

In the early stages of chronic kidney failure, lifestyle changes and medication treatments are used. However, in cases where kidney function falls below 15%, dialysis emerges as a life-saving treatment.

In cases of severe nausea, uncontrolled high blood pressure, shortness of breath, or excessive fluid accumulation in the body, dialysis treatment can be applied even before kidney function falls below 15%.

Acute kidney failure

It is the rapid deterioration of kidney function for various reasons. Dysfunction in the kidneys can occur even within a few hours. Acute kidney failure usually occurs in individuals receiving treatment in hospitals. However, acute kidney failure can arise from very different causes.

• Vomiting, diarrhea, excessive sweating, or dehydration due to insufficient fluid intake
• Deterioration in heart functions can reduce blood flow to the kidneys
• Severe infections can lower blood pressure and affect kidney functions
• Drug reactions can impair kidney functions
• Kidney stones can lead to acute kidney failure
• Tumors that block the urinary tract are among the causes of acute kidney failure.

In the treatment of acute kidney failure, identifying the underlying cause and addressing it is the first priority. During this treatment, supporting kidney functions is vital.

Severe cases of acute kidney failure usually require hospitalization for close monitoring and treatment. Fluid and electrolyte management, as well as medication treatments, are among the methods used to support kidney functions.

Dialysis treatment options are among the methods to prevent irreversible damage to kidney functions.

Uremia

It is a life-threatening condition that occurs due to the accumulation of high levels of urea toxins in the blood in the advanced stages of chronic kidney failure. Symptoms of uremia are similar to those of chronic kidney failure. The symptoms of uremia can generally be listed as follows.

• Uremic neuropathy, which is caused by toxic substances accumulating in the blood damaging the nerves, can lead to symptoms such as tingling and numbness, especially in the hands and feet.
• Weakness, fatigue, and confusion
• Nausea, vomiting, or loss of appetite
• High urea levels in blood tests
• High blood pressure
• Swelling in the hands and ankles
• Dry skin

Dialysis is vital in the treatment of uremia.

Electrolyte Disorders

Dialysis can be used to balance life-threatening electrolyte imbalances. It helps correct imbalances such as hyperkalemia, hypermagnesemia, and metabolic acidosis, which are commonly seen in kidney failure.

• Hyperkalemia; It is a condition where there is too much potassium in the blood. It usually occurs due to chronic kidney failure or medication use. Excess potassium can disrupt heart rhythm, causing palpitations, muscle weakness, or cardiac arrest, making it dangerous. Treatment includes dietary changes and medication adjustments, but in severe cases, dialysis is used.
• Hypermagnesemia; It is an electrolyte disorder that occurs due to abnormally high magnesium levels in the blood. It is more commonly seen in kidney failure and excessive magnesium intake. It can lead to various problems, including nausea, dizziness, muscle weakness, hypotension, respiratory difficulties, and potential cardiac arrest. Dialysis treatment is applied in advanced cases.
• Metabolic acidosis; It is a condition where there is too much acid accumulation in body fluids. It is usually related to kidney failure, uncontrolled diabetes, or severe dehydration.

Poisoning

Hemodialysis can be effectively used in many poisoning situations involving low molecular weight, water-soluble, and low protein-binding substances.

• Dialysis treatment yields effective results in poisoning cases involving fake alcohol and antifreeze, such as methanol and ethylene glycol.
• Dialysis is also very effective in lithium poisoning, which can also arise from kidney failure. Lithium poisoning can sometimes result from psychiatric medications.
• Poisoning can also occur from the incorrect use of certain painkillers, cardiovascular, or neurological medications. Dialysis treatment can be applied in such cases as well.

What are the Types of Dialysis and How is it Applied?

Generally, there are two types of dialysis used: Hemodialysis and Peritoneal dialysis.

Hemodialysis

In hemodialysis, waste and toxins that accumulate in the blood due to insufficient kidney function are filtered through a dialysis machine. The cleaned blood is then returned to the body.

How is Hemodialysis performed?

• Before starting hemodialysis, a vascular access called a fistula or graft must be created to allow blood to flow from the body to the dialysis machine and back easily. This vascular access, usually created in the arm, is performed through a minor surgical procedure to connect an artery and a vein.
• The surgical procedure for placing the catheter or access route takes about 1-1.5 hours.
• Blood from the body is sent to the dialysis machine through this vascular access. A special filter cleans the waste products from the blood, and then the blood is returned to your body.
• Dialysis treatment is usually performed in 3-5 sessions per week.
• Dialysis sessions typically last 4 hours.

Peritoneal dialysis

In peritoneal dialysis, the blood is filtered within the person's own body instead of a dialysis machine. The peritoneal membrane in the abdominal or belly area acts as a filter. Peritoneal dialysis allows the person to perform dialysis at home or while doing daily activities.

How is Peritoneal dialysis performed?

• Before starting peritoneal dialysis, a catheter is surgically placed into the inner layer of the abdominal wall.
• Before each peritoneal dialysis procedure, the abdominal cavity is filled with a dialysis solution made of a mixture of water, salt, and other additives using the catheter.
• The dialysis solution cleans your blood through the inner walls of the abdomen.
• After a few hours, the fluid mixture is drained from your abdomen using the same catheter and bag used at the beginning of the treatment.
• This can be repeated manually about 4 times within a 24-hour period, with each session lasting approximately 30-40 minutes.
• Peritoneal dialysis can be done almost anywhere if you have the necessary materials for treatment.
• Peritoneal dialysis allows some patients to continue working while receiving dialysis treatment.

Which Dialysis Method is Suitable for You?

Which dialysis method is more suitable for you depends on;

• The level of kidney function
• Overall health status
• Lifestyle
• It varies according to personal preferences.

The decision on which dialysis should be preferred should be made in consultation with a doctor, considering these criteria.

Peritoneal dialysis

• It is more suitable for active individuals who work, go to school, or travel frequently.
• Those living far from a dialysis center are more suitable for peritoneal dialysis as long as they provide the necessary equipment.
• Patients with needle phobia may prefer peritoneal dialysis instead of hemodialysis.
• Individuals who want to continue their treatment in the comfort of their own home may opt for peritoneal dialysis.
• Peritoneal dialysis imposes fewer dietary restrictions compared to hemodialysis. Those who do not want to be restricted in their diet may also prefer peritoneal dialysis.

Hemodialysis

• Patients who want their treatment to be conducted in a professional center or those who are required to do so are more suitable for hemodialysis.
• Those with wounds or hernias in the abdominal area or health issues such as Crohn's disease or hernias should prefer hemodialysis.
• Peritoneal dialysis requires a significant amount of storage space for materials. Those without such space may prefer hemodialysis.
• Peritoneal dialysis needs to be done every day. Patients who do not want to undergo dialysis every day may turn to hemodialysis.
• Those who want to leave the cleaning of equipment and hygiene rules in peritoneal dialysis to professionals may prefer hemodialysis.

How Should Nutrition and Lifestyle be for Dialysis Patients?

Following nutritional rules during the dialysis process is important for both overall health and for controlling fluid balance and electrolytes.

During dialysis treatment, in general;

• Consume more high-protein foods
• Keep potassium, phosphorus, and sodium levels under control.
• Consume less fluid, including coffee, tea, water, soup, and any food that is liquid at room temperature.

Protein

Individuals undergoing hemodialysis generally need to consume more protein.

• Lean meat
• Poultry
• Fish
• Eggs are healthy sources of protein.

Sodium

Sodium level is important during dialysis treatment. Daily salt intake should be monitored for this purpose.

• Processed foods
• Canned soups
• Fast food
• Salty snacks can raise sodium levels.

Paying attention to salt intake also helps prevent fluid accumulation between dialysis sessions and reduces thirst.

Potassium

Potassium from meat and dairy products is absorbed more easily than potassium from fruits, vegetables, and legumes. Therefore, a plant-based diet is possible while undergoing dialysis treatment. High or low potassium levels during dialysis treatment can lead to heart problems. Therefore, monitoring potassium levels is very important.

Foods High in Potassium

• Fruits; Banana, melon, apricot, kiwi, fig, pomegranate, and all dried fruits
• Vegetables; Dark green leafy vegetables such as potatoes, spinach, and chard
• Lentils, chickpeas, kidney beans, broad beans
• Nuts, peanuts, walnuts, almonds, seeds

Foods Low in Potassium

• Fruits; Apple, pear, quince, grape, strawberry, cherry, sour cherry
• Vegetables; Cucumber, eggplant, pepper, zucchini, green beans, cabbage, onion
• Grains

Phosphorus

In kidney failure, phosphorus levels in the blood can rise significantly. Increased phosphorus levels can lead to weakened bones and vascular stiffness.

Foods High in Phosphorus

• Processed foods; Salami, sausage, cola drinks, instant soups
• Dairy products; Milk, yogurt, cheese, ice cream, and milk-based desserts
• Whole grains; Whole wheat bread, rye, oats, bran biscuits, and bulgur
• Organ meats; Types of organ meats such as liver, kidney, and brain
• Seafood; Shrimp and mussels

Foods Low in Phosphorus

• Protein; Egg whites, fresh chicken, turkey
• Grains; White bread, rice, pasta, couscous, and noodles
• The vast majority of fruits and vegetables are low in phosphorus. However, potassium levels should also be monitored when consuming fruits and vegetables.

Fluid intake

Limiting fluid intake during the dialysis treatment process is vital. The amount of fluid that should be taken is related to the amount of fluid excreted.

• In excessive fluid intake, the following symptoms may occur;
• Sudden weight gain
• Swelling, edema
• Shortness of breath

Lifestyle changes

During the dialysis process, not only dietary habits but also certain changes in lifestyle are important for the continuation of treatment and psychological well-being.

• It is important to develop a habit of reading labels while shopping. This way, you can avoid consuming foods that may negatively affect your dialysis treatment.
• Regular walks are important for both speeding up blood circulation and preventing loss of muscle strength.
• Cleaning the fistula or catheter area is important for the continuity of treatment to reduce the risk of infection.