Hemodialysis is the most common method used to treat advanced and permanent
kidney failure. Since the 1960s, when hemodialysis first became a practical
treatment for kidney failure, we've learned much about how to make hemodialysis
treatments more effective and minimize side effects. In recent years, more
compact and simpler dialysis machines have made home dialysis increasingly
attractive. But even with better procedures and equipment, hemodialysis is still
a complicated and inconvenient therapy that requires a coordinated effort from
your whole health care team, including your nephrologist, dialysis nurse,
dialysis technician, dietitian, and social worker. The most important members of
your health care team are you and your family. By learning about your treatment,
you can work with your health care team to give yourself the best possible
results, and you can lead a full, active life.
When Your Kidneys Fail
Healthy kidneys clean your blood by removing excess fluid, minerals, and
wastes. They also make hormones that keep your bones strong and your blood
healthy. When your kidneys fail, harmful wastes build up in your body, your
blood pressure may rise, and your body may retain excess fluid and not make
enough red blood cells. When this happens, you need treatment to replace the
work of your failed kidneys.
How Hemodialysis Works
In hemodialysis, your blood is allowed to flow, a few ounces at a time,
through a special filter that removes wastes and extra fluids. The clean blood
is then returned to your body. Removing the harmful wastes and extra salt and
fluids helps control your blood pressure and keep the proper balance of
chemicals like potassium and sodium in your body.
One of the biggest adjustments you must make when you start hemodialysis
treatments is following a strict schedule. Most patients go to a clinic-a
dialysis center-three times a week for 3 to 5 or more hours each visit. For
example, you may be on a Monday-Wednesday-Friday schedule or a
Tuesday-Thursday-Saturday schedule. You may be asked to choose a morning,
afternoon, or evening shift, depending on availability and capacity at the
dialysis unit. Your dialysis center will explain your options for scheduling
regular treatments.
Researchers are exploring whether shorter daily sessions, or longer sessions
performed overnight while the patient sleeps, are more effective in removing
wastes. Newer dialysis machines make these alternatives more practical with home
dialysis. But the Federal Government has not yet established a policy to pay for
more than three hemodialysis sessions a week.
Picture of Hemodialysis
Several centers around the country teach people how to perform their own
hemodialysis treatments at home. A family member or friend who will be your
helper must also take the training, which usually takes at least 4 to 6 weeks.
Home dialysis gives you more flexibility in your dialysis schedule. With home
hemodialysis, the time for each session and the number of sessions per week may
vary, but you must maintain a regular schedule by giving yourself dialysis
treatments as often as you would receive them in a dialysis unit.
Kidney failure can occur from an acute event or a chronic condition or disease. Prerenal kidney failure is caused by blood loss, dehydration, medication. Some of the renal causes of kidney failure are from sepsis, medications, rhabdomyolysis, multiple myeloma, and acute glomerulonephritis. Post renal causes of kidney failure include bladder obstruction, prostate problems, tumors, or kidney stones. Treatment options included diet, medications, or dialysis.
Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most headaches.
Anemia is the condition of having less than the normal number of red blood cells or less than the normal quantity of hemoglobin in the blood. The oxygen-carrying capacity of the blood is, therefore, decreased.
Menopause is the time in a woman's life when menstrual periods permanently stop, also called the “change of life." Menopause symptoms include hot flashes, night sweats, irregular vaginal bleeding, vaginal dryness, painful intercourse, urinary incontinence, weight gain, and emotional symptoms such as mood swings. Treatment of menopausal symptoms varies, and should be discussed with your physician.
There are several types of kidney cancer, including renal cell cancer (renal adenocarcinoma or hypernephroma), transitional cell carcinoma, and Wilms tumor. Symptoms of kidney cancer include blood in the urine, an abdominal lump or mass, chronic pain in the side, and tiredness. Treatment of kidney cancer--which may include surgery, arterial embolization, radiation therapy, biological therapy or chemotherapy--depends upon the stage of the disease and the patient's overall health.
Restless leg syndrome (RLS or restless legs syndrome) is a common cause for painful legs that typically eases with motion, and becomes worse and more noticeable at rest. This characteristic nighttime worsening can frequently lead to insomnia. Treatment of the symptoms of restless leg syndrome is generally with medication as well as treating any underlying condition causing restless leg syndrome.
Sleep apnea is defined as a reduction or cessation of breathing during sleep. The three types of sleep apnea are central apnea, obstructive apnea (OSA), and a mixture of central and obstructive apnea. Central sleep apnea is caused by a failure of the brain to activate the muscles of breathing during sleep. OSA is caused by the collapse of the airway during sleep. OSA is diagnosed and evaluated through patient history, physical examination and polysomnography. There are many complications related to obstructive sleep apnea. Treatments are surgical and non-surgical.
Amyloidosis is a group of diseases resulting from abnormal deposition of certain proteins (amyloids) in various bodily areas. The amyloid proteins may either be deposited in one particular area of the body (localized amyloidosis) or they may be deposited throughout the body (systemic amyloidosis). There are three types of systemic amyloidosis: primary (AL), secondary (AA), and familial (ATTR). Primary amyloidosis is not associated with any other diseases and is considered a disease entity of its own. Secondary amyloidosis occurs as a result of another illness. Familial Mediterranean Fever is a form of familial (inherited) amyloidosis. Amyloidosis treatment involves treating the underlying illness and correcting organ failure.
Polycystic kidney disease (PKD) is characterized by numerous cysts in the kidneys. Polycystic kidney disease is a genetic disorder. There are two major inherited forms of PKD, autosomal dominant PKD, and autosomal recessive PKD. Symptoms include headaches, urinary tract infections, blood in the urine, liver and pancreatic cysts, abnormal heart valves, high blood pressure, kidney stones, aneurysms, and diverticulosis. Diagnosis of PKD is generally with ultrasound, CT or MRI scan. There is no cure for PKD, so treatment of symptoms is usually the general protocol.
High blood pressure can damage the kidneys and is one of the leading causes of kidney failure (end-stage renal kidney disease). Kidney damage, like hypertension, can be unnoticeable and detected only through medical tests. If you have kidney disease, you should control your blood pressure. Other treatment options include prescription medications.
Arsenic comes in two forms, inorganic and organic. Organic arsenic poisoning is usually not poisonous to humans; however, inorganic arsenic in large enough amounts can lead to shock and death. Symptoms of arsenic poisoning include nausea, abdominal pain, diarrhea, dehydration, dark urine, vertigo, delirium, shock, and death. Treatment for arsenic poisoning includes Hemodialysis and a variety of drugs.
Fabry disease (Fabry's disease, alpha-galactosidase-A) is a genetic disorder with symptoms such as burning sensations in the hands, small-raised reddish-purplish blemishes on the skin, fever, decreases sweating, and GI difficulties. Fabry disease patients are at increased risk of heart attack, heart disease, kidney failure, and stroke. Symptoms of Fabry disease can be treated with medication.
Hemolytic uremic syndrome (HUS) is a diseases in which blood clots within the capillaries. Causes associated with HUS include E. Coli, birth control pills, pneumonia, medications such as chemotherapy, Ticlid, and quinine. Symptoms of HUS include gastroenteritis, abdominal cramping, vomiting, and bloody diarrhea. Diagnosis of HUS includes medical history, physical examination, and medical tests. Treatment includes rest, fluids, possible hospitalization for blood transfusion or complications due to kidney failure.
Renal osteodystrophy is a bone disease. The kidneys fail to maintain required levels of phosphorous and calcium in the blood. Renal osteodystrophy is common in patients with kidney disease and affects dialysis patients. Diagnosis is performed with a blood sample, and in some cases a bone biopsy. Medication is the general treatment for renal osteodystrophy.
Depression in the elderly is very common. That doesn't mean, though, it's normal. Treatment may involve antidepressants, psychotherapy, or electroconvulsive therapy.
Sleep apnea is a disorder characterized by a reduction or pause of breathing (airflow)
during sleep. It is common among adults but rare among children. Although a diagnosis of sleep apnea often will be suspected on the basis of a person's
medical history, there are several tests that can be used to confirm the diagnosis. The treatment of sleep apnea may be either surgical or nonsurgical.
An apnea is a period of time during which breathing stops or is markedly reduced. In simplified terms, an apnea occurs when a person stops breathing for 10 seconds or more.
If you stop breathing completely or take less than 25% of a normal breath for a period that lasts 10 seconds or more,
this is an apnea. This definition includes complete stoppage of airflow. Other definitions of apnea that may be used include at least a 4% drop in oxygen in the blood, a direct result of the reduction in the transfer of oxygen into the blood when breathing stops.
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