by admin-blog-kh | December 17, 2025 12:48 pm
Kidneys are vital organs that perform the critical function of our body by filtering waste products and removing excess fluids from the blood. However, when they stop working effectively to clear the toxins from the body, a condition known as end-stage kidney disease (ESRD) or kidney failure—dialysis becomes essential. Dialysis is a life-saving treatment that is done in patients with ESRD to sustain life when the kidney fails.
Dialysis is a medical process that removes waste, toxins, and extra fluid from the blood when the kidneys are no longer able to do it effectively. There are two main types of dialysis:
Haemodialysis: This is the most common form of dialysis. It involves removing the patient’s blood from the dialysis access (usually AV fistula or dialysis catheter) through a machine (dialyser) that filters it and returns the clean blood back to the body. This is usually done at a dialysis centre, requiring about three times a week, and each session lasts about four hours.
Peritoneal Dialysis: This method uses the lining of the abdominal cavity (peritoneum) as a natural filter. A special fluid is introduced into the abdomen through a catheter, which absorbs waste and is then drained. This can be done at home, hence making it a more flexible option for some patients.
Dialysis becomes necessary when the kidneys lose about 85–90% of their function. Common causes of kidney failure include diabetes, hypertension, glomerular diseases, kidney stone diseases, long-term use of painkillers, and certain autoimmune or genetic conditions. Symptoms that may indicate worsening kidney function include excessive fatigue, swelling of feet and hands, shortness of breath, nausea, vomiting, decreased appetite, confusion, generalised itching, and reduced urine output.
If chronic kidney disease is diagnosed early by screening, before reaching the ESRD stage, patients are usually monitored closely by nephrologists, and efforts are made to slow down kidney damage with medications, diet modifications, and lifestyle changes.
Starting dialysis is a major life change. Patients often have questions, fears, and uncertainties. Will I still be able to work? Can I travel? Will my life ever feel normal again? The answer is yes; with support and good care, many do live full lives.
We as nephrologists have seen patients who do athletic activity, take long family vacations, attend weddings, and continue working—all while on dialysis. It’s not always easy, but it’s possible.
Of course, dialysis also comes with challenges—so many dietary restrictions, fatigue especially after dialysis, and waiting long hours in the clinic and dialysis units. But what stands out the most is the resilience of the patients. They smile through tough days, support each other like family at dialysis units, and find new routines that work for them.
Modern technology has made dialysis safer and more efficient. Portable machines and home-based dialysis options are now available for patients who can meet certain clinical criteria. In some of the cities, nocturnal dialysis is offered, where treatment is done overnight to better fit patients’ lifestyles, and it also improves the quality of life.
Efforts are also underway to improve dialysis access through vascular interventions, minimise complications, and provide more personalized treatment regimens. Interventional nephrology—a subspeciality of nephrology[1]—is playing a significant role in making dialysis safer and more accessible by handling vascular access procedures such as catheter placements, AV fistulograms, and angioplasties, as dialysis access is the lifeline for haemodialysis patients.
While dialysis sustains life, kidney transplantation remains the gold standard for eligible patients. A successful transplant often offers better quality of life and longer survival compared to long-term dialysis. However, due to a shortage of organs and medical constraints, many patients remain on dialysis while waiting for a donor kidney.
Living donation—where a healthy person donates one of their kidneys—has become a viable and increasingly common option, especially within families. Paired kidney exchange programs are also growing, helping incompatible donor-recipient pairs find matches.
One of the saddest truths we face as doctors is seeing people come to us when their kidneys are already badly damaged. Often, the signs—fatigue, swelling, decreased urine output—are ignored or mistaken for something else.
Kidney disease is known as a “silent killer” because it progresses quietly. Symptoms of kidney disease appear very late, when the kidneys are damaged already or in an irreversible stage. That’s why regular checkups, especially for people with diabetes, high blood pressure, or a family history of kidney disease, are crucial.
The rising incidence of kidney failure, particularly due to diabetes and hypertension, is a growing public health concern. Simple measures can go a long way in preventing kidney disease:
If you know someone on dialysis, support them. Encourage your loved ones to get regular health checks, especially if they have risk factors for kidney disease like diabetes or hypertension.
And if you’re a patient on dialysis or a care-giver reading this—know that you are not alone. The nephrologists, dialysis technicians, staff nurses, and NGOs are always available to support and help you. With today’s medical advances, strong willpower, and good support, life on dialysis is not the end—it’s a new beginning and a new life.
As a society, we must focus not only on improving dialysis services but also on early detection and prevention of kidney disease. Raising awareness about kidney health is the first step toward reducing the burden of chronic kidney disease. Let’s support those on dialysis and work toward a healthier future for all.
1. What is dialysis and why is it needed?
Dialysis is a life-saving medical treatment that removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions adequately. It becomes necessary in advanced or end-stage kidney disease to sustain life.
2. At what stage of kidney disease is dialysis required?
Dialysis is usually required when kidney function drops below 10–15% of normal capacity, typically in end-stage kidney disease (ESRD). The decision is based on symptoms, blood test results, and overall clinical condition—not just numbers alone.
3. What are the main types of dialysis?
There are two main types:
Haemodialysis, where blood is filtered through a dialysis machine, usually done at a dialysis centre.
Peritoneal dialysis, where the lining of the abdomen acts as a natural filter and treatment can often be done at home.
4. How often does a patient need haemodialysis?
Most patients require haemodialysis three times a week, with each session lasting about four hours. The schedule may vary depending on the patient’s medical condition and residual kidney function.
5. Can dialysis patients live a normal life?
Yes. While dialysis requires lifestyle adjustments, many patients continue to work, travel, exercise, attend family functions, and lead fulfilling lives. With proper medical care, diet control, and emotional support, quality of life can be maintained.
Dr. B. Karthikeyan[2]
Clinical Lead, Interventional Nephrology
Kauvery Hospital, Radial Road
Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai (Alwarpet, Radial Road & Vadapalani), Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and paediatric trauma care.
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