Medical Department

Supportive Kidney Care for Patients with Kidney Failure

The kidneys play an important role in removing waste products and excess fluid from the blood while helping maintain the body's fluid, electrolyte, and chemical balance. When the kidneys are no longer able to perform these functions adequately, dialysis may be required to help remove waste and excess fluid from the body.

At K & K Super Speciality Hospital, dialysis care can support patients who require kidney replacement therapy based on their medical condition and the recommendations of their treating doctor.

Dialysis is an important treatment for patients with significant loss of kidney function and requires appropriate medical evaluation and ongoing monitoring.

What is Dialysis?

Dialysis is a treatment that performs some of the functions normally carried out by healthy kidneys.

It helps remove:

• Waste products from the blood
• Excess fluid
• Certain electrolytes and dissolved substances

Dialysis may be required temporarily in some patients with acute kidney problems or may be needed regularly in patients with advanced or permanent kidney failure.

The type and frequency of dialysis depend on the patient's kidney function, overall health, and medical requirements.

When is Dialysis Required?

Dialysis may be recommended when the kidneys are unable to adequately remove waste and excess fluid from the body.

It may be required in situations such as:

• Advanced chronic kidney disease
• Kidney failure
• Severe acute kidney injury
• Significant fluid overload
• Certain electrolyte abnormalities
• Severe acid-base disturbances
• Certain cases of poisoning or toxin accumulation

The decision to start dialysis is based on the patient's overall clinical condition rather than a single laboratory value.

Types of Dialysis

There are two main forms of dialysis:

Haemodialysis

Haemodialysis uses a dialysis machine and a special filter called a dialyzer to remove waste products and excess fluid from the blood.

Blood is circulated through the dialyzer, where unwanted substances and excess fluid are removed, before the filtered blood is returned to the patient's body.

Haemodialysis is commonly performed through a vascular access site created specifically for dialysis.

Peritoneal Dialysis

Peritoneal dialysis uses the lining of the abdomen, known as the peritoneum, as a natural filtering membrane.

A special dialysis solution is introduced into the abdominal cavity through a catheter. Waste products and excess fluid move into the solution, which is then drained and replaced.

The suitability of each type of dialysis depends on the patient's medical condition, lifestyle, kidney function, and the recommendation of the treating nephrology team.

Dialysis for Acute Kidney Injury

Acute kidney injury can occur suddenly due to conditions such as severe infection, dehydration, certain medications, reduced blood flow to the kidneys, or other serious illnesses.

In some severe cases, temporary dialysis may be required while the kidneys recover.

The duration of dialysis in acute kidney injury varies according to the underlying cause and the patient's response to treatment.

Dialysis for Chronic Kidney Disease

Chronic kidney disease can gradually reduce kidney function over time.

When kidney function becomes severely reduced, dialysis may become necessary to replace some of the kidneys' filtering functions.

Patients receiving long-term dialysis require regular medical follow-up, monitoring, dietary guidance, medication management, and assessment of their overall health.

How Does Haemodialysis Work?

During haemodialysis:

1. Blood is accessed through the patient's dialysis access.
2. Blood passes through the dialyzer.
3. Waste products and excess fluid are removed.
4. The filtered blood is returned to the body.
5. The process continues for the duration recommended by the medical team.

The exact dialysis schedule and treatment duration vary from patient to patient.

Dialysis Access

Patients undergoing haemodialysis require a suitable way to connect their bloodstream to the dialysis machine.

Common forms of vascular access include:

• Arteriovenous fistula
• Arteriovenous graft
• Central venous catheter

The choice of access depends on the patient's condition and treatment requirements.

Proper care of the dialysis access is important to reduce the risk of infection and other complications.

Monitoring During Dialysis

Patients receiving dialysis require appropriate monitoring during treatment.

Depending on the patient's condition, the medical team may monitor:

• Blood pressure
• Heart rate
• Fluid balance
• Weight
• Symptoms during treatment
• Dialysis access
• Relevant blood investigations

Monitoring helps the healthcare team identify changes and make treatment adjustments when necessary.

What Symptoms May Indicate Advanced Kidney Problems?

Kidney disease can sometimes progress without obvious symptoms during its early stages.

As kidney function becomes significantly reduced, symptoms may include:

• Swelling of the legs or feet
• Reduced urine output
• Persistent tiredness
• Nausea or vomiting
• Loss of appetite
• Breathlessness
• Itching
• Muscle cramps
• Difficulty concentrating
• Changes in urination

These symptoms can have many different causes. Medical evaluation and appropriate investigations are important for identifying the underlying problem.

Dialysis and Fluid Management

When kidney function is severely reduced, the body may have difficulty removing excess fluid.

Dialysis can help remove excess fluid from the bloodstream.

Patients undergoing dialysis may also receive guidance regarding:

• Fluid intake
• Salt intake
• Dietary requirements
• Body weight monitoring
• Medication use

Individual dietary and fluid recommendations should be provided by the treating medical team based on the patient's condition.

Dialysis and Diet

Patients receiving regular dialysis often require specific dietary planning.

Depending on kidney function and laboratory results, doctors or dietitians may provide guidance regarding:

• Protein intake
• Sodium
• Potassium
• Phosphorus
• Fluid intake

Dietary requirements vary between patients, so individuals should follow the recommendations provided by their healthcare team rather than following a general diet plan.

Medicines During Dialysis Treatment

Patients with kidney disease may require medicines to manage blood pressure, anaemia, bone and mineral balance, or other associated conditions.

Medication requirements can change depending on kidney function and dialysis status.

Patients should inform their doctor about all medicines and supplements they are taking and should not change prescribed medicines without medical advice.

Possible Complications of Dialysis

Dialysis is an important treatment, but patients may experience certain complications.

Depending on the type of dialysis and individual health condition, these may include:

• Low blood pressure
• Muscle cramps
• Fatigue
• Nausea
• Headache
• Dialysis access problems
• Infection
• Changes in electrolyte levels

Patients should inform the dialysis team about any unusual symptoms during or after treatment.

Caring for Dialysis Access

For patients receiving haemodialysis through vascular access, proper access care is important.

Patients may be advised to:

• Keep the access area clean
• Watch for redness or swelling
• Report pain or unusual discharge
• Report fever or other signs of infection
• Follow instructions regarding the affected arm or access site
• Attend regular medical follow-up

Any sudden change in the appearance or function of the access should be reported to the healthcare team.

Dialysis and Regular Health Monitoring

Patients on long-term dialysis require regular monitoring to assess their response to treatment and overall health.

Follow-up may include:

• Blood investigations
• Blood pressure monitoring
• Weight assessment
• Fluid balance assessment
• Dialysis adequacy evaluation
• Vascular access assessment
• Management of associated medical conditions

Regular follow-up helps the medical team adjust treatment according to the patient's changing needs.

Preparing for Dialysis

Patients starting dialysis receive specific instructions from their medical team.

Preparation may involve:

• Medical evaluation
• Blood investigations
• Assessment of kidney function
• Review of current medicines
• Assessment of vascular access when required
• Dietary and fluid guidance
• Discussion of the dialysis schedule

Patients should communicate any new symptoms or changes in their health to the treating team.

Dialysis for Elderly Patients

Older adults with advanced kidney disease may require dialysis depending on their overall health, kidney function, and medical circumstances.

Treatment planning may take into consideration:

• Existing medical conditions
• Mobility and independence
• Nutritional status
• Cardiovascular health
• Medication requirements
• Overall treatment goals

The dialysis plan should be individualised according to the patient's clinical needs.

When Should You Seek Medical Attention?

Patients with kidney disease should seek medical evaluation if they develop symptoms such as:

• Severe breathlessness
• Significant swelling
• Very low or absent urine output
• Persistent vomiting
• Chest discomfort
• Confusion or significant drowsiness
• Fever or suspected infection
• Sudden deterioration in general health

Patients already receiving dialysis should contact their healthcare team promptly if they experience problems with their dialysis access or significant symptoms during or after treatment.

Dialysis Care at K & K Super Speciality Hospital

At K & K Super Speciality Hospital, dialysis care can support patients who require kidney replacement therapy following appropriate medical evaluation.

Our approach focuses on appropriate assessment, dialysis treatment, patient monitoring, and ongoing medical care according to individual clinical requirements.

Patients with kidney disease can discuss their treatment needs with their doctor to determine whether dialysis or another form of kidney care is appropriate.

Get Appropriate Kidney Care

Kidney disease can progress gradually, and timely medical evaluation can help identify changes in kidney function and guide appropriate treatment.

If you have been advised to undergo dialysis or are experiencing symptoms associated with significant kidney problems, consult a qualified healthcare professional for appropriate evaluation and treatment.

For dialysis care and kidney-related medical support, contact K & K Super Speciality Hospital.