The human body is a complex structure comprising different mechanisms, each fulfilling its essential functions. At a given time, if one of the mechanisms ceases to work, it often leads to urgent medical care depending upon the degree of graveness. One such mechanism working continuously is the urinary tract system which comprises the kidneys, bladder, ureters, and urethra. The urinary bladder is a muscular sac in the lower abdomen that retains urine until it is evacuated from the body during urination. Some significant functions include urine storage, contraction and relaxation of bladder walls, control of the urinary sphincter, and sensory functions.

 

 All these components combined carry out many critical functions in the body. Renal function measures how well the kidneys filter blood. The two healthy kidneys are entirely functional. Modest or minor decreases in kidney function—as much as 30-40%—would be unlikely. The estimated glomerular filtration rate is computed using a blood sample and a formula (eGFR). The eGFR represents the percentage of accessible renal function. Renal disease is prevalent in many persons with impaired kidney function and will worsen. Severe health complications arise when persons have fewer than 25% renal function. When a person’s kidney function falls below 10 to 15%, they require some renal replacement therapy—either blood-cleansing treatments known as dialysis or a kidney transplant—to survive.

 

What is dialysis?

 

Dialysis is the removal of waste and surplus water from the blood. It is generally utilized to give an artificial substitute for lost kidney function in patients suffering from renal failure. Those whose kidneys no longer work would die relatively fast owing to electrolyte imbalances and toxic accumulation in the blood. People on dialysis may live for many years, but other underlying and linked conditions frequently cause mortality.

The following are the primary causes of dialysis:

1. To eliminate excess fluid: Healthy kidneys aid in regulating the body’s fluid balance by eliminating excess fluid such as urine. Excess fluid in the body can cause swelling in the legs, arms, or face of people with renal failure and trouble breathing. Dialysis aids in removing excess fluid and maintaining a healthy fluid balance in the body.
2. Eliminate waste materials: The kidneys also aid in eliminating harmful waste from the body, such as urea and creatinine. However, in people with ESRD or AKI, the kidneys can no longer openly eliminate circulation waste, causing weariness, nausea, and disorientation. Dialysis aids in the removal of waste materials, circulation, and the restoration of everyday blood chemistry.
3. To maintain electrolyte balance: The kidneys also aid in regulating electrolyte levels, including sodium, potassium, and calcium. Electrolyte abnormalities can arise in people with renal failure, causing symptoms such as muscular cramps, weakness, and cardiac rhythms. Dialysis aids in the maintenance of a proper electrolyte balance in the body.

 

What is kidney disease? What are its types?

Kidney disease, often known as renal disease, is an ailment that impairs kidney function. The kidneys are vital organs that filter wastes and excess fluids from the blood and expel them as urine. They also aid in regulating blood pressure, synthesizing hormones that control red blood cell development, and maintaining a healthy electrolyte balance. In many situations, kidney impairment is the outcome of another sickness that has gradually developed over time.

 Doctors use the phrase “kidney disease” to describe any abnormalities of the kidneys, even if the harm is minor. It is frequently referred to as ‘chronic’ renal disease. Chronic is a medical phrase that refers to a condition that does not improve entirely in a few days. A kidney condition is not a superficial kidney disease like a simple urine infection that clears itself and leaves no harm.

In addition, numerous distinct kidney illnesses have multiple effects on the kidneys. The following are the most prevalent kidney illnesses:

1. Chronic kidney disease-: (CKD) is a disorder in which the kidneys gradually lose function over time. Many conditions, such as high blood pressure, diabetes, and other autoimmune illnesses, can lead to CKD.
2. Acute kidney injury (AKI): This is an abrupt loss of kidney function that frequently lasts just a short time. Dehydration, infections, and some drugs are a few causes.
3. Polycystic kidney disease (PKD): This genetic disorder causes kidney cysts, which cause gradual harm and loss of renal function over time.

The glomeruli, or microscopic filters in the kidneys, are affected by a category of illnesses called glomerulonephritis. Glomerulonephritis can result in inflammation, and kidney damage could be brought on by infections, autoimmune diseases, or other conditions.

5. Nephrotic syndrome: This ailment causes the protein to leak into the urine, which causes Edema and other symptoms.
6. Kidney stones are solid salt and mineral deposits that can develop in the kidneys and cause pain and other symptoms.
7. Urinary tract infections (UTIs): These infections, which may affect the kidneys, bladder, or other areas of the urinary system, can result in a wide range of symptoms, such as pain, fever, and frequent urination.

 

Types of dialysis? 

Although dialysis is considered the last resort for a chronic kidney disease patient, apart from getting a transplant, it is more challenging than it sounds. Dialysis is a long and expensive procedure that involves artificially filtering the blood in the body itself, as the kidneys cannot do it naturally. But patients do not see the complications that come with this process. Kidney failure happens when your kidneys can no longer adequately filter waste, resulting in a toxic excess in the body. This toxicity in the blood is removed through a machine that is connected through surgical procedures.

Before an individual can sit for dialysis, various parameters must be checked to ensure no complications arise during the dialysis. The patent gets thoroughly evaluated based on their weight, blood pressure, signs of infections, pulse rate, and other ailments that must be considered. Two types of dialysis procedures are carried out depending on the patient’s condition and will. The more common of the two is hemodialysis.

During hemodialysis, your blood is withdrawn from your body a few ounces via IV access. Next, a machine pumps blood through tubes to a filter or dialyzer. The dialyzer is a canister containing thousands of fibers that filter waste and excess fluid. The clean blood is then pumped back into the body through tubes. Eliminating hazardous wastes, extra salt, and fluids aid blood pressure regulation and maintains the right balance of substances such as potassium and sodium.

To do hemodialysis, vascular accessibility must be created so that blood may be easily extracted for the operation; commonly, vascular access is performed by a surgeon. Creating a fistula (a surgery that directly connects an artery and vein, usually in the arm), effectively putting a graft (tubing under the skin that connects a route to a vein, usually in the arm but can be placed in other parts of the body), or inserting a dialysis catheter are all options for vascular access.

The other type is known as peritoneal dialysis, in which the abdomen region is used instead of connecting the machine through the arm of the patient. A catheter fills the abdominal cavity with a washing liquid known as a dialysate solution. The peritoneum, a membrane that lines the walls of the abdominal cavity, permits waste materials and extra fluid from your blood to move into the dialysate solution. In addition, the solution contains dextrose, a sugar that draws additional fluid into the abdominal cavity. As the dialysate solution is drained and the spent solution is discarded, these wastes and fluids exit the body.

Peritoneal dialysis can be conducted at home without the presence of a health professional. Under these circumstances, training is offered. The PD catheter, like vascular access for hemodialysis, is surgically implanted. The PD catheter insertion site should be completely healed before starting peritoneal dialysis. Patients can wash and bathe routinely once the catheter has healed completely.

Side effects of dialysis and its impact on health.

The life expectancy of patients with advanced renal disease is lower than that of healthy persons. Once on dialysis, patients’ life expectancy is impacted by the same reasons as patients who are not on dialysis. The most prevalent cause of mortality for dialysis patients is another condition, such as cardiovascular disease, diabetes, or infection, rather than the renal disease itself.

Several studies have been conducted to follow the life expectancy of dialysis patients on various forms of dialysis. However, some unpleasant side effects of this life-saving surgery include low blood pressure (nausea, dry and itchy skin, restless leg syndrome, and muscle cramps (from excessive or quick loss of fluid in the body).

Fluid overload occurs when the body accumulates too much fluid during dialysis because the kidneys can no longer eliminate enough. This can cause Edema, bloating, cramps, high blood pressure, shortness of breath, and cardiac issues. As a result, the patient must limit their salt and fluid intake between dialysis sessions. Some of the common side effects of getting dialysis are:

 

1. Infection: Dialysis can raise the disease risk, particularly at the site of access creation. Bacterial infections, such as peritonitis, cellulitis, and sepsis, are prevalent and potentially fatal.
2. Hypotension: Dialysis can result in a sudden drop in blood pressure, which can induce dizziness, light-headedness, and fainting. Those with pre-existing cardiac problems are especially vulnerable to hypotension.
3. Muscle cramps: Dialysis can produce muscular cramps, especially in the legs, which are uncomfortable and disrupt sleep.
4. Anemia: Dialysis can result in anemia, a disease in which the body lacks enough red blood cells to transport oxygen to the tissues. This might result in exhaustion, shortness of breath, and other symptoms.
5. Fluid overload: Dialysis can result in fluid excess, a condition in which the body retains excessive fluid. This can result in leg and body Edema, elevated blood pressure, and shortness of breath.
6. Electrolyte abnormalities: Dialysis can create electrolyte imbalances such as sodium, potassium, and calcium, resulting in symptoms such as muscular weakness, cardiac arrhythmias, and seizures.
7. Blood clotting: Dialysis therapy can induce blood clotting, particularly in the access blood arteries. Blood clots are harmful because they can damage blood arteries or organs.

 

Conclusion

 

With chronic kidney disease, leading an everyday life for a patient indeed becomes extremely tough. A kidney transplant or dialysis is the only option left toward the end stage. Still, it is essential to understand that they are not permanent solutions to kidney disease. But natural ways can be adopted to heal the kidneys without artificial machinery. While most dialysis patients will remain on it indefinitely, dialysis can be temporary when the kidneys suddenly lose their ability to filter and clean your blood. Individuals can take many steps towards keeping their kidneys healthy, such as controlling their blood pressure and sugar levels.

Since smoking hastens the advancement of kidney disease, it is suggested that persons with kidney disease quit smoking. Naturally, eating a good diet, obtaining sufficient nutrients, decreasing excess weight, and exercising are all factors to the patient’s excellent health. In fact, by following those procedures, many type 2 diabetics can avoid developing diabetes. In addition, individuals with high blood pressure should reduce their salt intake. Several experts feel that limiting protein and phosphorus in the diet may also help to delay the course of renal disease.