Kidney Failure and Hemodialysis

What is Kidney Failure?

Kidney failure is the end result of a generally progressive loss of kidney function. It doesn't happen overnight. In the early stages of kidney disease, symptoms are rare, if any. Symptoms generally appear later in the process.

The most frequent causes of kidney failure are diabetes and hypertension. Kidney failure occurs when:

• 85 to 90% of kidney function is lost;
• The GFR (glomerular filtration rate) falls below 15;
• The kidneys don't function well enough to sustain life;

When your kidneys are not working properly, the level of creatinine in your blood increases. Creatinine blood levels are used to calculate your GFR (glomerular filtration rate, a measure of kidney function). As creatinine levels rise, the GFR falls. In cases of kidney failure, some patients may experience nausea, vomiting, loss of appetite, weakness, increasing fatigue, itching, muscle cramps (especially in the legs), and anemia (low blood count). With treatment for kidney failure, these symptoms lessen and you'll start to feel much better.

There is no cure for kidney failure, but with treatment, it's possible to live a long and fulfilling life. Kidney failure is not a death sentence. People with kidney failure live active lives and continue to do the things they enjoy.

Hemodialysis for the Treatment of Kidney Failure

What Happens During Hemodialysis?

Hemodialysis is a necessary treatment when your kidneys can no longer support your body's needs. During hemodialysis, your blood flows through tubes from your body to a dialysis machine. While your blood is in the machine, it passes through a filter that cleans your blood by removing waste and extra fluid. Then, the cleaned blood passes through tubes from the dialysis machine back into your body. Your doctor needs to create an access, or entry, into your blood vessels. This is called vascular access.

What Does Hemodialysis Do?

When your kidneys are failing, dialysis helps maintain your body's balance by:

• removing waste products, salt, and excess water to prevent them from building up in the body;
• maintaining safe levels of certain chemicals in your blood, such as potassium, sodium, and bicarbonate;
• helping to control blood pressure;

How Long Do Hemodialysis Treatments Last for Kidney Failure?

The length of hemodialysis depends on:

• how well your kidneys are working;
• how much fluid you consume between treatments;
• how much waste is in your body;
• your size;

Generally, each hemodialysis treatment lasts about four hours and is performed three times a week.

A type of hemodialysis called high-flux dialysis may take less time. You can talk to your doctor to see if this is an appropriate treatment for you.

Preparation for Hemodialysis and Fistula Placement

To avoid the discomfort of needles for weekly dialysis sessions, a fistula can be placed by a cardiovascular surgeon.

Does Hemodialysis Cause Discomfort?

You may experience some discomfort when the needles are inserted, but most patients don't have other problems. The hemodialysis treatment itself is usually painless. However, some patients may experience a drop in their blood pressure. If this happens, you may have stomach aches, vomiting, headaches, or cramps. With frequent treatments, these problems usually disappear.

Between Hemodialysis Treatments for Kidney Failure

Between hemodialysis treatments, you can help yourself get the best possible results by following a few rules:

• Maintain a healthy diet: Eating correctly can improve your hemodialysis results and your overall health. During your hemodialysis, you will need to carefully monitor your intake of fluids, protein, sodium, potassium, and phosphorus. A dietitian can help you develop a personalized meal plan based on your weight, personal preferences, remaining kidney function, and other medical conditions, such as diabetes or high blood pressure;
• Take your medications as prescribed: Follow the instructions of your healthcare team carefully;
• Communicate with your team: Your healthcare team can present options and help you cope with your concerns;

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Is Kidney Failure Permanent?

Usually, but not always. Some types of kidney failure, also known as acute kidney failure, recover after hemodialysis treatment. In some cases of acute kidney failure, dialysis may only be needed for a short period, until the kidneys recover.

In cases of chronic or end-stage kidney failure, you will likely require hemodialysis treatment for life. If your doctor says you are a candidate, you can choose to be placed on a waiting list for a kidney transplant.

How Long Can You Live on Dialysis?

If you have kidney failure, you will need dialysis treatments for life unless you receive a kidney transplant. Life expectancy for patients on dialysis varies depending on other medical conditions and how well you follow your treatment plan. The average life expectancy on dialysis is 5 to 10 years, but many patients live on dialysis for 20 or even 30 years. Talk to your healthcare team about how to take care of yourself and stay healthy during dialysis.