Simplified facts about kidney disease and dialysis

Kidney disease is a condition of damaged kidneys in which waste and fluid are not removed, instead of accumulating in the body. The severity of kidney disease may vary by group: *In India, more than 1,75,000 patients undergo chronic dialysis. Approximately 2,20,000-2,75,000 new patients require renal or renal replacement therapy each year.

Causes of kidney failure

Kidney failure doesn’t happen overnight. It is the result of the continued loss of kidney function. Kidneys are usually damaged due to medical conditions like diabetes, high blood pressure etc. A person with kidney failure may urinate frequently; blood in the urine; loss of appetite, weight loss; swelling over the body, tiredness; shortness of breath; soon.

Dialysis: why and when

Dialysis is a procedure recommended for a person who is suffering from approximately 90% kidney failure. When kidneys fail or don’t function properly, dialysis can help them do their job of removing waste and fluid from the blood. Dialysis procedure can help the person regain better mobility and flexibility; improved well-being with fewer dietary restrictions; live longer and healthier and much more. In addition, urine output may be normal at the time hemodialysis is started.

Answers to frequently asked questions: Myths solved

  1. Doctor asked me to start dialysis. Is this the end of my life?

The answer is a BIG NO. You can have dialysis and still enjoy life. Although transplantation is the best option, dialysis patients can enjoy their daily lives.

  1. Doctor advised 3 dialyses per week. Is it ok to have just 1 or 2 sessions instead?

Adequate dialysis is important to develop a good appetite and quality food intake. Insufficient dialysis can lead to loss of appetite, weight loss, anemia and breathing difficulties. Therefore, 1 dialysis per week makes no sense and 2 times per week can only lead to moderate kidney function. It is important to carry it out according to the doctor’s instructions.

  1. What Happens During Hemodialysis?

During hemodialysis, blood leaves your body through the port, travels through and is filtered by the dialysis machine, and later returns to your body.

  1. Why are regular biochemical tests advised?

They are done to make necessary changes in medicines. Adequate care can reduce complications.

  1. How much fluid should I take?

Daily fluid intake is 600 ml in addition to your urine output. If your urine output is 200 ml per day, you can drink up to 800 ml per day. It includes all types of liquids such as coffee, tea, rasam, dal etc.

  1. Can I eat all fruits and vegetables?

No not all. You should limit your food items rich in potassium, sodium and phosphorus which can be harmful to the body when consumed in excess.

  1. How do you follow a low-salt diet?

You can keep 3 grams (half a tablespoon) aside, add a little at a time while eating. You should avoid packaged foods such as meat, yeast, salted chips, cookies, nuts, popcorn, papad, pickle, soda, health drinks, cocoa, etc. have a high sodium content.

  1. Why do I get muscle cramps during dialysis?

When fluid removal is high, patients usually experience muscle cramps. Inform your doctor. Less weight gain between two dialysis sessions can help reduce fluid removal and prevent cramps and hypotension.

  1. What if I feel depressed?

It is important to maintain emotional health. Talk to a dialysis social worker or doctor to find out if counseling and/or medications may be helpful. Get help from a life partner, relatives, friends and other patients.

  1. Can I continue my work?

Yes, that’s possible. However, if your job requires a lot of physical work (heavy lifting, digging, driving, etc.), you may need to look for another job. You can also try to reschedule your work.

  1. Can I travel?

Yes, that’s possible. Avoid large amounts of liquid when traveling. Arrange dialysis at the place closest to your destination. You can also travel by plane. Please contact your doctor for this. Preferably dialyze immediately the day before the dialysis.

This article is written by Dr Suman Lata Nayak, Director & Senior Consultant – Nephrology & Kidney Transplantation, Dharamshila Narayana Superspeciality Hospital, Delhi

*thelancet.com

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