Friday, March 29, 2019

Understanding Dialysis and Kidney Diseases

By Jay Reddy, MD
Nephrology and Internal Medicine, Wichita Falls
Member, Texas Medical Association 

Editor’s Note:  March is National Kidney Month. The Wichita County Medical Society Magazine previously published a version of this article to promote “Walk With a Doc,” an outreach program for anyone interested in taking steps for a healthier lifestyle. The Wichita County Medical Society hosts its Walk With a Doc events the second Saturday of each month.

Make no mistake about it – your kidneys play a big role in your overall health. Located in back just below the rib cage, one on each side of your spine, your kidneys are responsible for filtering blood, and removing wastes and excess water from your body, through your urine. If your kidneys shut down, your nerves, muscles, and other tissues in your body might not work properly.
When this occurs, your physician might recommend kidney dialysis to do the job your kidneys cannot.

What is Dialysis?

Dialysis is a process of purification of blood. It involves removing excess water, solutes, and toxins from the blood in those who have lost the ability to perform these functions in a natural way because their kidneys have shut down.

There Are Two Forms of Dialysis: Hemodialysis (Blood Dialysis) and Peritoneal Dialysis

Hemodialysis (or blood dialysis) removes waste and water by circulating blood outside of the body through an external filter called a dialyzer (also called an artificial kidney). To achieve this, a doctor has to place a catheter in you to access your blood vessels to get the blood flow necessary for dialysis.

Peritoneal dialysis is another way to treat kidney failure. With this treatment, a tube is inserted into and out of the peritoneal cavity (your abdomen area). A solution called dialysate – which is water with salt, glucose, and other additives – flows through a tube into the patient’s belly.  Patients perform Peritoneal Dialysis at home by themselves, after undergoing thorough training by the dialysis team.

Having a vital organ such as the heart, liver, or kidneys shut down can be fatal, unless the organ is transplanted. But very often patients wait months or years for a suitable organ for transplantation. Fortunately, in the case of kidney failure – unlike heart or liver failure – dialysis offers a temporary solution until while the patient awaits a suitable donor kidney.

How Did We Get Here? Kidney Diseases and Failure

Kidneys can temporarily shut down from acute kidney injury (AKI), or permanently shut down from chronic kidney disease (CKD). If the patient needs dialysis, it would only be temporary. CKD on the other hand means your kidneys can’t filter blood the way they should, and if not managed the condition can lead to kidney failure (end stage kidney disease). Once you reach this stage, you will need dialysis or a transplant.

Two main factors that can lead to kidney failure are diabetes and hypertension (high blood pressure). High concentrations of sugar in the blood and high blood pressure over many years can ruin the filtering membranes in the kidney. This can result in further complications.

The first sign of kidney disease from diabetes is when the patient loses excess protein in his or her urine. This can go unnoticed unless urine is tested specifically for protein. According to the most recent statistics by the American Diabetes Association, more than 30 million Americans – or close to one in ten people – has been diagnosed with diabetes.

Not only is the combination of poorly managed diabetes and hypertension bad for your kidneys, they can lead to heart attack, stroke, or other fatal complications. Some patients successfully escape these fatal complications, but still develop late-stage kidney damage. They will require kidney replacement.

Prevention: What You Can Do to Protect Your Kidneys

To avoid kidney failure and other complications, you need to create a healthier you, with medications and lifestyle changes. This includes eating a healthy diet, being physically active, maintaining a healthy weight, and quitting bad habits (smoking or alcohol consumption, for example). All of these can prevent or slow the progression of kidney disease.

Contact Dr. Reddy here. 

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