Myths of Dialysis

What is Kidney Dialysis?

The kidneys are responsible for filtering waste products from the blood. Dialysis is a procedure that is a substitute for many of the normal duties of the kidneys. The kidneys are two organs located on either side of the back of the abdominal cavity. Dialysis can allow individuals to live productive and useful lives, even though their kidneys no longer work adequately

When is dialysis needed?

You need dialysis when you develop end stage kidney failure --usually by the time you lose about 85 to 90 percent of your kidney function.

What does dialysis do?

Like healthy kidneys, dialysis keeps your body in balance. Dialysis does the following: removes waste, salt and extra water to prevent them from building up in the body keeps a safe level of certain chemicals in your blood, such as potassium, sodium and bicarbonate helps to control blood pressure

What is hemodialysis?

Hemodialysis is a procedure in which a machine filters harmful waste and excess salt and fluid from your blood. A needle is inserted into your arm through a special access point. Your blood is then directed through the needle to a machine called a dialyzer, which filters your blood a few ounces at a time. The filtered blood returns to your body through another needle

Who needs hemodialysis?

If your kidneys are failing, you may need dialysis to help control your blood pressure and maintain the proper balance of fluid and various chemicals such as potassium and sodium in your body. Dialysis also helps your body maintain the proper acid-base balance

Sometimes kidney failure is caused by a specific kidney disease. In other cases, it's a complication of another condition, such as:

Diabetes High blood pressure (hypertension) Kidney inflammation (glomerulonephritis) Inflammation of blood vessels (vasculitis) Polycystic kidney disease

Myth 5: There are too many things to learn about dialysis FALSE! While there are many things to learn, whatever your treatment choice, there is an entire kidney healthcare team, including nephrologists, nurses, dietitians, social workers, care technicians and others, to support you throughout the dialysis process. Here are some ways they help: Educating patients about ESRD and dialysis treatment options Helping patients cope emotionally Mapping out a treatment plan for specific needs Prescribing a kidney diet and helping choose kidney-friendly foods Helping patients apply for insurance and financial assistance Connecting patients with support groups Scheduling dialysis treatments if patients decide to travel Providing in-depth training programs with close supervision and plenty of opportunities to practice for patients and their care partners who choose dialyzing at home

Myth: Dialysis isnt for someone who fears needles. FALSE! Fear of needles and the pain associated with needle sticks is common for patients. To ease your fear, medications are available to numb the skin prior to inserting the needle. You can apply a numbing cream over your vascular access (the area that allows your blood to travel to and from the dialysis machine to remove toxins from the body) about one hour before your treatment. Lidocaine, a local anesthetic, may be an option used by your center. If your access is an arteriovenous (AV) fistula, needles are inserted in the exact same site every treatment, which creates a tunnel similar to a pierced ear. This site is called a buttonhole and once established, needle insertion becomes less painful. Another way for patients to ease their fear of needles is self-cannulation. Your dialysis care team can teach you how to self-cannulate, which is inserting needles into your own access. Gaining control over the procedure may also make you more comfortable with it. Finally, peritoneal dialysis (PD) is a form of home dialysis that does not use needles. This treatment is explained in more detail below.

Before you start hemodialysis, a surgeon creates a vascular access point for blood to leave for cleansing and then re-enter your body during treatment. There are three types of access points :

Temporary access.

If you need emergency hemodialysis, the surgeon may insert a plastic tube (catheter) into a large vein in your neck or near your groin. The catheter is temporary. If it's left in place for too long, you face a risk of infection, clotting in the catheter and stenosis (narrowing) of surrounding blood vessels.

Arteriovenous (AV) fistula.

A surgically created AV fistula is a connection between an artery and a vein, usually in the forearm. Once the connection is made, faster flowing arterial blood flows into the vein causing it to grow larger and stronger. This makes repeated needle placements for hemodialysis easier. An AV fistula may take six weeks or longer to heal, but it can last for many years. An AV fistula is less likely than other types of access points to form clots or become infected.

Arteriovenous (AV) graft.

If your blood vessels are too small to form an AV fistula, the surgeon may instead connect an artery and a vein with a synthetic tube. This tube functions like an artificial vein, usually in your forearm or upper arm. An AV graft often heals within two to three weeks. With proper care, an AV graft may last several years but it's more likely to form clots and become infected than is an AV fistula.

How do you care for the access point?

Vascular access is a vital part of hemodialysis. Take special care to prevent injury and infection:
Keep the access area clean. Don't use the arm with the access point for blood pressure readings or to draw blood samples not associated with the dialysis treatment. Don't lift heavy objects or put pressure on the arm with the access point. Don't cover the access point with tight clothing or jewelry.

Check the pulse in the access point every day. Ask the nurse or technician to check the access point before each treatment. Don't sleep with the access arm under your head or body. If your access point stops working, the surgeon can create a new access point in your other forearm, your upper arm or your groin. Or you may consider peritoneal dialysis, another type of dialysis done through a catheter inserted in your abdomen

Can hemodialysis be done at home?

With special training and someone to help, it's possible to do hemodialysis at home. If patient comfortable doing the procedure yourself and keeping records for health care team, the benefits are appealing. patient quality of life will likely improve, patient will save yourself travel time to and from the dialysis center, and you'll have more flexibility about when to do your treatments perhaps even at night while you sleep.

Myth : People on dialysis can no longer travel FALSE! You can still soak up the sun, camp, visit family or travel for work with some advance planning and dialogue between you, your doctor, nurse and social worker. Patients on hemodialysis can arrange treatments at a center at their planned vacation destination. Patients on PD can have supplies directly delivered to wherever they are going. Follow the guidelines of this travel checklist to make traveling on dialysis an easier process.

Is there a special diet for people on hemodialysis?

> Eating the right foods can improve your dialysis results and your overall health. While you're receiving hemodialysis, you'll need to carefully monitor your intake of fluids, protein, sodium, potassium and phosphorus. Your dietitian will help you develop an individualized meal plan based on:

Your weight Your personal preferences How well your kidneys still function Other medical conditions you might have, such as diabetes or high blood pressure

What about medication?

While you're receiving hemodialysis, you'll likely need various medications: Blood thinners to prevent clots in the hemodialysis machine and tubing Blood pressure medication to control your blood pressure Erythropoietin to stimulate your bone marrow to produce new red blood cells Calcium, iron and other nutritional supplements to control the level of certain nutrients in your blood Phosphate binders to prevent the buildup of phosphorus in your blood Stool softeners and laxatives to manage constipation Your doctor will do frequent blood tests to monitor your condition

What are the potential complications of hemodialysis?

kidneys play a role in many of body's systems. When kidneys stop working, these other systems don't work as well as they did before. This can lead to various complications, including:

Lack of red blood cells (anemia) Bone diseases High blood pressure Fluid overload Inflammation of the membrane surrounding the heart (pericarditis) High potassium levels, which can affect your heart rhythm Nerve damage Infection Heart disease

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