Family Doctor: Doc offers a medical primer on dialysis

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Family Doctor: Doc offers a medical primer on dialysis

By Peter Gott, M.D.
United Media

Posted Jan 07, 2010 @ 12:00 PM

Q: Please enlighten me about dialysis. Who is it used by and how often? It causes me to vomit whenever I try to eat.

A: I assume, based on your letter, that you are currently undergoing dialysis. You do not give any other pertinent information, such as your age, gender, what medical conditions you have and what medications, including over-the-counter drugs and herbals, you are taking, therefore, I will give only a general overview.

Dialysis is a medical treatment that essentially cleanses the blood. It replaces some of the things that the kidneys normally do. It is used by those patients with end-stage kidney failure and its use usually implies that 85 percent to 90 percent of kidney function has been lost.

There are two types of dialysis: The first is known as hemodialysis. In this situation, the patient undergoes minor surgery to create an access point into the blood vessels. This area is then available to be hooked up to a machine that removes the impurities and balances certain chemicals, which is normally the job of the kidneys. These include removing salt, excess water and waste, and maintaining normal levels of sodium, bicarbonate and potassium.

The procedure is usually done three times a week, and each treatment may take up to four hours to complete.

The second type of dialysis is peritoneal. There are several forms, so, again, I will give only a general overview. Rather than having an external machine cleanse the blood, the process occurs within the body. Surgery is necessary to create an access point within the abdomen, in which a catheter is placed. A substance called dialysate is then slowly injected into the abdominal cavity. Dialysate then draws out the excess fluids and waste products from the blood, which are removed when it is drained away. Which type of peritoneal dialysis is appropriate is best determined by a nephrologist (kidney specialist).

Dialysis does not cure kidney disease. It is believed that those on it may live as long as people with normal, healthy kidneys, but it is not known for sure. The only cure is kidney transplant; however, only certain people may qualify based on general health status, age and other criteria.

Dialysis is an expensive treatment and may need to be continued for long periods of time or even for the rest of a patient's life if a compatible kidney cannot be found or the patient doesn't qualify for transplant. The good news is that private health insurance, state medical aid and the federal government may lower or eliminate the cost.

Most patients lead relatively normal lives while on this treatment. For those who continue to work, special arrangements must be made to accommodate the dialysis schedule. Dialysis centers are located through the United States and in many foreign countries. It is important for those on dialysis to contact the nearest center when traveling to make appointments prior their arrival. Because treatment is standardized, the same level of care will be received, regardless of where you are traveling.

Speak to your physician, because your questions involve subjects that he or she should have explained to you.



Write to Dr. Gott c/o United Media, 200 Madison Ave., 4th fl., New York NY 10016.

http://www.cantonrep.com/lifestyle/advice/x370512467/Family-Doctor-Doc-offers-a-medical-primer-on-dialysis