1/01/2009

Living with failed kidneys

Kidneys are a pair organ located just behind stomach and they have an important function: kidneys filter bacteria extra salt and water from your body. If they do not function properly, if they do not filtrate, salt and other waster can build up in the body. Kidney failure can happen very quickly, in...
Kidneys are a pair organ located just behind stomach and they have an important function: kidneys filter bacteria extra salt and water from your body. If they do not function properly, if they do not filtrate, salt and other waster can build up in the body. Kidney failure can happen very quickly, in a matter of few days or throughout years.
Kidney failure can also happen due to other illnesses, such as diabetes or high blood pressure. Both are an example of chronic kidney failure, when loss of kidney function develops gradually over time, with few signs or symptoms in the early stages. Most people with chronic kidney failure need to take medicines, and many need dialysis. On the other hand, sudden (acute) kidney failure is most common in people who are already hospitalized, especially those who need intensive care. It also tends to occur after complicated surgery or when blood flow to your kidneys is disrupted, and after a severe injury. However, unlike chronic kidney failure acute kidney failure is reversible and if patient is otherwise in good health condition, normal kidney function should recover within a few weeks.
If failed kidneys aren't treated properly, they will have negative effect on the heart, lungs, brain and other organs, or cause death.







Treatment

The first goal when treating kidney failure is to treat the illness or injury that originally damaged your kidneys. And once that illness is under control, the focus is on preventing the accumulation of excess fluids and wastes in your blood while your kidneys heal. This is done by following special diet, which focuses on limiting your fluid intake and following a high-carbohydrate, low-protein and low-potassium diet, and/or by undergoing dialysis treatment. Dialysis is a treatment where waste from your blood is mechanically filtered. Dialysis can replace the function of your kidney, albeit imperfectly, while your kidneys are healing. Dialysis treatment can be done either at home or in hospital, but dialysis for acute kidney failure is usually done at a hospital or dialysis center and not at home. There are two dialysis treatment choices for kidney failure: hemodialysis and peritoneal dialysis and if necessary kidney transplantation. The most common form of dialysis used for acute kidney failure is known as hemodialysis. First of all, it is important to clear that not everyone with kidney failure needs dialysis. Dialysis is necessary only when patient looses about 85 to 90 percent of kidney function, which is developing end stage of kidney failure.
The dialysis treatment itself isn't painless, but patients do report they feel some discomfort when the needles are put into your fistula or graft, but most patients have no other problems. There might be some side effects, like a drop in blood pressure, sickness, a headache or cramps, but with frequent treatments, those problems usually go away. However, it is treatment that requires discipline and is a treatment that patient and patients family need to get used to.

Hemodialysis

Hemodialysis cleans and filters your blood by using a machine, called dialyzer. Dialyzer functions as your kidney as filtrates all harmful wastes, extra salt and water, for that reason hemodialysis helps control blood pressure and helps your body keep the proper balance of important chemicals such as potassium, sodium, calcium, and bicarbonate. It works by pumping blood out of your body to the artificial kidney through a vascular access that's created surgically, usually in your arm or leg. So, blood travels through tubes and membranes into the dialyzer, which filters out wastes and extra water. Then the cleaned blood flows through another set of tubes back into your body. The dialyzer is connected to a machine that monitors blood flow and removes wastes from the blood. If patient undergoes hemodialysis, several months before first treatment, an access to patient's bloodstream must be created. This is done by minor surgery to your arm or leg. Sometimes, an access is made by joining an artery to a vein under your skin to make a bigger blood vessel called a fistula, but if your blood vessels are not adequate for a fistula, the doctor may use a graft. Graft is soft plastic tube to join an artery and a vein under your skin.
Usually, each hemodialysis treatment lasts about four hours and is done three times per week, although a type of hemodialysis called high-flux dialysis may take less time. The time needed for treatment vary and depends on how well your kidneys work, how much fluid weight you gain between treatments, how much waste you have in your body, how big you are, the type of artificial kidney used.

Peritoneal dialysis

Peritoneal dialysis is a type of dialysis when blood is cleansed inside patients body, but first the doctor will have to do a surgery to place a plastic tube (catheter) into your abdomen to make an access. During the treatment patients abdominal area (also called peritoneal cavity) is filed with dialysate through the catheter. Peritoneal dialysis works by using the body's peritoneal membrane, which is inside the abdomen, as a semi-permeable membrane. Special solutions that help remove toxins are infused in, remain in the abdomen for a time, and then are drained out. This form of dialysis can be performed at home, but must be done every day.
There are several kinds of peritoneal dialysis but two major ones are: Continuous Ambulatory Peritoneal Dialysis (CAPD) and Continuous Cycling Peritoneal Dialysis (CCPD). Continuous Ambulatory Peritoneal Dialysis (CAPD) is the only type of peritoneal dialysis that is done without machines. You do this yourself, usually four or five times a day at home and/or at work, while Continuous Cycling Peritoneal Dialysis (CCPD) usually is done at home using a special machine called a cycler.

Can kidney failure get better?

Final question is will patient get better. Kidney failure is not always permanent, for example in some cases of acute kidney failure, dialysis is only needed for a short time until the kidneys get better. However, in chronic or end stage kidney failure, kidneys do not get better and patient needs dialysis for the rest of life. Dialysis namely does some of the work of healthy kidneys, but it does not cure your kidney disease. You will need to have dialysis treatments for your whole life unless you are able to get a kidney transplant.