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Frequently Asked Questions About Dialysis What is dialysis? Dialysis is a way of cleaning the blood when the kidney can no longer function adequately. It removes the body's waste, including excess salt and water, and helps control blood pressure. When does a person need dialysis? When kidney failure occurs, then dialysis or a kidney transplant can help a person. Is kidney failure permanent? Not always. Some kinds of kidney failure get better on their own. But a patient may need dialysis for a short time until the kidneys recover. These patients have "acute" kidney failure. In other cases, a person's kidneys may stop working because of a long term problem. "Chronic" kidney failure does not usually get better. Patients then need dialysis for the rest of their lives, or until they get a kidney transplant. How does dialysis work? The patient's blood flows on one side of a membrane, and a washing fluid flows on the other side. Salt, water and waste materials can pass through this membrane from the blood into the wash. Normal components of blood, like cells and protein, cannot cross the membrane. They stay in the blood. What kinds of dialysis are there? There are two basic kinds of dialysis. In hemodialysis, blood is pumped out of the body to an artificial kidney machine, which contains the membrane and removes impurities. The cleaned blood is then returned. In peritoneal dialysis, blood stays in blood vessels which line the person's own abdominal (peritoneal) space. The lining of this space acts as the membrane. Wash fluid is pumped into and out of the abdomen. How does the blood get to the artificial kidney in hemodialysis? In order to get blood to the artificial kidney, patients have to have an "access" to blood vessels. This requires a minor surgical procedure. What is CAPD? Continuous Ambulatory Peritoneal Dialysis (CAPD) frees patients from a kidney machine. Patients perform this procedure themselves. Wastes from the blood are filtered through the peritoneum into dialysate (washing fluid), which has been drained into the abdominal cavity. The fluid remains inside the peritoneum while the patient goes about daily activities. Three or four times during the day the fluid is drained through a catheter and replaced with fresh dialysate to allow the cleansing process to continue. Will dialysis help cure kidney disease? No. Dialysis does not help the kidneys themselves, but takes over the work of the kidneys when they are diseased. That's why patients with chronic kidney disease need to continue dialysis throughout their lives, or until they receive a kidney transplant. Does dialysis hurt? There may be some slight discomfort when needles are inserted for hemodialysis, but most patients have no other problems. Each patient reacts differently to each treatment. Patients may occasionally have nausea, headache or cramps during a hemodialysis treatment. Peritoneal dialysis does not hurt. Is dialysis a new kind of treatment? No. Dialysis is an established treatment. Acute hemo and peritoneal dialysis have been around since the mid-1940s. Chronic hemodialysis has been on the books since 1960. CAPD, meanwhile, was introduced in 1976. Finally, peritoneal dialysis has been widely available since 1978. In the past 20 years, tens of thousands of patients have received dialysis treatments on an acute or chronic basis. How long can a person live on dialysis? There are many patients who have been on chronic dialysis since it was first available in the early 1960s. Specialists don't yet know the total life expectancy, but some dialysis patients may approach normal life spans. Is all dialysis done in the hospital? No. Many patients with chronic kidney failure have been taught to perform dialysis at home. With home dialysis, they can plan their treatments to fit in better with their jobs or family lives, and they don't have to drive to a dialysis facility. Other patients are dialyzed at centers around the country, many connected with a hospital. Chronic dialysis patients are generally not hospitalized for treatments. They live at home. Is dialysis expensive? Dialysis is very expensive. Fortunately the federal government now pays 80 percent of all dialysis costs, and private health insurance or state medical assistance pays almost everything else. So the cost of dialysis is no longer the financial drain it was before Medicare coverage was enacted. Do dialysis patients feel normal? Dialysis improves and relieves many but not all of the patient's symptoms. The degree of relief varies from patient to patient. Many dialysis patients lead normal lives. Emotional adjustment of the patient and family does take time and understanding. Help and counseling are available from the staff at Ochsner's Dialysis Centers. Do dialysis patients have to watch their diets? Yes, there are some limitations, especially on drinking fluids. Can dialysis patients travel? Yes. There are dialysis centers throughout the United States, which will allow prescheduled dialysis travelers. Some home dialysis patients have portable equipment, making travel even more convenient. Where is dialysis available? Dialysis centers are located in almost every part of the country. Programs to train and support peoples who want to perform their own dialysis at home have also been established at certain centers. Can dialysis patients continue to work? Dialysis patients can normally resume working after medically adjusting to dialysis. Those who have jobs very physical in nature may need to change careers. SOURCE: The National Kidney Foundation of Louisiana