World Kidney Day 2023: Understanding The Benefits And Challenges Of Dialysis For Chronic Kidney Disease

The kidneys are responsible for removing waste products that are produced in our bodies. However, in people with chronic kidney disease, the kidneys cannot function properly and waste products start to accumulate. This can cause various health problems.

People with advanced kidney failure need artificial support to remove waste products and extra water that the body doesn't need. This support is called dialysis, which is of two types - hemodialysis and peritoneal dialysis.

Peritoneal dialysis uses the lining of the abdominal cavity to remove waste products, while hemodialysis uses artificial filters to remove waste products from the bloodstream.

Hemodialysis is a life-saving therapy for people with chronic kidney disease, as it removes waste products and helps all the organ systems work properly, thus increasing the longevity of these people. It can also help improve the quality of life of patients by treating symptoms like fluid retention, loss of appetite, nausea, and vomiting.

People on hemodialysis can lead a productive life as the therapy enables them to continue activities of daily life. It makes them feel better and has more energy. People on dialysis can continue working, traveling, and engaging in other activities they enjoy which can improve their overall quality of life.

However, hemodialysis is not without its challenges. Patients need to have something called vascular access to perform hemodialysis, which is the site from where the blood leaves for the filter and is returned to the body from the filter. Without vascular access like a catheter or AV fistula, hemodialysis is not possible. Creating and maintaining such access is challenging for many patients.

Patients on hemodialysis also face higher risks of complications like infections and cardiovascular diseases, as well as challenges like malnutrition, anemia (low hemoglobin level), vitamin deficiencies, and bone disease.

Hemodialysis can put a lot of strain on the patients and their families, owing to its complex nature. However, with a multidisciplinary team consisting of nephrologists, dialysis nurses and technicians, dietitians, physical therapists, and primary care professionals, hemodialysis can make a difference in the lives of people with advanced kidney disease. It can sustain life for several years, but it is best used as a bridge therapy to kidney transplantation, which is a desirable modality of treatment for most patients.

Although hemodialysis cannot match the natural kidneys, it does offer hope to patients with advanced kidney disease.

(Dr. Vaibhav Keskar, Consultant Nephrologist at Kokilaben Dhirubhai Ambani Hospital Navi Mumbai)

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