End-stage renal disease (ESRD), often known as kidney failure, is a medical condition that is treated by dialysis.
When the kidneys are unable to efficiently perform these vital jobs, it acts as a life-saving medicine by replicating the actions of the kidneys, including filtering harmful substances and extra fluid from the blood.
Introduction of Dialysis Treatment
Symptoms
The need for dialysis treatment typically arises when a person’s kidneys fail to function adequately, leading to a buildup of waste products and excess fluids in the body. The symptoms indicating a need for dialysis can vary in severity and may include:
- Fatigue
- Fluid Retention
- Decreased Urine Output
- Shortness of Breath
- Nausea and Vomiting
- Itching
- Changes in Mental State
- High Blood Pressure
- Muscle Cramps and Restless Legs.
- Loss of Appetite
- Numbness and Tingling
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For those with kidney failure, generally known as end-stage renal disease (ESRD), there are mainly two methods of dialysis:
Haemodialysis (HD): A hemodialyzer is used to filter blood outside and remove waste materials and electrolytes during haemodialysis, a popular form of dialysis carried out at a dialysis clinic or hospital.
Peritoneal Dialysis (PD): Patients can do peritoneal dialysis at home or at night by using the peritoneum as a natural filter and delivering a dialysis solution (dialysate) through a catheter.
Diagnosis
The decision to start dialysis treatment is based on several factors, including the patient’s clinical condition and laboratory test results.
Diagnosis for dialysis treatment involves a combination of medical assessments and lab tests. Here are the key components of the diagnosis process:
Clinical Evaluation
Blood Tests:
– Serum Creatinine and Glomerular Filtration Rate (GFR)
– Blood Urea Nitrogen (BUN)
– Electrolyte Levels
– Complete Blood Count (CBC)
Urine Tests:
– Urinalysis
– Urine Protein-to-Creatinine Ratio
Imaging Studies:
– Ultrasound
– CT or MRI Scans
Kidney Biopsy
Assessment of Symptoms: Symptoms such as fatigue, swelling, decreased urine output, and high blood pressure are considered in the diagnosis and treatment decision.
Assessment of Complications: Kidney disease stages are determined by GFR, with dialysis considered when kidney function falls below 15 mL/min/1.73 m², influenced by complications like fluid overload, electrolyte imbalances, and uncontrolled hypertension.
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Outlook
A chronic and developing illness, ESRD.
For those with renal failure, dialysis can prolong their lives and enhance their quality of life, but ultimately a kidney transplant may be a preferable long-term alternative.
Treatment of Dialysis Treatment
Complications
Dialysis is a life-saving treatment for individuals with kidney failure, but like any medical procedure, it can be associated with various complications. Some common complications during or after dialysis treatment include:
- Hypotension (Low Blood Pressure)
- Muscle Cramps
- Infections
- Access Site Problems
- Bleeding
- Arrhythmias
- Allergic Reactions
- Anemia
- Electrolyte Imbalances
- Cardiovascular Issues
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Prognosis
Dialysis is not a cure for ESRD, but it can prolong life for those who have it. Age, general health, and adherence to the prescribed course of therapy are some of the variables that affect prognosis.
Risk Factors
During dialysis treatment, there are several risk factors and potential complications that patients and healthcare providers need to be aware of.
It’s important to manage these risks to ensure the safety and effectiveness of the treatment. Here are some common risk factors associated with dialysis:
- Low Blood Pressure (Hypotension)
- Blood Clotting
- Access Site Complications (Haemodialysis)
- Anemia
- Electrolyte Imbalances
- Fluid Overload
- Cardiovascular Issues
- Access-Related Infections (Peritoneal Dialysis)
- Psychological and Emotional Stress
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Side Effects
Common side effects of dialysis may include fatigue, dizziness, nausea, and sleep disturbances.
Pre / Post Care
Patients on dialysis require careful dietary management, fluid restrictions, and regular monitoring of blood pressure and lab values. Pre-dialysis care focuses on managing the underlying causes of kidney failure.
Treatment Cost of Dialysis Treatment
The cost of treatment can be divided as follow:
Haemodialysis: Haemodialysis sessions in India cost between ₹1,000 and ₹3,000 per session, with patients often needing multiple monthly sessions, not including additional expenses like medications and tests.
Peritoneal Dialysis: Peritoneal dialysis may have lower monthly costs compared to haemodialysis, ranging from ₹15,000 to ₹30,000, including dialysis fluid and supplies.
Kidney Transplant: Kidney transplantation costs can range from ₹5 lakhs to ₹15 lakhs, depending on factors like hospital, surgeon fees, post-transplant care, and medication expenses.
