By Ruth Bautista
Change is unsettling to most people. And one of the most unsettling change we experience is life is having an illness. Illness brings unwanted change and it also brings unwanted emotions. More often than not those emotions do not feel safe. These cause us to feel out of control and without foundational security. It causes us to lose our moorings and set us adrift on a frightening sea of unfamiliarity. Take patients with kidney failure for example. Most of the people who first told that they have a kidney failure and that they will need dialysis are worried and confused. Dialysis is a dreadful procedure but it helps to prolong the life of a person who has a kidney failure.
Dialysis is a medical process through which a person's blood is cleansed of the toxins the kidneys normally would flush out. It is generally used when a person's kidneys no longer function properly. Depending on the person, dialysis can be temporary or permanent. For patients who are not a good transplant candidate or condition did not alleviate after kidney transplant need to be in a life-long routine of dialysis. What is Kidney Disease? As defined by the National Kidney Foundation (NKF), it is the disorders that affect the kidneys. Kidneys are the two organs that remove waste products, produce certain hormones, and regulate the level of chemicals in blood. Kidney failure may develop suddenly or over a period of time, and although patient may become very sick, kidney failure is treatable and you may recover with partial or complete kidney function. The causes of kidney failure include infections, injuries or loss of blood supply to the kidneys. There are several ways to treat a patient with kidney failure. Kidney failure can be treated by a combination of methods. These include diet, medication, and possibly dialysis. Another option which may be possible for a patient is to consider a kidney transplant. However, one of the most important aspect of kidney failure treatment is to control the disease that is causing it. Patient who suffers with diabetes and high blood pressure need to be disciplined and create a plan with their physician to manage their condition to help slow additional damage to the patient’s kidney. Understanding how the kidneys work can help a person keep them healthy and will help the kidney patients understand more how the dialysis treatment works. The kidneys are bean-shaped organs, each about the size of a fist. They are located near the middle of the back, just below the rib cage, one on each side of the spine. The kidneys are sophisticated reprocessing machines. Every day, a person’s kidneys process about 200 quarts of blood to sift out about 2 quarts of waste products and extra water. The wastes and extra water become urine, which flows to the bladder through tubes called ureters. The bladder stores urine until releasing it through urination. Wastes in the blood come from the normal breakdown of active tissues, such as muscles, and from food. The body uses food for energy and self-repairs. After the body has taken what it needs from food, wastes are sent to the blood. If the kidneys did not remove them, these wastes would build up in the blood and damage the body. As mentioned above there are several factors that contribute for the kidneys to fail. In time that the person’s kidney fail to function, Dialysis can help a person with kidney failure to feel better and live longer, but it is not a cure for kidney failure. There are different types of Dialysis, the Hemodialysis and the Peritoneal Dialysis. Patients needs to understand the difference between these two types of Dialysis. They have to decide together with their physician which kind of treatment will be best for them. Both types require patients to follow a strict treatment schedule, take medications regularly and, often, make changes in their diet. Hemodialysis is a serious responsibility. In hemodialysis, a dialysis machine and a special filter called an artificial kidney, or a dialyzer, are used to clean the patient’s blood. To get the patient’s blood into the dialyzer, the doctor needs to make an access, or entrance, into your blood vessels. This is done with minor surgery, usually to your arm. Hemodialysis can be done in a hospital, in a dialysis center that is not part of a hospital or at home. The patient have the option which place is best, based on the patient’s condition and wishes. Hemodialysis treatments usually last about four hours, and they are done three times a week.
Peritoneal dialysis is the technique that uses the patient's own body tissues inside of the belly to act as a filter. The intestines lie in the abdominal cavity, the space between the abdominal wall and the spine. A plastic tube called a "dialysis catheter" is placed through the abdominal wall into the abdominal cavity. A special fluid is then flushed into the abdominal cavity and washes around the intestines. The intestinal walls act as a filter between this fluid and the blood stream. By using different types of solutions, waste products and excess water can be removed from the body through this process. Peritoneal dialysis is less physiologically stressful than hemodialysis, does not require vascular access, can be performed at home, and allows patients much greater flexibility. However, it requires much more patient involvement.
Patients with the kidney failure not only need to understand difference between these two procedure but they also need to be aware of the advantages and the disadvantages of these treatment. Comparison of dialysis methods|
| Hemodialysis| Peritoneal dialysis|
Advantages | It is most often done by trained health professionals who can watch for any problems. It allows you to be in contact with other people having dialysis, which may give you emotional support. You don't have to do it yourself, as you do with peritoneal dialysis. You do it for a shorter amount of time and on fewer days each week than peritoneal dialysis.| It gives you more freedom than hemodialysis. It can be done at home or in any clean place. You can do it when you travel. You may be able to do it while you sleep. You can do it by yourself. It doesn't require as many food and fluid restrictions as hemodialysis, and it does not use needles. It doesn't require the use of blood thinners, so it may be a better choice if you have bleeding problems or take medicines that interfere with blood clotting.| Disadvantages | It causes you to feel tired on the day of the treatments. It can cause problems such as low blood pressure and blood clots in the dialysis access. It increases your risk of bloodstream infections. It requires the use of blood thinners during the procedure, so it may not be the best choice if you have bleeding problems or take medicines that interfere with blood clotting. | The procedure may be hard for some people to do. It increases your risk for an infection of the lining of the belly, called peritonitis|
Azores, N.F. (2005). Initiation of Dialysis Therapy. Manulife, Inc.
Nissenson, A.R. (2002). Dialysis Therapy.Philadelphia: Hanley & Belfus Inc