Is dialysis a cure for kidney failure?

Dialysis is not a cure for kidney failure; rather, it is a treatment that partially compensates for kidney functions that have stopped working correctly [1]. When kidneys fail, they can no longer clean blood of waste and excess fluids, requiring medical intervention to filter the blood. Dialysis helps control blood pressure and the balance of essential minerals such as potassium, sodium, and calcium in the blood, which improves the patient's well-being and extends their life [2].

Dialysis cannot replace all the functions of healthy kidneys. However, it can contribute to improving a patient's energy levels, and accompanying dietary adjustments can enhance their sense of well-being [2]. Continuing dialysis is necessary unless a kidney transplant (Arabic) is performed.

Types of Dialysis

There are two main types of dialysis, both of which work to filter blood to eliminate harmful waste, salts, and excess fluids from the body [1]:

• Hemodialysis: This method uses a machine outside the body known as a dialyzer to filter the blood. The patient is typically connected to the machine at a specialized clinic several times a week [1]. Each session lasts about 4 hours and is usually performed three times a week [2].
• Peritoneal Dialysis: This method uses the peritoneal membrane, which is the lining of the abdomen, to filter blood inside the body [1]. A soft tube (catheter) is implanted in the abdomen a few weeks before starting treatment. Dialysis solution flows through the catheter into the abdomen, where it absorbs waste and excess fluids, then it is drained after a few hours [3]. This type can be performed at home, either manually (CAPD) or using a machine during sleep (Automated Peritoneal Dialysis) [3].

Preparing for Dialysis

Preparation for dialysis requires time and a comprehensive understanding of the treatment. An important step before starting hemodialysis is undergoing a minor surgery to create a vascular access. This access is the point of contact through which blood is drawn and returned to the body at a high flow rate during dialysis [2]. There are three types of vascular access:

• Arteriovenous (AV) Fistula: Considered the best long-term option. A surgeon connects an artery to a vein, usually in the arm, which makes the vein wider and thicker, facilitating the insertion of needles [2].
• Arteriovenous (AV) Graft: If the veins do not allow for the creation of a fistula, a synthetic tube can be used to connect the artery to the vein [2].
• Catheter: Typically used for temporary access or in emergency situations [2].

Peritoneal dialysis also requires surgery to implant a catheter in the abdomen, and it is preferred that this be done at least 3 weeks before starting treatment to ensure healing and improve the effectiveness of the catheter [3].

Living with Dialysis

Living with dialysis requires lifestyle adjustments, including diet and physical activity. The healthcare team, including a dietitian, will provide guidance on foods and drinks to consume or avoid [2]. It is also important to monitor for signs of infection, especially around the catheter site or vascular access, and report them immediately [3].

When to Seek Emergency Care

Seek emergency care immediately if any signs of infection appear, such as redness, pus, swelling, pain, or tenderness at the catheter or vascular access site [3]. In the case of peritoneal dialysis, signs of infection (peritonitis) may include abdominal pain, fever, nausea or vomiting, or unusual cloudiness in the used dialysis fluid [3]. Prompt treatment with antibiotics can prevent problems from worsening [3].

Medical references

• Dialysis
• Hemodialysis
• Peritoneal Dialysis