HEALTHY kidneys clean our blood by removing excess fluid, minerals and waste. They also make hormones that keep our bones strong and our blood healthy. But, if the kidneys are damaged, they don’t work properly.
Medical science tells us that harmful waste can build up in our body. Our blood pressure may rise. Our body may retain excess fluid and not make enough red blood cells. Doctors call this kidney failure.
Records from the Department of Health show that at least one Filipino dies each hour from kidney failure, which is considered the ninth leading cause of death in the country.
“If your kidneys fail, you need treatment to replace the work they normally do,” the National Institute of Health in the United States says. “Before dialysis was available, total kidney failure meant death,” notes the US National Kidney Foundation (NKF). “Today people with kidney failure can live because of treatments, such as dialysis and kidney transplant.”
According to medical experts, dialysis is a way of cleaning our blood when our kidneys can no longer do the job. It gets rid of our body’s wastes, extra salt and water and helps control our blood pressure.
Actually there are two kinds of dialysis: hemodialysis and peritoneal dialysis. “In hemodialysis, blood is pumped out of your body to an artificial kidney machine and returned to your body by tubes that connect you to the machine,” NKF explains. “In peritoneal dialysis, the inside lining of your own belly acts as a natural filter. Waste are taken out by means of a cleansing fluid called dialysate, which is washed in and out of your belly in cycles.”
The Mayo Clinic says your doctor can help you decide which type of dialysis will work best for you and when you should start, based on several factors: overall health, kidney function (as measured by blood and urine tests), personal preferences and home situation.
Peritoneal dialysis may be the better option if a person can’t tolerate the rapid changes of fluid balance associated with hemodialysis. “During hemodialysis, your blood is pumped into a machine to be filtered and then returned to your body,” the Mayo Clinic says.
Another reason for having a peritoneal dialysis is when the person wants to minimize the disruption of his daily activities and work, or prefers to travel more easily.
On the other side of the coin, peritoneal dialysis might not work for a person if he or she has extensive surgical scars in his abdomen; has a large abdominal hernia; has a limited ability to care for himself or lack caregiving support at home; and has inflammatory bowel disease or frequent bouts of diverticulitis.
The Mayo Clinic also points out that peritoneal dialysis may be done only to manage kidney failure until a kidney transplant is possible.
Here’s how peritoneal dialysis work: “A soft plastic tube [catheter] is placed in your belly by surgery. A sterile cleansing fluid is put into your belly through this catheter. After the filtering process is finished, the fluid leaves your body through the catheter.”
The NKF says there are two kinds of peritoneal dialysis: continuous ambulatory peritoneal dialysis (CAPD) and automated peritoneal dialysis (APD). “The basic treatment is the same for each,” it says. “However, the number of treatments and the way the treatments are done make each method different.”
The NKF shares the following information: “CAPD is ‘continuous,’ machine-free and done while you go about your normal activities, such as work or school. You do the treatment by placing about two quarts of cleansing fluid into your belly and later draining it. This is done by hooking up a plastic bag of cleansing fluid to the tube in your belly. Raising the plastic bag to shoulder level causes gravity to pull the fluid into your belly. When empty, the plastic bag is removed and thrown away.
“When an exchange [putting in and taking out the fluid] is finished, the fluid [which now has waste removed from your blood] is drained from your belly and thrown away. This process usually is done three, four or five times in a 24-hour period, while you are awake during normal activities. Each exchange takes about 30 to 40 minutes. Some patients like to do their exchanges at mealtimes and at bedtime.
“APD differs from CAPD in that a machine [cycler] delivers and then drains the cleansing fluid for you. The treatment usually is done at night while you sleep.”
“Which form of peritoneal dialysis is best for you depends on your lifestyle, personal preferences and medical condition,” the Mayo Clinic says. “You may also customize your program by combining the two forms.”
Aside from doing the regular peritoneal dialysis, there are other things you can do to improve the dialysis results and overall health. “Eat the right food, including food low in sodium and phosphorus,” the Mayo Clinic suggests. “A dietitian can help you develop an individualized meal plan based on your weight, your personal preferences, your remaining kidney function and other medical conditions, such as diabetes or high blood pressure.”
In addition, “Taking your medications as prescribed also is important for getting the best possible results,” the Mayo Clinic further notes. “While you’re receiving peritoneal dialysis, you’ll likely need various medications to control your blood pressure, stimulate production of red blood cells, control the levels of certain nutrients in your blood and prevent the buildup of phosphorus in your blood.”
Here’s a word of caution from NKF: “Peritoneal dialysis is not for everyone. People must receive training and be able to perform correctly each of the steps of the treatment. A trained helper may also be used.”