Coping with DIALYSIS

This is a way of cleaning the blood when the kidneys no longer work

There are two main kinds of dialysis: haemodialysis, involving diverting blood into an external machine for filtering; and peritoneal dialysis, involving pumping dialysis fluid into your abdomen to draw out waste products from the blood.

For haemodialysis, you’ll need a blood vessel called an arteriovenous (AV) fistula in your arm, which connects an artery to a vein, facilitating blood transfer into the dialysis machine and back. Alternatively, an AV graft may be used. Short-term, you may need a neck line.

Most people need three four-hour sessions weekly. Needles are inserted into the fistula to slowly move blood to a dialysis machine to filter waste products. During your sessions, you’ll rest, and you may feel nausea, dizziness or muscle cramps.

Having haemodialysis, your fluid intake is restricted, depending on your size and weight, to around 1,000-1,500ml daily. This is because the machine can’t remove two to three days’ worth of excess fluid from your blood in four hours if you drink too much and excess fluid builds up in your tissues. You’ll also need to get advice from a dietitian because minerals such as sodium, potassium and phosphorus, normally filtered out by the kidneys, can build up dangerously. An advantage of haemodialysis is that you have four dialysis-free days a week.

There are two main types of

peritoneal dialysis: continuous ambulatory peritoneal dialysis (CAPD), where blood is filtered several times daily; and automated peritoneal dialysis’ (APD), where a machine filters your blood as you sleep. Both treatments can be done at home once you’re trained.

Before you can have CAPD or APD, an opening will be made in your abdomen to allow dialysis fluid to be pumped into the cavity through a permanent catheter, which some people find difficult. You should be given a 24-hour hotline to call if you have technical problems.

If you’re having peritonal dialysis, there are generally fewer diet and fluid intake restrictions than haemodialysis, but you may sometimes be advised to limit fluid intake -– a dietitian will help you.

Both dialysis types can cause side effects, and only partially compensate for the loss of kidney function. Fatigue is a common symptom of using either form long-term, due to kidney failure, dietary restrictions and overall stress associated with the condition. Low blood pressure is common with haemodialysis due to the drop in fluid levels during dialysis, causing nausea and dizziness – keep to your daily fluid intake recommendations.