Lisa Johnson's House and Home - Articles on Home, Family, and Living

Kidney Dialysis

Basic facts and information about Kidney Dialysis

Lisa has kidney failure, and receives dialysis treatment three times each week. She describes what kidney dialysis is, what it is like, and what it's like living on dialysis.

Kidney dialysis is a way to cleanse the blood in your body.   Normally, your liver and kidneys perform this function.  Your liver actually cleans out a lot of the impurities, but the kidneys clean out other stuff, and most importantly, gets rid of excess water.

When your kidneys fail to work, you will need dialysis.   Most people require it about three times a week.   Each dialysis treatment lasts on average of three hours.   Basically, they hook up a couple tubes to your arm, while the other ends are hooked up to a dialysis machine.   The machine pumps blood out of your body, through the cleaning device, and sends it back into your body.   The waste and excess water are filtered out.

In general, there are two ways to perform dialysis, the first is what I described above, and is referred to as, "Hemodialysis".   The other way is to embed a "bag" into your abdomen, and let your abdominal tissue linings filter out the blood, and capture it into the bag.   This is called, "Peritoneal Dialysis".

The advantage of Peritoneal Dialysis is that you don't have to visit a dialysis center several times a week.   The process actually runs all the time and never stops.   Hence, you are recreating a similar process as if your kidneys were operating.   But, you have to dump the waste in the bag, which is embedded in your belly.   This has to be done about every four hours.   At night, while you are asleep, you must hook yourself up to a miniature dialysis machine that automatically removes the waste, so that you don't have to wake up every four hours to dump the waste.  Another problem is that people often suffer from abdominal infections.

The advantage to Hemodialysis is that you don't have to have a bag put into your belly, and you don't have to dump the waste every few hours, and you don't have to hook yourself up to a machine each night just to get some decent sleep.   But, you do have to visit the dialysis center several times a week, and get your arm poked.   Needless to say, you end up getting a really nasty scar from getting poked in the arm, in the same place, several times a week.

Hemodialysis still requires surgery to set up.   That is, before they can perform Hemodialysis, surgery needs to be performed to create a shunt in your vein.   Essentially, they cut one of the arteries in your arm, and redirect it into a vein.   This results in the vein becoming thicker and stronger, and thus better able to withstand the rigors of routine dialysis.   But as a result, your arm ends up getting a little more puffy because an artery was cut, causing water to build up.   It takes about a month to two months before the vein is ready.   Meanwhile, they insert a temporary access in your chest to perform the dialysis.

How Well Does Dialysis Work?

It works "ok".   It does not perform as well as a pair of kidneys, in fact, it doesn't even come close.   But, it does keep you alive, for awhile.

Most dialysis patients do not live a full life.   First, most kidney failure patients are usually elderly people.  Many times, kidney failure is brought about as a result of Diabetes.   Statistics shows that once someone is put on dialysis, about half of them die within 10 years.  But keep in mind that this statistic is skewed because most patients are elderly, and many of them had Diabetes to begin with.  Otherwise, some people have been known to live for as long as 30 years on dialysis.

Dialysis does an excellent job of removing excess water from the body.  But it still cannot match the effectiveness of real human kidneys.  Impurities which kidneys normally remove from the blood cannot be removed continuously by a dialysis machine.   If not treated properly, Kidney failure can weaken the heart, adding a greater risk to heart failure.  For some patients, their hearts have become so weakened from the kidney failure, that they are no longer eligible for organ transplants.

Can You Still Function Like a Normal Person?

Yes and no.   People on dialysis, can in theory, still do anything that normal people can do.   But, the reality is that the process of being on dialysis, and having kidney failure, puts stress on the body.   A common side effect of dialysis is low blood pressure.   This causes people to feel faint or tired.   When you feel that way, you don't want to do anything but sleep.  In between dialysis treatments, people often take in too much fluids, due to not managing their fluid intake very well.   Excess water will collect in the lungs, and cause a shortness of breath, and lack of oxygen to the brain and muscles.   This also causes you to become tired.

The fact that I often end up with no energy, is the reason why I cannot hold down a regular job anymore.   Hence, the federal goverment has classified me as disabled.

If you are on Hemodialysis, you end up feeling like you're trapped in your town.   Because you need dialysis treatment several times a week, you can't really travel anywhere.   It is possible to coordinate dialysis treatment in another town, and thus, be able to travel.  But coordinating such treatment, requires about a one month preparation.  You can't take those spontaneous trips anymore.

Kidney failure patients must eat a "renal diet", which essentially avoids foods high in certain nutrients, or limits them to small quantities.  Water, for example, can only be consumed at about 1 liter per day.  Sodium must be limited to absolute minimum.  Phosphorus, which is abdundant in corn, potatoes, dairy, and chocolate, must be limited to small amounts, or best, avoided completely.  Potassium, which is abundant in tomatoes and several fruits and vegetables, must be greatly limited.  Basically, no Mexican food, no Italian food, no french fries, no pop-corn.  It can get pretty tough.

How Much Does Dialysis Cost?

It's very expensive, that's all I can say.   I don't actually pay for dialysis, but I've heard it runs around $500.00 per treatment.  The federal government actually pays for dialysis for most Americans, including me.   If you require dialysis, you are automatically eligible for Medicare, regardless of your age.  Medicare pays for your dialysis treatment.

However, if you also have group health insurance, which I have through my husband, then the health insurance becomes the primary payer, and Medicare will pick up anything that they don't cover.   But, that arrangement usually lasts for only three years.   At that point, the health insurance stops paying for dialysis, and Medicare takes over as primary.

If you end up getting a donor kidney, then Medicare will cease coverage, and you will have to pay for any subsequent care.   Group health insurance will pay for post-transplant care.

How Painful is Dialysis?

It's not painful.   The only pain is when they stick the needles in your arm.   The needles are larger than the typical needles they use for shots.   But once they are in, they don't really hurt.   The dialysis process doesn't really hurt, and you don't really feel anything.

Sometimes you may experience cramping in your feet and legs.   This happens if they take too much water out of you.   The cramps can become quite painful.   When this happens, they usually end treatment.

Usually after dialysis, it is common for your blood pressure to get low, and you may feel weak or tired as a result.

Suggested Links

·  Kidney Dialysis Foundation

·  Living Day to Day with Kidney Dialysis

·  Dialysis in the Kidneys

·  National Kidney Foundation

·  How a Dialysis Machine Works