Dialysis is a way of removing toxic substances which accumulate in the body when one’s kidneys do not function. Dialysis also removes certain drugs and chemicals which are ingested accidentally. Dialysis can also help in removing excess water especially in the lungs (pulmonary edema).
Dialysis is done for various indications like:
• Kidney dysfunction
• Drug overdose
• Pulmonary edema
Myths associated with dialysis:
Myth No.1: Dialysis when done once has to be done lifelong.
This is not true.
The term ‘kidney failure’ is commonly used and it is misleading. Not all kidney diseases are terminal.
The body does not get “addicted” to dialysis once it requires. If kidneys recover its function then dialysis can be stopped. If dialysis is done for drug overdose, it’s only done once or twice. Even in patients with kidney disease, many a times, dialysis is done only for a short period.It’s important to understand this because nowadays there are many standalone dialysis units without a nephrologist and the treating team in charge of the unit may not be aware of minor nuances and clues which will indicate a treatable cause.
Myth No.2: Dialysis = End of life
This is not true either.
According to data from the US, once a patient matches for age and sex, survival rate for 3 years on Haemodialysis (HD) is 92%. The survival is much higher in certain modalities like home HD where median survival was 18.5 years compared to 11.9 years for regular HD. Patients who undergo renal transplant do even better and their survival is not vastly different from matched population. It is difficult to get Indian data on this.
Myth No.3: Once you are on dialysis, quality of life is severely affected.
This is being remedied with the availability of late shifts in dialysis centres.
Home dialysis options give dialysis patients the chance of being employed again. Ability to work and quality of life depends at least partially on the quality of dialysis and management of associated health issues like anemia and bone disease which require a tailored dialysis and medication prescription by a
nephrologist. There is no one size fits all. Of course the social support system of the patient plays a big role in the quality of life.
Severe forms of kidney disease which requires dialysis are curable in some instances. Even if it is not curable, the patient can still lead a meaningful life while on dialysis. Kidney is the only vital organ which can be replaced long term by a machine with reasonable success. In future, with advancement in stem cells and bio artificial kidney, dialysis is likely to be even more efficient.
So please consult your nephrologist and do not get bogged down by mistaken beliefs of uninformed people!
Dialysis is not the end of life!
Article by Dr.K.Abirami, Nephrologist, Kauvery Hospital, Salem