Kidney disease is a condition of damaged kidneys when waste & fluid are not getting removed, instead of getting accumulated in the body. The severity of kidney disease may differ according to different groups: *In India, over 1, 75,000 patients are on chronic dialysis. Every year, about 2,20,000-2,75,000 new patients need kidney or Renal Replacement Therapy.
Cause of Kidney Failure
Kidney failure is not an overnight occurrence. It is the result of the continuing loss of kidney function. Kidneys are most commonly damaged due to medical ailments such as Diabetes, high blood pressure etc. A person with kidney failure may experience frequent urination; blood in the urine; appetite loss, weight loss; swelling over the body, fatigue; shortness of breath; so on.
Dialysis: Why & When
Dialysis is a procedure recommended for a person suffering from around 90% renal failure. When Kidneys fail or do not function properly, dialysis can help in performing their roles of removing wastes &fluid from the blood. Dialysis procedure can help the person regain better mobility & flexibility; improved well- being fewer diet restrictions; longer and healthier life and many more. Additionally, urine output may be normal at the time of initiation of hemodialysis
Answers to Common Queries: Myths Resolved
- Doctor has asked me to initiate dialysis. Is it the end of my life?
The answer is a BIG NO. You can take dialysis and still enjoy life. Although transplantation is the best option, patients on dialysis can enjoy their everyday life.
- Doctor has advised 3 dialyses per week. Is it ok to have only 1 or 2 sessions instead?
Adequate dialysis is important to develop a good appetite and quality of food intake. Inadequate dialysis can lead to loss of appetite, weight loss, anaemia and breathing difficulties. Therefore, 1 dialysis per week is pointless and 2 times a week can lead only to a modest degree of kidney function. It’s important to conduct it as per the doctor’s instructions.
- What happens during hemodialysis?
During hemodialysis, blood leaves your body through the access, travels through and is filtered by the dialysis apparatus, later on, returns to your body.
- Why are regular biochemical tests advised?
They are done to make necessary changes in medications. Adequate care can reduce complications.
- How much fluid should I take?
Daily fluid intake is 600 ml in addition to your urine output. If your urine output is 200ml per day, you can drink up to 800ml per day. It includes all types of fluids such as coffee, tea, rasam, dal etc.
- Can I eat all kinds of fruits and vegetables?
No, not all. You must restrict your food items that are rich in potassium, sodium, phosphorus which may have deleterious on the body when consuming in excess amounts.
- How to take a low salt diet?
You can keep 3 grams (half tablespoon) separately, can add it little by little during eating. You must avoid packed foods items such as meat, yeast, salted chips, biscuits, nuts, popcorn, papad, pickle, soft drinks, health drinks, cocoa etc. are high in sodium content.
- Why am I getting muscle cramps during dialysis?
When fluid removal is high, patients usually get muscle cramps. Inform your doctor. Lesser weight gains between two dialysis sessions can help reduce fluid removal and avoid cramps and hypotension.
- What if I feel depressed?
It’s important to maintain emotional health. Talk to a dialysis social worker or doctor to find out if counselling and/or medications may be helpful. Take help from a life partner, family members, friends, and other patients.
- Can I continue my job?
Yes, you can. However, if your job requires a lot of physical labour (heavy lifting, digging, driving etc.), you may need to find a different job. You can also try to reschedule your job.
- Can I travel?
Yes, you can. Avoid large fluid intake during travel. Arrange dialysis at the nearest place to your destination. You can travel by flight also. Before that contact your doctor. Preferably take dialysis immediate the day before dialysis.
This article is authored by Dr. Suman Lata Nayak, Director & Senior Consultant – Nephrology & Kidney Transplant, Dharamshila Narayana Superspeciality Hospital, Delhi
*thelancet.com