10 things a patient need to know before dialysis

Planning for a dialysis can be challenging. Psychological adaptation to treatment, education, financial burden, carying family and loved ones along with information and economic hours lost at hospital. In addition is the uncertainty of how long the individual is going to live on dialysis. Dialysis can be haemodioalysis or Peritoneal dialysis. In hemodialysis, a dialysis machine is used to withdraw blood from the body, pass it through a cleanser called dialyzer, and return the cleaned blood back to the body. In peritoneal dialysis, the peritoneal membrane covering the inside of the abdomen of the patient is used to remove the waste in the blood.

 For the purpose of this write up, the word dialysis will refer to haemodialysis. 

Part of patient preparation is education on the following

1. Understanding dialysis. The use of artificial kidney, called a dialyzer, to remove the waste and excess fluid which has accumulated due to non functional kidneys. A dialysis machine is used to achieve this and different machines are used for normal patient and for those infected with HIV and Hepatitis infection. Screening for these infections will be done prior to the first dialysis session.

2. Expectations: If a temporary kidney failure, the kidney function will restore after 3 to 5 dialysis sessions. Some time more or less. If long term kidney failure, the function of kidneys will not return. In this case, dialysis will be needed at least twice a week until kidney transplantation is done. Dialysis improves quality of life, ability to think, sleep, reason well and keep your body dry. 

3. Dialysis causes some changes in nutritional need especially due to loss if vitamins and amino acids during dialysis; and a dietician is needed to tailor your dietary need accordingly.

4. What dialysis does not do: It does not improve blood count; blood boosters will be needed to do that. It does not improve calcium in body; Calcium tablets will be needed. In other words, dialysis does not replace entire kidney function

5. Amount of money to be paid for each session including provision for emergency medications. Patient also may need to check blood level prior to each dialysis and blood sugar level in between dialysis sessions. 

6. Vascular access: This is the means through which blood is withdrawn from the body, for cleansing and through which same blood is returned to the body. It can be temporary or permanent. Creation of a fistula is ideal and will take about 6-12 weeks to mature. It is a permanent type of vascular access. While waiting for maturation, temporary access or permanent neck catheters can be used.

6. Avoid heavy meals and BP medication in the morning prior to dialysis.

7. There is need for an accompanying person for each session of dialysis

8. Complications or side effect of dialysis include low blood pressure, high blood pressure, low blood sugar, fever, cramps, headache, itching tc. All these can be handled and treated during dialysis without interrupting the treatment process.

9. Patient can read newspaper and have light meals while undergoing dialysis. 

10. Patients should remember to book for next session of dialysis after completion of a session. Also remember to have the phone numbers of the hospital and attending nurse and Doctor

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  1. Informative and exactly your practise. This I can personally verify. Thanks Doc