Any discussion of kidney diseases invariably brings in the term dialysis. We all know of someone who has been through dialysis.

But what exactly is dialysis, and how does it work?

In this comprehensive guide, we will delve deep into the world of kidney dialysis and explore various aspects associated with it.

The Crucial Role of the Kidneys

Before diving into the details of dialysis, it is important to understand the vital role kidneys play in our bodies:

The kidneys are bean-shaped organs, each roughly the size of a fist, located near the lower back. They perform several essential functions, including:

• Filtration: The primary job of the kidneys is to filter waste and excess substances from the blood, creating urine that carries these toxins out of the body.
• Fluid Balance: They regulate the body’s fluid balance, ensuring that we don’t become either dehydrated or overloaded with fluids.
• Electrolyte Balance: Kidneys help maintain the proper balance of electrolytes in the body, such as sodium, potassium, and calcium.
• Blood Pressure Regulation: The kidneys also play a role in regulating blood pressure by controlling the volume of blood in the body.

Unfortunately, due to various factors such as high blood pressure, diabetes, or certain medical conditions, the kidneys can lose their functionality, leading to kidney failure. When the kidneys can no longer effectively perform their tasks, dangerous levels of waste and fluid can build up in the body, leading to life-threatening complications.

Challenges and Lifestyle Changes

Hemodialysis is a life-saving procedure, but it does come with its challenges. Patients undergoing hemodialysis often experience changes in their lifestyle, including dietary restrictions and the need to carefully manage their fluid intake. Furthermore, the procedure itself can be physically demanding and may lead to fatigue.

Advantages and Considerations

Peritoneal dialysis offers several advantages, such as greater flexibility in treatment location, less dietary restriction, and a gentler impact on the patient’s body. However, it requires strict adherence to the treatment schedule and increased personal responsibility.

Living a Healthy Life while on Dialysis

Dialysis can be a prolonged process, typically requiring several rounds depending on the condition of the kidney. Living with dialysis can be challenging, but it is essential to understand that life doesn’t end with a diagnosis of kidney failure. With the right support and attitude, many individuals lead fulfilling lives while undergoing dialysis treatment.

Here are some key considerations for maintaining a healthy lifestyle:

• Diet and Fluid Management: Following a kidney-friendly diet and managing fluid intake is crucial. This often means limiting certain foods high in potassium, phosphorus, and sodium.
• Medications: Patients may need to take medications to control blood pressure, manage anaemia, and address other complications related to kidney failure.
• Emotional Well-Being: Coping with kidney disease and dialysis can be emotionally taxing. Seek support from friends, family, or a therapist if needed.
• Regular Exercise: While some restrictions may apply, regular physical activity can help improve overall health.
• Frequent Check-ups: Regular appointments with healthcare providers are essential to monitor kidney function and overall health.

Dietary Restrictions and Recommendations for a Healthy Dialysis Lifestyle

Maintaining a kidney-friendly diet is crucial for individuals undergoing dialysis. Such a diet can help manage the buildup of waste and fluid in the body, control blood pressure, and reduce the risk of complications.

Diet Restrictions

Intake of certain foods will be restricted during a kidney disease, such as:

• Sodium (salt) Restriction: Sodium can lead to fluid retention and high blood pressure. Therefore, the doctor will recommend limiting sodium intake by avoiding high-sodium processed foods, canned soups, and salty snacks, and adding salt during cooking or at the table.
• Potassium Control: Elevated potassium levels can cause irregular heart rhythms. Intake of potassium-rich foods, such as bananas, oranges, tomatoes, potatoes, and spinach, will also be restricted. The patient may be advised to opt for low-potassium alternatives like apples, grapes, and cauliflower.
• Phosphorus Management: High phosphorus levels can weaken bones and cause itching. Hence, intake of foods high in phosphorus, like dairy products, nuts, and colas, will be restricted. Consider phosphate binders, prescribed by your healthcare provider, to control phosphorus absorption.
• Fluid Control: Dialysis patients are required to closely monitor fluid intake to avoid fluid overload, which can lead to swelling and high blood pressure.
• Limiting Fruits and Vegetables: Some fruits and vegetables, like oranges, tomatoes, and potatoes, are high in potassium. There can be restrictions on the intake of these fruits and vegetables as well.

Diet Recommendations

Now let us take a look at some of the dietary recommendations suitable for dialysis patients:

• High-Quality Protein: Dialysis can lead to protein loss, but protein is essential for the overall health of a kidney patient. Balance your protein intake to prevent malnutrition. Choose lean sources of protein like fish, poultry, and eggs. These are lower in phosphorus and can help maintain muscle mass.
• Grains and Carbohydrates: Opt for whole grains like brown rice, whole wheat bread, and pasta. These are good sources of energy and fibre.
• Healthy Fats: Use healthy fats like olive oil and canola oil instead of saturated and trans fats. Fatty fish like salmon and nuts are also good sources of healthy fats.
• Portion Control: Pay attention to portion sizes to avoid overeating, which can lead to excess calorie and fluid intake.
• Phosphorus Binders: Take phosphorus binders with meals to help control phosphorus absorption. Follow your healthcare provider’s recommendations.
• Vitamins and Minerals: Dialysis can lead to deficiencies in certain vitamins and minerals. Discuss supplementation with your healthcare provider or dietitian.
• Limit Sugary Foods and Beverages: Excess sugar can contribute to weight gain and diabetes. Limit sugary treats and beverages.
• Calcium Supplements: Dialysis patients may lose calcium through dialysis, and this can weaken bones. Your healthcare provider may recommend calcium supplements.

Emotional support and coping strategies for patients on dialysis

Emotional support and coping strategies are vital for patients undergoing dialysis, as managing a chronic health condition like kidney failure can be mentally and emotionally challenging.

Here are some helpful ways to cope and seek emotional support during your dialysis journey:

Emotional Support:

• Family and Friends: The diagnosis of a kidney disease and undergoing dialysis can be emotionally taxing. Having loved ones around can be very helpful. A strong emotional support group can help dialysis patients bridge difficult times with ease.
• Support Groups: Joining a local or online support group for individuals with kidney disease can help connect with others facing similar challenges. These groups offer a safe space to share experiences, ask questions, and receive encouragement.
• Mental Health Professionals: If the treatment leads to anxiety, depression, or other severe emotional distress, seeking help from a professional can be helpful.
• Spiritual and Religious Support: For those who are religious or spiritual, attending services, seeking pastoral counselling, or engaging in prayer and meditation can provide comfort and strength.
• Patient Advocacy Organisations: Many organisations, such as the National Kidney Foundation of Malaysia, offer resources, educational materials, and support for kidney disease patients. They can also connect a patient with peer mentors who have experience managing kidney disease.
• Online Communities: There are several online forums, social media groups, and websites dedicated to kidney health. These can provide a sense of community and a platform for sharing experiences and insights.
• Open Communication: Talking openly to the healthcare team can also release emotional stress. They can offer guidance, recommend support resources, and even provide references to mental health professionals.

Coping Strategies:

• Education: Understanding the condition and treatment can alleviate anxiety. Learning about dialysis, kidney disease, and how to manage diet and medications effectively.
• Set Realistic Goals: Establish achievable short-term and long-term goals to maintain a sense of purpose and accomplishment.
• Positive Thinking: Practising positive thinking and maintaining a hopeful outlook. Focus on the aspects of life that bring you joy and fulfilment.
• Mindfulness and Relaxation Techniques: Incorporate relaxation exercises and mindfulness practices into your daily routine to reduce stress. Deep breathing, meditation, and yoga can be beneficial.
• Exercise: Engage in regular, low-impact physical activity, as permitted by your healthcare team. Exercise releases endorphins, which can improve mood and reduce stress.
• Diet and Nutrition: Following a kidney-friendly diet can positively impact your physical and emotional well-being. Eating well can help you feel better and have more energy.
• Hobbies and Interests: Pursue hobbies and interests that you enjoy. Engaging in activities you love can provide a welcome distraction from the challenges of dialysis.
• Accept Your Emotions: It is normal to experience a range of emotions, including frustration, anger, sadness, and fear. Accepting these feelings and acknowledging them can be a healthy part of the coping process.

Dialysis is a lifeline for individuals suffering from kidney failure. Understanding the basics of this essential medical procedure is crucial for patients, their families, and anyone interested in kidney health. While living with kidney failure and undergoing dialysis can be challenging, it is possible to lead a fulfilling life with the right support and a positive outlook. As medical science continues to advance, we can hope for better, more convenient, and more effective treatments for kidney disease in the future.

Sources

• https://www.verywellhealth.com/everything-you-wanted-to-know-about-dialysis
• https://my.clevelandclinic.org/health/treatments/
• https://www.kidney.org/atoz/Topic_Dialysis
• https://www.kidney.org/atoz/coping-effectively-guide-patients-and-their-families
• https://www.kidney.org/atoz/content/peritoneal
• https://www.kidney.org/atoz/content/hemocatheter