Dialysis

What Is Dialysis, How Is It Done? What Are the Types of Dialysis?

Dialysis is a treatment method that cleans waste products and excess fluid from the blood when the kidneys cannot perform their functions for various reasons. The main function of the kidneys is to filter the blood and remove waste products and excess fluid from the body through urine. Dialysis is a life-saving procedure that helps maintain the body’s balance when the kidneys can no longer sustain their function.

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

At the Daviva Health Group Dialysis Unit, patients are offered a treatment environment with the comfort of home, supported by equipment infrastructure, hygiene protocols, and an expert team experienced in kidney health.

What Is Dialysis?

Dialysis is a treatment method that removes excess fluid and waste products that build up in the blood when the kidneys are not working well enough. Dialysis is used as the standard treatment for chronic kidney failure. However, it is also sometimes used in sudden kidney problems or in cases such as drug overdose and poisoning. Dialysis also artificially replaces kidney function by balancing electrolyte levels such as potassium and sodium in the blood.

Who Needs Dialysis? What Conditions Require Dialysis?

Chronic Kidney Failure

These are irreversible losses of kidney function due to various causes such as diabetes and high blood pressure. Chronic kidney failure may not cause any symptoms in the early stages. In general,

• 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 medications are used. However, in end-stage chronic kidney failure, when kidney function drops below 15%, dialysis becomes a life-saving treatment.

In cases of severe nausea, uncontrolled high blood pressure, shortness of breath, or excessive fluid buildup in the body, dialysis treatment may be applied without waiting for kidney function to drop below 15%.

Acute Kidney Failure

This is a rapid decline in kidney function due to various causes. Kidney dysfunction can occur within just a few hours. Acute kidney failure usually occurs in people receiving hospital care. However, acute kidney failure can arise for many different reasons.

• It may occur in cases of dehydration, that is, fluid loss due to vomiting, diarrhea, excessive sweating, or not drinking enough fluids.
• Problems in heart function can reduce blood flow to the kidneys.
• Severe infections can affect kidney function by lowering blood pressure.
• Drug reactions can impair kidney function.
• Kidney stones can lead to acute kidney failure.
• Tumors blocking 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 with appropriate treatment is the first priority. Supporting kidney function during this treatment is vital.

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

Dialysis is among the treatment options to prevent kidney function from being irreversibly affected.

Uremia

This is a life-threatening condition that occurs in the advanced stages of chronic kidney failure as a result of the buildup of high levels of waste urea toxins in the blood. The symptoms of uremia are similar to those of chronic kidney failure. In general, the symptoms of uremia can be listed as follows.

• Due to toxic substances accumulating in the blood and damaging the nerves, a condition called uremic neuropathy may cause symptoms such as tingling and numbness, especially in the hands and feet.
• Weakness, fatigue, and confusion
• Nausea, vomiting, or loss of appetite
• High blood 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 Imbalances

Dialysis can be used to correct life-threatening electrolyte imbalances. It is especially helpful in correcting imbalances such as hyperkalemia, hypermagnesemia, and metabolic acidosis, which are common in kidney failure.

• Hyperkalemia; this is a condition in which there is too much potassium in the blood. It usually occurs due to chronic kidney failure or medication use. Excess potassium is dangerous because it can disrupt heart rhythm and cause palpitations, muscle weakness, or cardiac arrest. In treatment, dietary changes and medication adjustments are also used, but in severe cases dialysis is used.
• Hypermagnesemia; this is an electrolyte disorder that occurs when there is abnormally high magnesium in the blood. It develops mostly with kidney failure and excessive magnesium intake. It can lead to nausea, dizziness, and muscle weakness, hypotension, breathing difficulty, and even potential cardiac arrest. In advanced cases, dialysis treatment is applied.
• Metabolic acidosis; this is a condition in which too much acid builds up in body fluids. It is usually related to kidney failure, uncontrolled diabetes, or severe dehydration.

Poisoning

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

• Dialysis treatment is effective in cases of counterfeit alcohol and antifreeze poisoning such as methanol and ethylene glycol.
• Dialysis is also highly effective in lithium poisoning, which can also be caused by kidney failure. Lithium poisoning can sometimes result from psychiatric medications as well.
• Poisoning may also occur when certain painkillers, cardiovascular drugs, or neurological medications are used at incorrect doses. In such cases, dialysis treatment may also be applied.

What Are the Types of Dialysis and How Are They Performed?

In general, two types of dialysis are used: hemodialysis and peritoneal dialysis.

Hemodialysis

Because the kidneys are not working well enough, waste and toxins that build up in the blood 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 pass from the body to the dialysis machine and then easily return to the body. This vascular access, usually created in the arm, is formed through a minor surgical procedure to connect an artery and a vein.
• The surgical procedure for placing the catheter or access line takes about 1-1.5 hours.
• The blood in the body is sent to the dialysis machine through this created vascular access. A special filter cleans waste products from the blood, and then the blood is sent back to your body.
• Dialysis treatment is generally performed in 3-5 sessions per week.
• Dialysis sessions usually last 4 hours.

Peritoneal Dialysis

In peritoneal dialysis, the blood is filtered inside the person’s own body instead of in a dialysis machine. The peritoneal membrane in the abdominal or navel area acts as the filter. Peritoneal dialysis allows a person to have dialysis at home or while carrying out daily activities.

How is peritoneal dialysis performed?

• Before starting peritoneal dialysis, a catheter is placed into the inner lining of the abdominal wall through a surgical procedure.
• Before each peritoneal dialysis procedure, the abdominal cavity is filled with dialysate, a mixture of water, salt, and other additives, using the catheter.
• The dialysate fluid 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 start of treatment.
• It can be repeated manually about 4 times within a 24-hour period, with each session lasting about 30-40 minutes.
• Peritoneal dialysis can be performed almost anywhere if you have the supplies needed for treatment.
• Peritoneal dialysis allows some patients to continue working while receiving dialysis treatment.

Which Dialysis Method Is Right for You?

Which dialysis method is more suitable for you;

• Level of kidney function
• General health status
• Lifestyle
• It varies according to personal preferences.

Which dialysis method should be preferred is a situation that should be decided together with your doctor, taking these criteria into account.

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 can provide the necessary equipment.
• For patients with needle phobia, peritoneal dialysis may be preferred instead of hemodialysis.
• People who want to continue treatment in the comfort of their own home may choose peritoneal dialysis.
• Peritoneal dialysis involves fewer dietary restrictions than hemodialysis. Those who do not want to restrict their diet may also prefer peritoneal dialysis.

Hemodialysis

• Patients who want treatment to be carried out in a professional center, or those who have to receive it there, are more suitable for hemodialysis.
• Those with wounds or hernias in the abdominal area, or with health problems such as Crohn’s disease or a hernia, should prefer hemodialysis.
• Peritoneal dialysis requires a significant amount of storage space for supplies. Those who do not have such space may prefer hemodialysis.
• Peritoneal dialysis must be performed every day. Patients who do not want dialysis every day may turn to hemodialysis.
• Those who want the equipment cleaning and hygiene rules required for peritoneal dialysis to be handled by professionals may prefer hemodialysis.

What Should Nutrition and Lifestyle Be Like for Dialysis Patients?

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

In general, during dialysis treatment;

• Eat 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

People receiving hemodialysis treatment generally need to consume more protein.

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

Sodium

Sodium level is important during dialysis treatment. For this reason, daily salt intake should be monitored.

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

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

Potassium

Potassium obtained from meat and dairy products is absorbed more easily than potassium obtained from fruits, vegetables, and legumes. Therefore, a plant-based diet is possible while receiving dialysis treatment. During dialysis treatment, high or low potassium levels can lead to heart problems. For this reason, monitoring potassium levels is very important.

Foods High in Potassium

• Fruit; Bananas, melon, apricots, kiwi, figs, pomegranates, and all dried fruits
• Vegetables; Potatoes, dark green leafy vegetables such as spinach and chard
• Lentils, chickpeas, dried beans, broad beans
• Hazelnuts, peanuts, walnuts, almonds, seeds

Foods Low in Potassium

• Fruit; Apples, pears, quince, grapes, strawberries, cherries, sour cherries
• Vegetables; cucumber, eggplant, peppers, zucchini, green beans, cabbage, onions
• Grains

Phosphorus

Phosphorus levels in the blood can become very high in kidney failure. Increased phosphorus levels may pave the way for bone weakening and arteriosclerosis.

Foods High in Phosphorus

• Processed foods; salami, sausage, cola drinks, instant soups
• Milk and dairy products; milk, yogurt, cheese, ice cream, and milk-based desserts
• Whole grains; whole wheat bread, rye, oats, whole-grain biscuits, and bulgur
• Organ meats; 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
• Most fruits and vegetables are low in phosphorus. However, potassium levels should also be considered when consuming fruits and vegetables.

Fluid Intake

Limiting fluid intake is vital during dialysis treatment. How much fluid should be taken depends on the amount of fluid excreted.

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

Lifestyle Changes

During dialysis, making certain changes not only in eating habits but also in lifestyle is important both for continuing treatment and for psychological well-being.

• It is important to get into the habit of reading labels while shopping. This can help you avoid consuming foods that may negatively affect dialysis treatment.
• Regular walks are important both for improving blood circulation and for preserving muscle strength.
• To reduce the risk of infection, cleaning the fistula or catheter area is important for the continuity of treatment.

FREQUENTLY ASKED QUESTIONS ABOUT DIALYSIS

Can dialysis patients continue eating at restaurants?

Yes, but careful choices are necessary. Ask for low-sodium options, avoid high-potassium side dishes, and limit portion sizes to keep phosphorus and sodium intake under control.

Can dialysis patients drink water? Why is fluid restriction done?

Dialysis patients can drink water. However, the amount should be carefully measured and limited. Fluid restriction is very important. This is because dialysis patients usually produce little or no urine. This leads to extra fluid buildup in the body between treatments, high blood pressure, fluid in the lungs, edema, and serious strain on the heart.

Does starting dialysis shorten life?

Dialysis is a treatment method that helps people with kidney failure hold on to life. With proper management, patients can live comfortably for many years. However, the process is more difficult for patients who also have heart and diabetes problems along with kidney failure.

Can a dialysis patient take a bath?

Dialysis patients can take a bath. However, to prevent infection, it is important to protect fistula or catheter entry points as much as possible and keep them dry.