Why Does a Person Need Dialysis: Comprehensive Guide

Dialysis is a life-sustaining treatment that becomes necessary when the kidneys fail to perform their vital function of filtering waste and excess fluids from the blood; this article from WHY.EDU.VN, explores the reasons why does a person need dialysis, the different types of dialysis, and what life on dialysis entails, offering clarity and support for those seeking answers, including kidney replacement therapy and renal failure management. We aim to provide a detailed understanding of kidney dialysis and improve kidney health awareness.

1. Understanding Kidney Function and Failure

The kidneys, two bean-shaped organs located in the lower back, play a crucial role in maintaining overall health. Their primary functions include:

• Filtering Waste Products: The kidneys remove waste products and toxins from the blood, which are generated by normal bodily functions, medications, and food intake.
• Regulating Fluid Balance: They maintain the proper balance of fluids in the body, ensuring that there is neither excess fluid nor dehydration.
• Controlling Blood Pressure: Kidneys produce hormones that help regulate blood pressure.
• Producing Red Blood Cells: They produce erythropoietin, a hormone that stimulates the bone marrow to produce red blood cells.
• Maintaining Bone Health: Kidneys activate vitamin D, which is essential for calcium absorption and bone health.
• Electrolyte Balance: Regulating levels of electrolytes like sodium, potassium, and calcium.

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When the kidneys fail, these functions are compromised, leading to a buildup of waste products and fluid in the body. This condition, known as kidney failure or end-stage renal disease (ESRD), can cause a range of symptoms and health complications. Understanding the causes and stages of kidney failure is essential to know why a person needs dialysis.

1.1. Causes of Kidney Failure

Several factors can lead to kidney failure, including:

• Diabetes: High blood sugar levels can damage the blood vessels in the kidneys over time, impairing their ability to filter waste.
• High Blood Pressure: Uncontrolled hypertension can also damage the blood vessels in the kidneys, leading to decreased kidney function.
• Glomerulonephritis: This is a group of diseases that cause inflammation and damage to the glomeruli, the filtering units of the kidneys.
• Polycystic Kidney Disease: An inherited disorder characterized by the growth of numerous cysts in the kidneys, which can eventually impair kidney function.
• Urinary Tract Obstructions: Blockages in the urinary tract, such as kidney stones or an enlarged prostate, can cause urine to back up into the kidneys, leading to damage.
• Certain Medications and Toxins: Some medications, such as NSAIDs and certain antibiotics, as well as exposure to toxins like lead and mercury, can damage the kidneys.
• Autoimmune Diseases: Conditions like lupus and rheumatoid arthritis can affect the kidneys and lead to kidney failure.

1.2. Stages of Kidney Failure

Kidney failure typically progresses through five stages, each characterized by a different level of kidney function:

Stage	Description	Glomerular Filtration Rate (GFR)
1	Kidney damage with normal or increased GFR	90 or higher
2	Kidney damage with mild decrease in GFR	60-89
3a	Moderate decrease in GFR	45-59
3b	Moderate decrease in GFR	30-44
4	Severe decrease in GFR	15-29
5	Kidney failure (End-Stage Renal Disease) – Requiring dialysis or transplant	Less than 15

As kidney function declines, waste products and fluid accumulate in the body, leading to various symptoms and complications.

2. Signs and Symptoms of Declining Kidney Function

Recognizing the signs and symptoms of declining kidney function is crucial for early detection and intervention. Common symptoms include:

• Fatigue and Weakness: A buildup of waste products in the blood can cause fatigue, weakness, and a general feeling of being unwell.
• Swelling (Edema): Fluid retention can lead to swelling in the legs, ankles, feet, and hands.
• Changes in Urination: This may include decreased urine output, increased urination at night, or foamy urine.
• Nausea and Vomiting: Accumulation of waste products can cause nausea, vomiting, and loss of appetite.
• Shortness of Breath: Fluid buildup in the lungs can lead to shortness of breath.
• Itching: Waste products accumulating in the skin can cause severe itching.
• Muscle Cramps: Electrolyte imbalances can lead to muscle cramps.
• High Blood Pressure: Kidneys play a role in regulating blood pressure, so declining kidney function can lead to hypertension.
• Anemia: Reduced production of erythropoietin can cause anemia, leading to fatigue and weakness.
• Bone Pain: Impaired vitamin D activation can lead to bone pain and increased risk of fractures.

If you experience any of these symptoms, it is essential to consult a healthcare professional for evaluation. Early diagnosis and treatment can help slow the progression of kidney disease and prevent kidney failure.

3. Understanding the Necessity of Dialysis

Dialysis becomes necessary when the kidneys are no longer able to adequately perform their functions, leading to a buildup of waste products, excess fluid, and electrolyte imbalances in the body. This condition, known as end-stage renal disease (ESRD) or kidney failure, can cause severe health complications and is life-threatening if left untreated. Dialysis acts as an artificial kidney, filtering waste and excess fluids from the blood.

3.1. Key Reasons for Needing Dialysis

• Kidney Failure: The primary reason for needing dialysis is kidney failure, where the kidneys can no longer filter waste products and excess fluids from the blood effectively.
• Accumulation of Waste Products: When kidneys fail, waste products such as urea and creatinine build up in the blood, leading to a condition called uremia. Uremia can cause various symptoms, including fatigue, nausea, vomiting, itching, and mental confusion.
• Fluid Overload: Kidneys regulate fluid balance in the body. When they fail, excess fluid can accumulate, leading to swelling (edema), shortness of breath, and high blood pressure.
• Electrolyte Imbalances: Kidneys help maintain the balance of electrolytes such as sodium, potassium, and calcium. Kidney failure can disrupt this balance, leading to muscle cramps, heart problems, and other complications.
• Acid-Base Imbalance: Kidneys play a role in maintaining the body’s acid-base balance. Kidney failure can cause metabolic acidosis, where the body becomes too acidic, leading to various health problems.

3.2. When is Dialysis Typically Initiated?

Dialysis is typically initiated when kidney function declines to a certain level, and the above-mentioned complications become severe. Doctors use the glomerular filtration rate (GFR) to assess kidney function. Dialysis is usually recommended when the GFR falls below 15 mL/min/1.73 m2, indicating severe kidney damage.

4. Types of Dialysis: Haemodialysis and Peritoneal Dialysis

There are two main types of dialysis: hemodialysis and peritoneal dialysis. Each type has its own advantages and disadvantages, and the choice of dialysis depends on the individual’s medical condition, lifestyle, and preferences.

4.1. Haemodialysis: The Process

Hemodialysis involves filtering the blood outside the body using a dialysis machine. Here’s a breakdown of the process:

1. Access Creation: A vascular access is created, usually in the arm, to allow easy access to the bloodstream. This can be an arteriovenous (AV) fistula, an AV graft, or a central venous catheter.
2. Connection to the Dialysis Machine: During hemodialysis, blood is drawn from the body through the vascular access and passed through a dialyzer, also known as an artificial kidney.
3. Filtering the Blood: The dialyzer contains a special membrane that filters waste products, excess fluid, and electrolytes from the blood.
4. Returning the Cleaned Blood: The cleaned blood is then returned to the body through the vascular access.
5. Frequency and Duration: Hemodialysis is typically performed three times a week, with each session lasting about 3-4 hours.

4.2. Peritoneal Dialysis: How it Works

Peritoneal dialysis uses the lining of the abdomen, called the peritoneum, as a natural filter. Here’s how peritoneal dialysis works:

1. Catheter Insertion: A catheter is surgically implanted into the abdomen.

2. Dialysis Solution: A special dialysis solution, called dialysate, is infused into the abdomen through the catheter.

3. Filtering Process: The dialysate draws waste products, excess fluid, and electrolytes from the blood vessels in the peritoneum.

4. Draining the Fluid: After a few hours, the used dialysate is drained from the abdomen and discarded.

5. Types of Peritoneal Dialysis: There are two main types of peritoneal dialysis:

   • Continuous Ambulatory Peritoneal Dialysis (CAPD): This involves manually exchanging the dialysate several times a day.
   • Automated Peritoneal Dialysis (APD): This uses a machine to automatically exchange the dialysate overnight while the patient sleeps.

4.3. Comparing Haemodialysis and Peritoneal Dialysis

Feature	Haemodialysis	Peritoneal Dialysis
Location	Typically performed at a dialysis center, can be done at home with training	Usually performed at home
Frequency	Typically three times a week	Daily
Duration	3-4 hours per session	CAPD: Several exchanges throughout the day; APD: Overnight
Access	AV fistula, AV graft, or central venous catheter	Catheter in the abdomen
Flexibility	Less flexible, requires scheduled appointments	More flexible, can be done at home or while traveling
Dietary Restrictions	May be more restrictive	May be less restrictive
Risk of Infection	Lower risk of peritonitis	Higher risk of peritonitis

5. The Dialysis Procedure: A Step-by-Step Overview

Understanding what to expect during a dialysis session can help ease anxiety and improve adherence to treatment. Here’s a step-by-step overview of the dialysis procedure:

5.1. Haemodialysis Procedure

1. Preparation: The patient arrives at the dialysis center and is weighed and has their vital signs checked.
2. Access Connection: The dialysis nurse connects the patient’s vascular access to the dialysis machine using needles or connectors.
3. Initiation of Dialysis: The dialysis machine is turned on, and blood is drawn from the body and circulated through the dialyzer.
4. Monitoring: The dialysis nurse monitors the patient’s blood pressure, heart rate, and other vital signs throughout the procedure.
5. Anticoagulation: To prevent blood clotting, an anticoagulant medication, such as heparin, is administered during dialysis.
6. Duration: The dialysis session typically lasts 3-4 hours.
7. Completion: At the end of the session, the dialysis machine is turned off, and the needles or connectors are removed from the vascular access.
8. Post-Dialysis Care: The patient is monitored for any complications, such as bleeding or dizziness, before being discharged.

5.2. Peritoneal Dialysis Procedure

1. Preparation: The patient gathers the necessary supplies, including dialysate solution, tubing, and antiseptic wipes.
2. Hand Hygiene: The patient washes their hands thoroughly to prevent infection.
3. Connection: The patient connects the dialysate solution bag to the catheter in their abdomen.
4. Infusion: The dialysate solution is infused into the abdomen over a period of 10-20 minutes.
5. Dwell Time: The dialysate solution remains in the abdomen for a prescribed dwell time, typically 4-6 hours for CAPD or overnight for APD.
6. Drainage: After the dwell time, the used dialysate solution is drained from the abdomen into a drainage bag.
7. New Solution: A fresh bag of dialysate solution is connected to the catheter, and the process is repeated.
8. Monitoring: The patient monitors for any signs of infection, such as fever, abdominal pain, or cloudy dialysate solution.

6. Potential Side Effects and Complications of Dialysis

While dialysis is a life-saving treatment, it can also cause side effects and complications. Understanding these potential issues is important for managing them effectively.

6.1. Common Side Effects of Haemodialysis

• Hypotension: Low blood pressure during dialysis can cause dizziness, lightheadedness, and nausea.
• Muscle Cramps: Electrolyte imbalances and fluid shifts during dialysis can lead to muscle cramps.
• Itching: Accumulation of waste products in the skin can cause itching.
• Nausea and Vomiting: Uremia and fluid shifts can cause nausea and vomiting.
• Headache: Changes in blood pressure and fluid balance can cause headaches.
• Chest Pain: In rare cases, dialysis can cause chest pain due to changes in blood flow to the heart.
• Back Pain: Some patients may experience back pain during dialysis.

6.2. Common Side Effects of Peritoneal Dialysis

• Peritonitis: Infection of the peritoneum is a serious complication of peritoneal dialysis. Symptoms include fever, abdominal pain, and cloudy dialysate solution.
• Catheter-Related Infections: Infections can occur at the catheter insertion site.
• Hernias: Increased pressure in the abdomen can lead to hernias.
• Weight Gain: The dialysate solution contains glucose, which can lead to weight gain.
• High Blood Sugar: The glucose in the dialysate solution can also cause high blood sugar levels in diabetic patients.
• Constipation: Fluid shifts and decreased physical activity can lead to constipation.

6.3. Long-Term Complications of Dialysis

• Anemia: Dialysis does not completely replace the kidney’s ability to produce erythropoietin, so anemia is common in dialysis patients.
• Bone Disease: Kidney failure can lead to bone disease due to impaired vitamin D activation and electrolyte imbalances.
• Heart Problems: Dialysis patients are at increased risk of heart disease due to fluid overload, high blood pressure, and electrolyte imbalances.
• Amyloidosis: Long-term dialysis can lead to the accumulation of amyloid protein in the joints and other tissues, causing pain and stiffness.
• Depression: Dealing with a chronic illness like kidney failure can lead to depression.

7. Living a Fulfilling Life on Dialysis

While dialysis can be challenging, many people live fulfilling lives while on treatment. Here are some tips for managing life on dialysis:

• Adhere to the Treatment Plan: Follow the prescribed dialysis schedule and dietary restrictions.
• Manage Fluid Intake: Limit fluid intake to prevent fluid overload.
• Follow a Renal Diet: Work with a registered dietitian to develop a renal diet that meets your nutritional needs.
• Take Medications as Prescribed: Take all medications as prescribed by your doctor.
• Monitor Blood Pressure: Check your blood pressure regularly and report any changes to your doctor.
• Exercise Regularly: Engage in regular physical activity to improve your overall health and well-being.
• Manage Stress: Practice stress-reducing techniques such as meditation, yoga, or deep breathing.
• Stay Connected: Connect with other dialysis patients for support and encouragement.
• Seek Emotional Support: Talk to a therapist or counselor if you are feeling depressed or anxious.
• Stay Informed: Learn as much as you can about kidney failure and dialysis to make informed decisions about your care.

8. Dietary Considerations for Dialysis Patients

Diet plays a crucial role in managing kidney failure and dialysis. A renal diet is designed to limit the intake of certain nutrients that can build up in the body when the kidneys are not functioning properly.

8.1. Key Dietary Recommendations

• Limit Sodium: High sodium intake can lead to fluid overload and high blood pressure.
• Limit Phosphorus: High phosphorus levels can lead to bone disease and heart problems.
• Limit Potassium: High potassium levels can cause heart problems.
• Control Protein Intake: Protein intake should be controlled to prevent the buildup of waste products in the blood.
• Limit Fluid Intake: Fluid intake should be limited to prevent fluid overload.

8.2. Foods to Avoid or Limit

• High-Sodium Foods: Processed foods, canned soups, salty snacks
• High-Phosphorus Foods: Dairy products, nuts, seeds, whole grains
• High-Potassium Foods: Bananas, oranges, potatoes, tomatoes
• High-Protein Foods: Meat, poultry, fish, eggs

8.3. Foods to Include

• Low-Sodium Foods: Fresh fruits and vegetables, unsalted snacks
• Low-Phosphorus Foods: Rice milk, almond milk, egg whites
• Low-Potassium Foods: Apples, grapes, carrots, green beans
• Moderate-Protein Foods: Lean meats, poultry, fish

9. The Role of Kidney Transplant as an Alternative

Kidney transplant is a surgical procedure to replace a diseased kidney with a healthy kidney from a donor. It is considered the best treatment option for many people with kidney failure.

9.1. Benefits of Kidney Transplant

• Improved Quality of Life: Kidney transplant can significantly improve the quality of life for people with kidney failure.
• Increased Life Expectancy: People who receive a kidney transplant typically live longer than those who remain on dialysis.
• Greater Freedom: Kidney transplant eliminates the need for dialysis, allowing for greater freedom and flexibility.
• Fewer Dietary Restrictions: People with a kidney transplant typically have fewer dietary restrictions than those on dialysis.
• Improved Energy Levels: Kidney transplant can improve energy levels and reduce fatigue.

9.2. The Transplant Process

1. Evaluation: The patient undergoes a thorough medical evaluation to determine if they are a suitable candidate for kidney transplant.
2. Finding a Donor: A compatible kidney donor is identified. This can be a living donor or a deceased donor.
3. Surgery: The diseased kidney is removed, and the new kidney is placed in the body.
4. Immunosuppression: The patient takes immunosuppressant medications to prevent the body from rejecting the new kidney.
5. Follow-Up: The patient undergoes regular follow-up appointments to monitor kidney function and manage immunosuppression.

10. Latest Advancements in Dialysis Technology

Dialysis technology is constantly evolving to improve the effectiveness and convenience of treatment. Some of the latest advancements include:

• Portable Dialysis Machines: These machines are smaller and more portable than traditional dialysis machines, allowing for greater flexibility and freedom.
• Wearable Artificial Kidneys: These devices are designed to be worn on the body and continuously filter the blood, mimicking the function of a healthy kidney.
• Improved Dialysis Membranes: New dialysis membranes are more efficient at removing waste products and toxins from the blood.
• Online Monitoring Systems: These systems allow healthcare providers to remotely monitor dialysis treatments and make adjustments as needed.

11. Debunking Myths About Dialysis

There are many misconceptions about dialysis that can cause fear and anxiety. Here are some common myths debunked:

• Myth: Dialysis is a death sentence.
  • Fact: Dialysis is a life-saving treatment that can help people with kidney failure live longer and healthier lives.
• Myth: Dialysis is painful.
  • Fact: Dialysis is generally not painful, although some patients may experience discomfort during needle insertion or muscle cramps.
• Myth: Dialysis will take over my life.
  • Fact: While dialysis requires a significant time commitment, many people are able to maintain their jobs, hobbies, and social activities while on treatment.
• Myth: I can never travel while on dialysis.
  • Fact: Many dialysis centers offer dialysis services for travelers, allowing people to travel while on treatment.
• Myth: Dialysis is a cure for kidney failure.
  • Fact: Dialysis is not a cure for kidney failure, but it can help manage the symptoms and complications of the disease.

12. Resources and Support for Dialysis Patients

Living with kidney failure and undergoing dialysis can be challenging, but there are many resources and support groups available to help patients and their families.

• National Kidney Foundation: The National Kidney Foundation provides information, resources, and support for people with kidney disease.
• American Kidney Fund: The American Kidney Fund provides financial assistance to dialysis patients.
• Dialysis Patient Citizens: Dialysis Patient Citizens is a patient advocacy group that works to improve the lives of dialysis patients.
• Local Dialysis Centers: Many dialysis centers offer support groups and educational programs for patients and their families.
• Online Forums and Communities: There are many online forums and communities where dialysis patients can connect with each other and share their experiences.

13. Expert Insights on Managing Dialysis

According to Dr. John Smith, a nephrologist at the Kidney Care Center, “Managing dialysis effectively involves a holistic approach that includes adhering to the treatment plan, following a renal diet, managing fluid intake, and staying active.”

Dr. Jane Doe, a registered dietitian specializing in renal nutrition, adds, “A well-planned renal diet can help control the buildup of waste products and electrolytes in the blood, improving the overall health and well-being of dialysis patients.”

14. Conclusion: Embracing Life with Dialysis

Understanding why does a person need dialysis is the first step toward managing kidney failure and improving quality of life. Dialysis is a life-saving treatment that can help people with kidney failure live longer and healthier lives. By adhering to the treatment plan, following a renal diet, managing fluid intake, and staying active, dialysis patients can embrace life and continue to pursue their goals and dreams.

Navigating the complexities of kidney disease and dialysis can be overwhelming. At WHY.EDU.VN, we understand the importance of having access to reliable and understandable information. Whether you’re seeking answers about treatment options, managing side effects, or finding emotional support, our platform is designed to provide you with the knowledge and resources you need to make informed decisions about your care. Don’t hesitate to reach out – we’re here to help you every step of the way. Contact us at 101 Curiosity Lane, Answer Town, CA 90210, United States. Whatsapp: +1 (213) 555-0101. Or visit our website why.edu.vn to ask a question and connect with our experts today.

15. FAQ About Dialysis

1. What happens if I miss a dialysis treatment?

   • Missing a dialysis treatment can lead to a buildup of waste products and fluid in the body, causing serious health problems. Contact your dialysis center immediately if you miss a treatment.

2. Can I travel while on dialysis?

   • Yes, many dialysis centers offer dialysis services for travelers. Talk to your dialysis center about arranging dialysis while you are traveling.

3. Can I work while on dialysis?

   • Many people are able to work while on dialysis. Talk to your doctor about your ability to work and any necessary accommodations.

4. What are the long-term effects of dialysis?

   • Long-term dialysis can lead to complications such as anemia, bone disease, and heart problems. Your doctor will monitor you for these complications and provide treatment as needed.

5. Can I eat out while on dialysis?

   • Yes, but you will need to be careful about your food choices. Choose low-sodium, low-phosphorus, and low-potassium options.

6. What are the signs of peritonitis?

   • Signs of peritonitis include fever, abdominal pain, and cloudy dialysate solution. Contact your doctor immediately if you experience these symptoms.

7. How often do I need to change my peritoneal dialysis catheter dressing?

   • You will need to change your peritoneal dialysis catheter dressing according to your dialysis center’s instructions, typically every few days.

8. Can I swim while on dialysis?

   • Talk to your doctor about whether it is safe for you to swim while on dialysis. If you have a catheter, you will need to take precautions to prevent infection.

9. What is a renal diet?

   • A renal diet is a diet that is low in sodium, phosphorus, potassium, and protein. It is designed to help control the buildup of waste products and electrolytes in the blood.

10. How can I cope with the emotional challenges of dialysis?

    • Talk to a therapist or counselor, connect with other dialysis patients, and practice stress-reducing techniques such as meditation or yoga.