What Is Dialysis?

 
a.   In our food we have meat (protein, fat, Ghee, oil, carbohydrate(CH), Roti, Bread, Rice, Fruit)
b   These foods are digested
c  
  1. Useful material of protein, CHO  and fats are absorbed into the blood
d   These useful substances look-after our body for energy and growth.
e.   During digestion, metabolism of these foods toxic / dangerous substances are produced which are excreted by the kidneys.
   
 
    1. The toxics substances which are widely known are urea and Creatinine and acid.
When the kidneys fails toxic substances are retained and accumulate in the body giving rise to:
  Loss of appetite
  Vomiting and Nausea
  Itching
  Weakness due to anemia (less HB)
  Drowsiness
  Fatigue
 
   

Dialysis is a process which cleans the blood of the toxics products of urea creatinine and removes any access of water and removes or normalizes the salt required in the body (sodium, potassium, chloride & bicarbonate).
Dialysis also normalizes the calcium and phosphorus responsible for healthy bones.
It normalizes BP by removing access of water or salt.

   

Is it painful?

   
 
  • In an emergency a catheter is passed with local anesthesia in a neck and dialysis can be performed.
 
  • AV Fistula is made in left arm by a surgeon under local anesthesia, when the patient is fit.
  Here an artery of the arm and a vein is joined so that blood vessels of the arm increase in size and visible.
  AV fistula should be performed when kidneys functions reach to stage 15ml per minute.
   

Is it habit farming?

 
  • No, it is a life saving procedure without which patient will not survive.
  Delay in Dialysis which is a usual pattern in our country must be discouraged and stopped.
  Relatives and friends appear to be a greatest obstruction in decision making by the patient.
  Please understand dialysis is a must for your life, if kidneys are not functioning (Earlier start is better gives a good quality of life).
   

Transplant

    Dialysis has to be performed until a suitable transplant is available by relative. Good dialysis ensures a good transplant result, dialysis has to be 4 hours duration and 3 times a week.
   

Diets with dialysis

    No particular restriction. Lower fluid is restricted to 500ml to 700ml + urine output.
Whatever patient wants like Citrous fruits etc. can be taken before dialysis.
Proteins i.e. meat in any form must be taken which helps in formation of blood.
   

Drugs

    Blood pressure drugs must be taken regularly but not on the day of dialysis.
Blood pressure must be maintained 120/70.
Pre and Post dialysis pressure should be maintained at the same level.
The weight if BP is same is the dry weight of patient, and the patient must maintain same weight.
   

Diabetes and CKD

    Patient with advance kidney failure require only small doses of soluble insulin, he may not require any insulin on a regular basis Sodamint tablets 2 tab 4 times daily are necessary to reduce acid which ensure a healthy bone..
   

Haemoglobin (Hb)

    Iron in blood must be estimated and intravenous iron is better than oral. Once serum is normal (saturation of more than 20%)
Feritin (500mg ) the patient must be given. EPOKINE – 5000 units twice a week.  Ensure Hb. should be 10.5-11mg
   

Calcium

    Calcium carbonate is a best supplement which looks-after calcium and acids as well.
Vitamin D3 need estimation and any deficiency preferably should be corrected by injection Vitamin D3.
   

Review

    3 monthly review of a long term patient on haemo-dialysis by a nephrologists.
   

How long can one live on Dialysis

   
 
  • It entirely depends upon the regularity in dialysis.
 
  1. The Foundation has patient who have Diabetes, Hypertension, and Bypass operation on Dialysis for more than 4 years at present.
 
  1. Recently reported in New England Journal of Medicines letter showing a patient lived 42 years on dialysis.
 
  1. Infact the quality of life longevity and survival entirely depends upon the patient only. YOUR LIFE IS IN YOUR HANDS - TAKE CARE.
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