What Are Dialysis And Hemodialysis
Dialysis cleanses the body of waste products by body by use of filter systems. There are two types of dialysis, 1) hemodialysis and 2) peritoneal dialysis.
Hemodialysis uses a machine filter called a dialyzer or artificial kidney to remove excess water and salt, to balance the other electrolytes in the body, and to remove waste products of metabolism. Blood is removed from the body and flows through tubing into the machine, where it passes next to a filter membrane. A specialized chemical solution flows on the other side of the membrane. The dialysate is formulated to draw impurities from the blood through the filter membrane. Blood and dialysate are never touched in the artificial kidney machine.
For this type of dialysis, access to the blood vessels needs to be surgically created so that large amounts of blood can flow into the machine and back to the body. Surgeons can build a fistula, a connection between a large artery and vein in the body, usually in the arm, that allows a large amount of blood to flow into the vein. This makes the vein swell or dilate, and its walls become thicker so that it can tolerate repeated needle sticks to attach tubing from the body to the machine. Since it takes many weeks or months for a fistula to mature enough to be used, significant planning is required if hemodialysis is to be considered as an option.
Biopsy For Kidney Disease
A biopsy means that a small piece of tissue is taken for testing in a laboratory. Biopsies used in the investigation of kidney disease may include:
- kidney biopsy the doctor inserts a special needle into the back, under local anaesthesia, to obtain a small sample of kidney tissue. A kidney biopsy can confirm a diagnosis of chronic kidney disease.
- bladder biopsy the doctor inserts a thin tube into the bladder via the urethra. This allows the doctor to view the inside of the bladder and check for abnormalities. This procedure is called a cystoscopy. The doctor may take a biopsy of bladder tissue for examination in a laboratory.
Your doctor may arrange other tests, depending on the suspected cause of your kidney disorder.
What Are The Kidneys Where Are They Located
The kidneys play key roles in body function, not only by filtering the blood and getting rid of waste products, but also by balancing the electrolyte levels in the body, controlling blood pressure, and stimulating the production of red blood cells.
The kidneys are located in the abdomen toward the back, normally one on each side of the spine. They get their blood supply through the renal arteries directly from the aorta and send blood back to the heart via the renal veins to the vena cava.
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What Questions Should I Ask About Conservative Management
If youre thinking about conservative management, you may want to ask your doctor these questions:
- Is conservative management a treatment option for me to consider?
- Will dialysis improve my quality of life?
- Will dialysis prolong my life?
- Is there any downside to trying dialysis first?
- What should I do to prepare for conservative management?
- Who will continue to provide my care?
- Who will help my family?
- How long will I live?
- Will I be in pain?
- Can I stay at home?
- Where can I learn more about hospice?
- Who can I talk with about finances, advanced directives, sex, or family concerns?
Learn about conservative management.
What Medications Are Prescribed For People With Chronic Kidney Disease
Depending on the cause of your kidney disease, you may be prescribed one or more medications. Medications your nephrologist may prescribe include:
- An angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker to lower your blood pressure.
- A diuretic to help your body eliminate extra fluid.
- Medications to lower cholesterol levels.
- Erythropoetin, to build red blood cells if you are anemic.
- Vitamin D and calcitrol to prevent bone loss.
- Phosphate binder if your kidneys cant eliminate phosphate.
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Sample Questions To Ask Your Provider For People With Kidney Disease
About your tests
- What is my GFR? What does that mean?
- Has my GFR changed since last time?
- What is my urine albumin? What does it mean?
- Has my urine albumin changed since the last time it was checked?
- Is my kidney disease getting worse?
- Is my blood pressure where it needs to be?
About treatment and self-care
- What can I do to keep my disease from getting worse?
- Do any of my medicines or doses need to be changed?
- What time of day should I take each of my medicines?
- Do I need to change what I eat?
- Will you refer me to a dietitian for diet counseling?
- When will I need to see a nephrologist ?
- Do I need to worry about dialysis or a kidney transplant?
- What do I need to do to protect my veins?
About complications
- What other health problems may I face because of my kidney disease?
- Should I be looking for any symptoms? If so, what are they?
Bring a friend or relative with you for supportA trusted friend or family member can take notes, ask questions you may not have thought of, offer support, and help remember what the provider said during the visit. Talk ahead of time about what you want to get out of the visit and the role you would like your friend or relative to play.
Know That Your Medicines May Change Over Time
Your health care provider may change your medicines as your kidney disease gets worse. Your kidneys dont filter as well as they did in the past, and this can cause an unsafe buildup of medicines in your blood. Some medicines can also harm your kidneys. As a result, your provider may tell you to
- take a medicine less often or take a smaller dose
- stop taking a medicine or switch to a different one
Your pharmacist and health care provider need to know about all the medicines you take, including OTC medicines, vitamins, and supplements.
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What Do The Kidneys Do
When blood flows to the kidney, sensors within specialized kidney cells regulate how much water to excrete as urine, along with what concentration of electrolytes. For example, if a person is dehydrated from exercise or from an illness, the kidneys will hold onto as much water as possible and the urine becomes very concentrated. When adequate water is present in the body, the urine is much more dilute, and the urine becomes clear. This system is controlled by renin, a hormone produced in the kidney that is part of the fluid and blood pressure regulation systems of the body.
Kidneys are also the source of erythropoietin in the body, a hormone that stimulates the bone marrow to make red blood cells. Special cells in the kidney monitor the oxygen concentration in blood. If oxygen levels fall, erythropoietin levels rise and the body starts to manufacture more red blood cells.
Urine that is made by each kidney flows through the ureter, a tube that connects the kidney to the bladder. Urine is stored within the bladder, and when urination occurs, the bladder empties urine through a tube called the urethra.
When Do I Have To Start Dialysis
For most people, the need for dialysis comes on slowly. Symptoms, such as losing your desire to eat and losing muscle, may begin so slowly that you dont notice them. Many people start dialysis when their kidney function is between 5 and 10. When kidney function is this low, you may have symptoms from kidney failure and starting dialysis may help relieve them. Starting dialysis can help you regain your appetite and maintain your strength, which is harder to rebuild than it is to retain. Your health care provider can help you decide the best time to begin treatment.
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What Is Kidney Transplantation
Kidney transplantation involves placing a healthy kidney into your body where it can perform all of the functions that a failing kidney cant. Kidneys for transplantation come from two sources: living donors and deceased donors. Living donors are usually immediate family members or sometimes spouses. This is possible because a person can live well with one healthy kidney.
How Can I Decide Which Treatment Is Right For Me
Choosing the kidney failure treatment that is best for you may be hard. To make it easier
- start learning about your treatment options early
- think about how each treatment will affect your daily routine and how you feel
Talk with your doctor and with people who are on hemodialysis or peritoneal dialysis, or whove had a transplant, to find out the pros and cons of each treatment. Find out how the treatment changed their lives and the lives of those closest to them. Ask your doctor about the transplant waiting list, and about diet changes and medicines youll need with each treatment.
If youre thinking about conservative management, ask your doctor how youll feel and how treatment can help keep you comfortable.
Reflect on whats most important to you. If you plan to keep working, think about which treatment can make that easier. If spending time with family and friends means a lot to you, ask which treatment would give you the most free time. Find out which treatment would give you the best chance of feeling good and living longer.
You may wish to speak with your family, friends, health care team, spiritual advisor, or mental health counselor as you decide.
View a chart comparing hemodialysis, peritoneal dialysis, and kidney transplantation.
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Signs You May Have Kidney Disease
More than 37 million American adults are living with kidney disease and most dont know it. There are a number of physical signs of kidney disease, but sometimes people attribute them to other conditions. Also, those with kidney disease tend not to experience symptoms until the very late stages, when the kidneys are failing or when there are large amounts of protein in the urine. This is one of the reasons why only 10% of people with chronic kidney disease know that they have it, says Dr. Joseph Vassalotti, Chief Medical Officer at the National Kidney Foundation.
While the only way to know for sure if you have kidney disease is to get tested, Dr. Vassalotti shares 10 possible signs you may have kidney disease. If youre at risk for kidney disease due to high blood pressure, diabetes, a family history of kidney failure or if youre older than age 60, its important to get tested annually for kidney disease. Be sure to mention any symptoms youre experiencing to your healthcare practitioner.
Kidney Disease And Cardiovascular Risks
Cardiovascular disease is the most common cause of death in people with chronic kidney disease. Compared to the general population, people with chronic kidney disease are two to three times more likely to have cardiovascular problems such as:
This increased risk is partly caused by factors common to both chronic kidney disease and cardiovascular disease, such as high blood pressure. However, researchers are discovering that chronic kidney disease is, in itself, an important risk factor for the development of cardiovascular disease, and a history of cardiovascular disease is a risk factor for the development of chronic kidney disease.
The kidneys regulate water and salts, remove certain wastes and make various hormones. Kidney disease increases the risk of cardiovascular disease in many ways, including:
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Approval Is First To Cover Many Causes Of Disease
- For Immediate Release:
Today, the U.S. Food and Drug Administration approved Farxiga oral tablets to reduce the risk of kidney function decline, kidney failure, cardiovascular death and hospitalization for heart failure in adults with chronic kidney disease who are at risk of disease progression.
Chronic kidney disease is an important public health issue, and there is a significant unmet need for therapies that slow disease progression and improve outcomes, said Aliza Thompson, M.D., M.S., deputy director of the Division of Cardiology and Nephrology in the FDAs Center for Drug Evaluation and Research. Todays approval of Farxiga for the treatment of chronic kidney disease is an important step forward in helping people living with kidney disease.
Chronic kidney disease occurs when the kidneys are damaged and cannot filter blood normally. Due to this defective filtering, patients can have complications related to fluid, electrolytes , and waste build-up in the body. Chronic kidney disease sometimes can progress to kidney failure. Patients also are at high risk of cardiovascular disease, including heart disease and stroke.
Farxiga was not studied, nor is expected to be effective, in treating chronic kidney disease among patients with autosomal dominant or recessive polycystic kidney disease or among patients who require or have recently used immunosuppressive therapy to treat kidney disease.
The FDA granted the approval of Farxiga to AstraZeneca.
Who Is Part Of My Health Care Team
The following health care providers may be part of the health care team involved in your treatment:
Primary care provider. Your primary care provider doctor, nurse practitioner, or physician assistantis the person you see for routine medical visits. Your PCP may monitor your kidney health and help you manage your diabetes and high blood pressure. A PCP also prescribes medicines and may refer you to specialists.
Nurse. A nurse may help with your treatment and teach you about monitoring and treating kidney disease, as well as managing your health conditions. Some nurses specialize in kidney disease.
Registered dietitian. A registered dietitian is a food and nutrition expert who helps people create a healthy eating plan when they have a health condition such as kidney disease. Dietitians can help you by creating an eating plan based on how your kidneys are doing. Renal dietitians often work in dialysis centers and are specially trained to work with people with kidney failure.
Diabetes educator. A diabetes educator teaches people with diabetes how to manage their disease and handle diabetes-related problems.
Pharmacist. A pharmacist educates you about your medicines and fills your prescriptions. An important job for the pharmacist is to review all of your medicines, including over-the-counter medicines, and supplements, to avoid unsafe combinations and side effects.
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Stay Away From Phosphorous:
Phosphorous is the mineral which can be found in most foods. However, you may rarely hear about this mineral. The possible reason may be that people hardly lack of phosphorous mineral. Therefore, too much phosphorous may become the problems, especially for your kidneys. Processed, prepared foods and carbonated soft drinks which have the great source of phosphorous should be avoided. According to the Standard American Diet , you should only consume 800 mg to 1,200 mg of phosphorus per day. The extra phosphorus will be flushed from your body thank to healthy kidneys. If the kidneys function deteriorates, phosphorus may accumulate in your body. Overtime, it will lead to some serious complication such as bone or heart or bone disorders, calcification of tissues. Therefore, as the effective way on how to treat kidney stones naturally, you should not get too much phosphorus in your diet. It is recommended eating nutritious, whole foods diet and staying away from convenience and fast foods.
How To Improve Kidney Function: Can Natural Remedies Help
This article was co-authored by Zora Degrandpre, ND. Dr. Degrandpre is a Licensed Naturopathic Physician in Vancouver, Washington. She is also a grant reviewer for the National Institutes of Health and the National Center for Complementary and Alternative Medicine. She received her ND from the National College of Natural Medicine in 2007.There are 17 references cited in this article, which can be found at the bottom of the page. This article has been viewed 46,789 times.
Your kidneys are responsible for filtering toxins out of your body, so youll want to keep them healthy and in working order for as long as possible. Luckily, there are many ways to support your kidney health. In general, if you dont have any kidney diseases, then following a healthy dietary and lifestyle routine should maintain your kidney function. If you do have kidney issues, then you should see a doctor before trying any home treatments. The doctor may want you to take some medications or undergo a procedure to support your kidneys. After this, you can try some lifestyle management methods to improve your kidney function on your own.
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Diet And Kidney Disease
Dietary restrictions vary depending on the level of kidney damage.
For example, people in the early stages of kidney disease have different restrictions than those with kidney failure, also known as end-stage renal disease .
If you have kidney disease, your health care provider will determine the best diet for your needs.
For most people with advanced kidney disease, its important to follow a kidney-friendly diet that helps decrease the amount of waste in the blood.
This diet is often referred to as a renal diet.
It helps boost kidney function while preventing further damage .
While dietary restrictions vary, its commonly recommended that all people with kidney disease restrict the following nutrients:
- Sodium.Sodium is found in many foods and a major component of table salt. Damaged kidneys cant filter out excess sodium, causing its blood levels to rise. Its often recommended to limit sodium to less than 2,000 mg per day (
Tips For Managing Your Medicines
The next time you pick up a prescription or buy an OTC medicine or supplement, ask your pharmacist how the product may
- affect your kidneys
- affect other medicines you take
Fill your prescriptions at only one pharmacy or pharmacy chain so your pharmacist can
- keep track of your medicines and supplements
- check for harmful interactions
Keep track of your medicines and supplements:
- Keep an up-to-date list of your medicines and supplements in your wallet. Take your list with you, or bring all of your medicine bottles, to all health care visits.
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