The complexity of dialysis treatment options available in recent years has been helpful to patients grappling with kidney diseases. For those suffering from acute kidney injury (AKI) and chronic kidney disease (CKD), dialysis has proven to be a lifesaver, significantly improving the quality of life for individuals facing kidney failure. While patients typically visit a dialysis centre for treatment, the specific type of dialysis—whether done at a centre or at home—depends on the nature and severity of the kidney disease.
Doctors use two principal types of dialysis treatments: hemodialysis and peritoneal dialysis. Doctors most commonly conduct hemodialysis at a dialysis centre, where they use a dialyser or ‘artificial kidney’ to cleanse the blood of toxins, extra salts, and fluids. In contrast, patients perform peritoneal dialysis at home, using the body’s peritoneum as a natural filter to cleanse the blood. Although all dialysis methods serve the same purpose—blood purification—the best choice varies. It depends on whether the condition is acute kidney injury, chronic kidney disease, or another illness. Understanding these differences is crucial for managing kidney disease effectively.
Causes and Symptoms
Acute Kidney Injury (AKI) and Chronic Kidney Disease (CKD) fundamentally differ in their onset and progression rates. AKI often occurs as a sudden, short-term event that impacts kidney function due to various causes such as trauma, infection, inflammation of the kidneys, or blockage of blood vessels supplying the kidneys. Symptoms of this condition often manifest abruptly and may include decreased urine output, fatigue, and shortness of breath. On the other hand, CKD is a long-term condition where kidney function declines gradually over months or years. Common causes include diabetes, hypertension, and recurrent kidney infections. People with CKD often experience nonspecific symptoms like loss of appetite, nausea, and fatigue, which tend to intensify as the kidney function decreases.
In managing both conditions, the type of dialysis employed significantly varies. For those with AKI, dialysis may offer a short-term solution to remove waste products from the blood. This helps until the kidneys regain their functionality. The dialysis machine acts as an artificial kidney, performing its function several times a week. During each dialysis session, the medical team cleans the patient’s blood and returns it to their body. For people on dialysis due to CKD, this is a long-term commitment. Unless a kidney transplant becomes a viable option, reliance on dialysis continues due to the irreversible nature of CKD.
Dialysis Treatment for AKI
Patients with Acute Kidney Injury (AKI) may need dialysis urgently to help artificially control the functionality that the kidney has lost. This is imperative in AKI cases, as kidney failure may lead to an accumulation of these harmful substances. One common method people opt for is home hemodialysis. This method lets patients administer the treatment in the comfort of their homes, offering greater flexibility and convenience. However, doctors must personalise the frequency of treatment according to the patient’s condition to efficiently manage waste removal.
While undergoing dialysis treatment for AKI, patients must follow a strict meal plan tailored to their needs. This plan helps regulate nutrient consumption and excretion, which is crucial for balancing fluids and electrolytes. With home hemodialysis, it’s common side effect is low blood pressure, which patients need to monitor. AKI can sometimes lead to chronic kidney disease if left unmanaged for an extended period. Immediate dialysis treatment and a proper meal plan are crucial for managing the disease and avoiding further complications.
Dialysis Treatment for CKD
Chronic Kidney Disease (CKD) often necessitates the initiation of hemodialysis treatment to execute kidney functions artificially. Unlike acute kidney injury, where dialysis may be a temporary measure, CKD patients usually require long-term dialysis as their kidneys cannot naturally recover.
Two primary options offered for home dialysis are traditional hemodialysis and automated peritoneal dialysis (APD). In a home setting, patients perform hemodialysis a few times per week and control the schedule, ensuring it doesn’t interfere with their usual activities. APD, on the other hand, employs a special dialysis solution that is infused into the abdomen through a catheter. It uses the patient’s own body tissues within the abdominal cavity to act as a filter. Despite the differences, both techniques present a simplified method of receiving treatment, thus improving the overall quality of life for the dialysis patient.
Comparison of Dialysis Treatment for AKI and CKD
Dialysis treatment often varies according to the specific needs of kidney failure patients, whether their illness is acute or chronic. The decision between forms of dialysis, such as hemodialysis or peritoneal dialysis, depends on various factors. These factors include the patient’s health, lifestyle, and personal preferences. Hemodialysis at home offers comfort and flexibility. However, the care team must carefully manage the dialysis fluid and monitor it persistently. A hospital or dialysis centre may be recommended for patients unable to manage at-home care. In these settings, expert medical staff can oversee the patient’s condition.
On the other hand, what happens during dialysis also has implications for the form of dialysis being chosen. Peritoneal dialysis may be less stressful on the body compared to hemodialysis. It mimics the slower, more constant filtration performed by a normal kidney. However, for individuals with Acute Kidney Injury (AKI), hemodialysis offers rapid and robust filtration. This may provide a quicker route to stabilisation. Rigorous consultations with a dialysis care team are integral. They help determine the optimal type of dialysis for a patient’s recovery. Undoubtedly, the form, setting, and execution of dialysis may need to be tailored to each patient’s unique circumstance.
Life on Dialysis
For many patients, life on dialysis due to both Acute Kidney Injury (AKI) and Chronic Kidney Disease (CKD) signifies a substantial lifestyle change. While dialysis involves a complex procedure to perform the kidney’s function, it may not necessarily imply a dire prognosis. It is worth noting that even after AKI, in some cases where kidney function remains marginally viable, a patient may be able to stop dialysis. However, this requires extensive medical examinations and should never be attempted without proper medical guidance.
In the case of CKD, patients will most likely have to undergo dialysis for the rest of their lives, especially if they have progressed to end-stage kidney disease. The complications are more extensive, and thus, it becomes essential to maintain a semblance of normal kidney function. Dialysis costs can become a significant concern for many households, particularly if the treatment is long-term, as is often the case with CKD. Although it poses fiscal and physical challenges, dialysis treatment provides CKD and AKI patients with a vital lifeline, facilitating a better quality of life than they would otherwise have.