Comprehensive Guide To Dialysis: Explore Purpose, Benefits, & Process

What is the Purpose of Dialysis?

Before we explore what is dialysis, we must understand why it is important for you. Dialysis plays a vital role for patients with kidney-related diseases, providing health options for patients with end-stage renal disease (ESRD) or acute kidney injury (AKI). The significance of dialysis lies in maintaining the balance of vital substances in the body. As a core aspect of nephrology, dialysis ensures proper management of fluid and electrolyte balance to support kidney function.

Dialysis also plays a vital role in regulating electrolytes, such as potassium, calcium, and sodium, in the blood. A proper balance of electrolytes is crucial for normal cell function, nerve transmission, and muscle function. Therefore, dialysis is a life-sustaining therapy which allows patients to maintain a normal lifestyle and ensure overall well-being.

Let’s now understand what are the 4 types of dialysis are and their importance in kidney care.

4 Types of Dialysis

When you ask what is dialysis, you refer to treatments that replace kidney function when your kidneys fail. There are four main types: haemodialysis, peritoneal dialysis, continuous renal replacement therapy, and sustained low-efficiency dialysis. Globally, about 69% of all kidney replacement therapy (KRT) patients receive haemodialysis ¹.

Here are the four primary types of dialysis that you must know:

1. Haemodialysis

It is one of the most common methods for renal replacement therapy. It involves the use of a dialysis machine to remove waste products and extra fluid from the blood. The process is conducted outside the body and requires specialised intervention from medical professionals.

How is it conducted?

A vascular access point is created with the help of inserting a catheter or creating an arteriovenous graft or fistula. The respective access allows for the flow of blood out of the body into the dialysis machine, where it passes through the special filter called a dialyser. The dialyser helps clean the blood by removing waste products and excess fluids, and then the filtered blood returns into the body.

2. Peritoneal Dialysis

Peritoneal dialysis uses a peritoneal membrane in the abdomen to filter waste and excess fluid from the blood. Peritoneal dialysis can be conducted at home and does not require a dialysis machine.

How is it conducted?

A healthcare professional inserts a catheter surgically into the abdomen, and a special dialysis fluid called dialysate is then infused into the peritoneal cavity through the catheter. The peritoneal membrane acts as a natural filter, which allows the excess fluid and waste products to pass from the blood vessels into the dialysate. After a specific period, the used-up dialysate is drained and replaced with fresh dialysate.

3. Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy (CRRT) is referred to as a specialised technique for dialysis, which is critical for critical conditions. It is a vital dialysis technique for patients suffering from fluid overload and acute kidney injury.

How is it conducted?

CRRT uses a technique where patients connect with a machine that continuously circulates the blood through a filter, removing excess fluids and waste products. The process is gentle and stabilises the blood chemistry and minimises stress in the cardiovascular system.

4. Sustained Low-Efficiency Dialysis (SLED)

SLED is a hybrid form of dialysis which can act as an alternative to CRRT or conventional haemodialysis. Patients with acute kidney injury (AKI) can use the SLED technique, which is feasible for such conditions. Moreover, SLED provides haemodynamic control and solute removal, which reduces the need for blood transfusions and lowers intensive care costs.

How is it conducted?

The SLED procedure uses a standard haemodialysis machine but operates with reduced dialysate over an extended period. The setup helps with efficient detoxification while maintaining cardiovascular stability, which is beneficial for critical patients with chronic kidney disease. The process of SLED is typically longer than traditional intermittent dialysis, which allows for solute clearance.

Next, let’s understand the procedure for dialysis in simple terms that will help you have a better overview of what is dialysis and its process.

The Procedure for Dialysis

Before each kidney dialysis session, proper preparation is critical to ensure a smooth and effective procedure.

Here is a comprehensive overview of the process of dialysis:

• Dietary and Medication Management: Your Healthcare provider may provide you with dietary guidelines such as limitations on fluid intake, sodium, potassium, and phosphorus consumption. It is also important to take prescribed medications from your doctor.
• Access Point Preparation: The dialysis team at this point will prepare your access point, which may be a vascular access such as an arteriovenous fistula or graft, or a catheter.
• Blood Flow and Filtration: Once you are connected to a dialysis unit, blood flows through the dialyser into the dialysis machine. The dialyser helps remove excess fluids and waste products from your body.
• Monitoring: Throughout the session, it is important to monitor vital signs such as blood pressure, heart rate, and oxygen levels. Your healthcare professional will assess your condition and address any discomfort during the procedure.
• Post-dialysis Instructions: There are specific guidelines in terms of diet and medicines after a dialysis session. The instructions are critical for the appropriate post-dialysis care; you must follow them to maintain your health between dialysis sessions.

With a better understanding of what is dialysis and its procedure, let’s explore some of its benefits for effective kidney care.

Benefits of dialysis

When you consider what is dialysis, one clear benefit is that it offers a life-sustaining option for kidney failure patients. A systematic review suggests that switching to a high-dose haemodiafiltration reduces the risk of death by 16% ².

Here are some of the benefits of dialysis

• Better Quality of Life: Dialysis helps in relieving symptoms such as nausea, swelling, fatigue and more for an active and healthy lifestyle.
• Prolonged Lifespan: Regular dialysis treatments can help prolong the lifespan of the kidneys without compromising their overall function.
• Flexibility: There is a wide array of dialysis processes you can use, including peritoneal dialysis, haemodialysis, and more, enhancing the flexibility of treatment based on individual requirements.
• Enhanced Nutrient Uptake: Dialysis enhances overall nutrition absorption among patients and maintains the balance of electrolytes with the removal of excess waste from the body.

Now, having a better understanding of what is dialysis. Let’s explore some of the safety and hygiene standards that healthcare professionals comply with for an effective dialysis session.

Hygiene and Safety Protocols During a Dialysis Session

Maintaining strict hygiene during dialysis is critical to prevent infections, especially among patients who meet the indications for dialysis due to kidney failure.

These protocols help protect patients and healthcare personnel and ensure equipment remains sterile during the process.

• Control of Infection: Healthcare professionals follow strict infection control protocols during a dialysis session. Protocols include proper hand hygiene and the use of sterile equipment to minimise the risk of infections.
• Maintenance of Equipment: The dialysis machine and all the related equipment undergo regular maintenance and sterilisation processes to ensure the safety and effectiveness for patients.
• Vascular Access Care: In case of a vascular access point, it is important to monitor for signs of infection and complications. Appropriate follow-up of the process is important for optimal access to care.
• Awareness and Education: Caregivers must have appropriate education regarding hygiene practices and reducing infection chances, and undertake necessary actions to avoid complications.

Also read: How to Manage Chronic Kidney Disease: A Guide from Kidney Specialists