01-10-2024 11:03 AM

What is Kidney dialysis? Types, Complications and Procedures

Introduction

Dialysis is a treatment procedure for renal failure. When the kidneys fail to perform their function, the blood is filtered through an artificial method known as dialysis. Dialysis is performed using a machine known as dialyzer that filters blood and removes waste products. Without dialysis, harmful waste and toxins build up in the body

Dialysis was first successfully used in the 1940s and became the standard treatment in the 1970s. About millions of patients suffering from renal failure are treated with dialysis.

In dialysis, the blood is entered into a machine known as a dialyzer, which filters and removes extra waste products and fluid and returns the cleaned blood to the body.

Understanding Kidney Dialysis

Dialysis is usually necessary when kidney function is severely impaired. It starts when the kidneys are working at about 10% of their normal capacity.

Dialysis treatment must be continued for the rest of life unless the patient has a kidney transplant. Without dialysis, salts and other waste products accumulate in the blood and can damage other organs.

It is most often needed because of kidney failure, but it is also recommended for acute kidney failure. Acute kidney failure occurs over a short period of time (some days to weeks) due to a serious illness or accident, and dialysis is used as a short-term treatment procedure.

Kidney failure commonly results from chronic kidney disease, where kidney function gets worse over many years.

There are two types of dialysis: hemodialysis and peritoneal dialysis.

Hemodialysis: In hemodialysis, the blood is diverted into a machine called a hemodialyzer, which filters the blood and returns the cleaned blood back to the body.
Peritoneal Dialysis: Peritoneal dialysis is another method of dialysis in which the blood is filtered through tiny blood vessels inside the abdominal lining with the help of a dialysis solution. The solution consists of water, salts, and other additives. It absorbs waste products from the blood through blood vessels in the lining. The fluid is then drained from the body.

There are two types of peritoneal dialysis: Continuous Ambulatory Peritoneal Dialysis (CAPD) and Automated Peritoneal Dialysis (APD). Both methods offer greater flexibility than traditional hemodialysis.

Continuous Ambulatory Peritoneal Dialysis (CAPD) involves the patient manually performing fluid exchanges throughout the day, while Automated Peritoneal Dialysis uses a machine to perform exchanges overnight while the patient sleeps.

According to the National Kidney Foundation, 10/% of the total population is affected by chronic kidney diseases worldwide, and millions of people die each year due to having low resources to afford its treatment.

More than 2 million people around the world are currently being treated with either dialysis or a kidney transplant to stay alive.

However, this number may only represent about 10% of the people who actually need these treatments to survive. This means many people who need help with kidney failure are not receiving the care they require.

When is Kidney Dialysis Needed?

According to the National Kidney Foundation, a renal patient needs dialysis when kidney function drops 15% or less.

There are five stages of kidney disease, and the fifth stage (in which kidneys leave only 10 -15% of normal functioning) is considered end-stage renal failure(ESRD).

The renal patient is recommended to start dialysis when the condition and symptoms become severe.

Doctors also prescribe dialysis based on lab test results and severe symptoms of renal failure patients.

In cases of sudden kidney failure, dialysis may be needed temporarily until the kidneys recover.

This can occur due to severe dehydration, obstruction of urine flow, or exposure to toxins.

Key symptoms that may indicate the need for dialysis include:

Fatigue: Extreme fatigue, tiredness, or weakness.
Nausea and Vomiting: On and off complaints of nausea and vomiting.
Shortness of Breath: Difficulty in breathing due to excessive fluid in the lungs.
Swelling (Edema): Accumulation of fluid in the body, especially in the legs, feet, and hands.
Muscle Cramps: An imbalance of minerals like potassium and calcium can lead to cramps.
Confusion: Toxin build-up can affect brain function, leading to difficulty concentrating or mental confusion.
High Blood Pressure: Kidneys regulate blood pressure, and failure results in disruption of blood pressure management.

These symptoms show that the kidneys are no longer effectively working and filtering waste from the body, which requires dialysis to restore balance.

How Kidney Dialysis Works

Medication is no longer effective for patients suffering from end-stage renal disease. Dialysis and kidney transplant options are left for renal failure patients.

It is important to note that dialysis is not a permanent cure for kidney failure; it is a lifetime treatment that must be continued unless a patient receives a kidney transplant.

There are two types of dialysis: hemodialysis and peritoneal dialysis. T

he choice between hemodialysis and peritoneal dialysis depends on factors like the patient's lifestyle, medical condition, availability of the treatment, and personal preference.

Hemodialysis

During hemodialysis, the blood is filtered through a dialyzer machine. The machine is also responsible for maintaining blood pressure and balancing important minerals like sodium, potassium, and calcium in the blood. The blood is passed through a tube into a dialyzer that is divided into two parts, separated by a thin wall.

As blood passes through one part of the filter, a special fluid (containing electrolyte solution) in the other part draws waste from the blood.
The filtered blood from the dialyzer is then returned back to the body through a tube.

To create access to attach a tube, doctors are required to make an arteriovenous fistula in the arm or create a graft, if necessary, to perform a dialysis procedure. An arteriovenous (AV) fistula is usually created once and serves as a long-term access point for dialysis. With proper care, it can last many years, about 5 to 10 years or longer,

Peritoneal Dialysis

In peritoneal dialysis, a catheter is inserted into the abdomen before a few weeks to perform a dialysis.

The process involves pumping dialysis fluid into the peritoneal cavity (the lining of the abdomen), where it absorbs waste products from the blood through blood vessels.

The fluid is then drained from the body.

This type of dialysis is usually performed at home, but it can also be done at work or during travelling.

However, it's not a treatment option for everyone with kidney failure. There are two types of peritoneal dialysis.

Automated peritoneal dialysis (APD): It uses a machine called a cycler to perform dialysis procedure
Continuous ambulatory peritoneal dialysis (CAPD): This process can take place manually.

Home Dialysis Options:

Hemodialysis and peritoneal dialysis both can be done at home under specific circumstances.Peritoneal Dialysis is the most common type of home dialysis treatment.

In peritoneal dialysis, patients dialyzed daily at home with little or no assistance from others because the process is convenient and accessible.

The highly vascular peritoneal membrane, which covers the internal organs, is located inside the abdominal cavity. This internal membrane allows people with Peritoneal dialysis to remove waste products and extra fluid from their blood flow.

The dialysis solution is introduced into the abdomen via a catheter, where it stays for a few hours.

Through blood vessels in the peritoneal membrane, toxins and fluid move to the dialysate solution. Waste and excess fluid are removed from the dialysate when the predetermined dwell period has elapsed.

After a new dialysis solution is administered, the cleaning procedure starts. The exchange process consists of the drain, fill, and dwell phases. Exchanges can be carried out manually or by a device known as a cycler.

Benefits of Home Dialysis Option

Ensures greater flexibility to schedule dialysis sessions at home
Provide high quality of life due to home treatment
Reduces expenses and travel time during each visit.
Improves patient autonomy and control over the dialysis process.

Challenges Regarding Home Dialysis Option

Requires a specific and dedicated space in the home.
Emotional and physical burden of self-management during treatment.
Higher risk of infection if not performed correctly.
Strict treatment schedules are required.

Equipment and Training Required for Home Dialysis

Dialysis machine (for hemodialysis or peritoneal dialysis).
Water filtration or cycler for peritoneal dialysis.
Medical supplies (dialysis solutions, needles, catheters).
Proper storage is required for equipment and medications.

Proper training is required in setting and operating the dialysis machine to use at home.

Education on proper hygiene and management to prevent infections.
Proper handling during emergency procedures.
Requires continuous support from healthcare providers for monitoring and advice.

The Kidney Dialysis Procedure

The dialysis process involves careful monitoring and follow-up. The detailed process of hemodialysis and peritoneal dialysis is described below, along with pre-and post-dialysis preparations.

Pre-Dialysis Preparations for hemodialysis:

Before starting hemodialysis, a patient needs to undergo a minor surgical procedure to gain easy access to the bloodstream.

The procedure involves the formation of an AV fistula, AV grafting, or catheter insertion.

Arteriovenous fistula (AV fistula): Arteriovenous fistula is made by connecting an artery and vein in the arm for a dialysis procedure.
Arteriovenous graft (AV graft): If the artery or vein is too short to connect, the surgeon will use a graft (a soft, hollow tube) to connect them. The graft enlarges the connected artery and vein to facilitate dialysis and help blood flow in and out of the body faster.
Catheter: If dialysis needs to start quickly, the doctor inserts a small tube (called a catheter) into a vein in the neck, chest, or leg to temporarily treat the patient.

What happens during hemodialysis?

During hemodialysis, blood is pumped through a filter called a dialyzer. A dialyzer is sometimes called an “artificial kidney” because it filters the blood the same way kidneys do.

The dialysis machine is responsible for performing the following functions.

A needle removes blood from the arm, neck, chest, or leg through an AV fistula, AV graft, or catheter and enters it into a dialyzer machine for filtration.
The dialyzer is separated into two parts by a thin wall.
The blood is passed through one part of the dialyzer and circulates through the filter, which moves waste into a dialysis solution. A special fluid on the other part of the dialyzer removes the waste from the blood. This cleansing liquid contains water, salt, and other additives.
The blood is then returned to the body through a different needle in the arm.
During hemodialysis, the blood pressure is monitored to adjust the blood flow in and out of the body.

Post-Dialysis Care in hemodialysis:

After dialysis, some people experience fluctuations in blood pressure during or immediately after hemodialysis.

Due to imbalances in electrolytes and low blood pressure, they may experience nausea, dizziness, or faintness.

The other side effects of hemodialysis also include

Chest pain or back pain.
Headaches
Skin Irritation
Muscle cramps.
Restless legs syndrome.

Pre-Dialysis Preparations for Peritoneal Dialysis:

For peritoneal dialysis, a catheter (thin, soft tube) is placed through the stomach into the peritoneum three weeks before the dialysis is performed.

This catheter stays in place permanently. The patient can perform their own dialysis at home and prevent infections at the catheter site according to the surgeon's instructions.

What Happens During Peritoneal Dialysis?

Peritoneal dialysis involves the following steps.

The catheter placed in the abdomen is connected to a branch of a Y-shaped tube that is connected to a bag containing dialysis solution. The solution is moved through the tube and catheter into the peritoneal cavity.
When the fluid bag is empty, disconnect the bag and catheter after 10 minutes of interval.
Close the catheter with a cap.
The patient can perform their usual activities while the dialysis solution inside the peritoneal cavity absorbs waste and extra fluids from the body. The procedure takes about 60 to 90 minutes.
After this, remove the catheter's cap and use the other branch of the Y-shaped tube to drain the fluid into a clean, empty bag.
The whole process needs to be repeated four times a day.

Some people prefer to do peritoneal dialysis at night. With automated peritoneal dialysis (APD), a machine called a cycler pumps fluid in and out of the body, even during sleep.

Post-Dialysis Care in Peritoneal Dialysis:

After peritoneal dialysis, the fluid in the belly can make one feel uncomfortable due to bloatedness or fullness.

The treatment is not painful, but the stomach may appear bigger than normal when it's filled with liquid.

Which Type of Dialysis is Preferable?

Both types of dialysis can filter blood, but peritoneal dialysis has more advantages as compared to hemodialysis. It includes.

More convenient and reliable for daily routine: Compared to hemodialysis, peritoneal dialysis can be done at home, at work, or in any other clean and dry space. It is a more convenient method and can be done during work, travelling, or even while sleeping.
Least restriction on Diet: Peritoneal dialysis allows for a more flexible diet compared to hemodialysis because less potassium, sodium, and fluids build up in the body.
Long-lasting kidney functioning: In renal failure, the kidneys lose most of their functioning capability. However, in peritoneal dialysis, the remaining kidney functioning remains slightly longer than in people with hemodialysis.

No needle insertion in veins: In hemodialysis, needles are inserted in veins every time the blood is cleaned; peritoneal dialysis does not require needle insertion. The one-time catheter is placed only in the abdomen before peritoneal dialysis to filter and clean the blood outside the body.

What Should I Choose for Dialysis?

Consultation with a nephrologist is the best option for choosing the type of dialysis required based on the kidneys' functioning.

However, the selection of the type of dialysis depends on the following factors.

Kidney function.
The overall health of the patient
Personal preferences.
Home situation.
Living lifestyle.

Considerations of Peritoneal Dialysis

Peritoneal dialysis is a better option if the renal patient is:

Unable to bear side effects from hemodialysis like muscle cramps or sudden drop in blood pressure
Higher risk of heart problems
If the patient has a busy routine and a long travelling schedule
Wants to preserve residual kidney function because it better maintains any remaining kidney function compared to hemodialysis.

Peritoneal dialysis is not a viable option for the renal patient if:

There are already scars on the abdomen from past surgeries.
The presence of hernia in the abdomen (Large area of weakened muscle)
Unable to take proper self-care or a lack of caregiving support.
Patients have other conditions that affect the digestive tract, like inflammatory bowel disease or frequent diverticulitis.

Table 01: Considerations of Peritoneal Dialysis

Life on Kidney Dialysis

How to Adjust Daily Life on Kidney Dialysis

Life on dialysis feels like a big change, but proper planning and time management help renal patients cope better with it.

The biggest challenge for dialysis patients is scheduling their treatment on time because they need to perform it several times a week, and each session lasts about four hours. Better scheduling helps to balance daily life, work, and other activities around it.

Working people need to schedule a dialysis time that fits into their routine.

The majority of people prefer to have their treatments early in the morning or late in the day so they can keep a balance in their working life and family in between.

It’s important to consult with a doctor to find a routine that works best for them.

Besides scheduling a dialysis routine, it’s important to keep yourself active and do things you enjoy.

This could be spending time with friends, exercising, or having hobbies. Staying active and social helps you to feel more active and have control of your life.

How to Manage Diet and Lifestyle on Kidney Dialysis

One needs to modify one's diet during dialysis because the kidneys are unable to remove some things from the blood, such as potassium, sodium, and phosphorus.

Therefore, patients on dialysis should avoid frequent consumption of bananas, potatoes, salt, and dairy products since they lead to severe health risks.

It is suggested that a dietitian develops a personalised diet program for patients on dialysis to consume in order to obtain adequate energy needs per day.

It is important to control diet and fluid intake. Increased fluid intake leads to fluid accumulation in the lungs, which can affect patients' breathing.

It is also advisable for patients on dialysis to exercise to maintain good health. Even simple activities such as walking or performing yoga-like poses increase overall health and optimise mood.

How to Manage Side Effects of Kidney Dialysis

The side effects of dialysis should be managed in daily life.

Some patients tend to experience fatigue and tiredness after dialysis, so it is advised that they should rest when feeling exhausted.

One potential risk of dialysis is muscle cramps due to low fluid intake.

To avoid future episodes of muscle cramps, it is advised to seek medical advice and consume enough water.

However, these side effects are associated with dialysis, and some measures can be taken to address them.

Modifying the schedule, altering diet, or exploring methods to ease mental and physical loads can regulate such symptoms.

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Life Expectancy and Quality of Life

Hemodialysis and kidney transplants are two treatments for kidney failure, both of which have their own positive and negative qualities.

Dialysis normally provides a shorter life expectancy and requires many hours on the chair, leaving the patient feeling tired and strict restrictions on diet.

It is quite frequent in nature and does not need the performance of an operation.

However, kidney transplant patients have longer life expectancy and achieve much better improvement in the quality of life and diet limitations.

Controversially, transplants require major surgery, possible rejection of organs, and the use of immunosuppressive drugs throughout an individual’s life.

Comparing Dialysis and Kidney Transplant

Aspect	Dialysis	Kidney Transplant
Life Expectancy	Average 5-10 years for patients on dialysis. Influenced by age, underlying conditions, and dialysis type.	According to the National Kidney Foundation, the average life of a kidney is 15-20 years with a living donor kidney. With a deceased donor kidney, life expectancy is typically 8-12 years.
Quality of Life	Lower quality of life due to multiple sessions (3-4 times a week). Strict dietary restrictions. Fatigue and physical discomfort are common.	Improved quality of life. Fewer dietary restrictions. Do not require regular treatment that leads to an active lifestyle.
Pros	Available and accessible. No need for surgery. Suitable for patients who can not take transplants due to health issues.	Better survival rates and quality of life. Does not require regular dialysis sessions. Long-term health benefits.
Cons	Time-consuming and can be irritating Higher risk of infections and CVD complications. Lower life expectancy.	Requires major surgery and higher chances for organ rejection. Lifelong immunosuppressive medication. The waiting time for donor kidneys can be long.
Success Rates	Lower success rate than transplant. Also depends on health, age, and dialysis type (hemodialysis vs. peritoneal).	The higher success rate from living donor kidneys than from deceased donors.
Suitability	Ideal for patients with higher risk factors	Ideal for patients for long-term solutions.

Table 02: Comparison of Dialysis and Kidney Transplant

Complications and Risks

Potential Risks or Complications Associated with Hemodialysis

Infection is one of the major complications that may occur when an AV fistula or grafting is done.

This may cause inadequate blood circulation, blood vessel blockage by scar tissues and even the formation of blood clots.

In dialysis, the dialysis needles usually come from the arm of a renal patient or from a tube coming from a dialysis machine.

The blood leak detection system helps notify doctors and other health facility workers to prevent any other adverse outcomes.

It ceases operation occasionally to prevent excessive blood loss to protect the patient from blood loss.

Potential Risks or Complications Associated with Peritoneal Dialysis

Since peritoneal dialysis involves using a catheter to connect with the peritoneum, some individuals are vulnerable to a rise in catheter-related infections.

This may cause peritonitis, an infection that occurs when bacteria enter the abdomen through the catheter; the symptoms include vomiting, nausea, fever, and abdominal pain.

Pumping fluid using an abdominal catheter weakens abdominal muscles over time, resulting in a hernia.

A hernia occurs when one of the organs pushes through the muscle or tissue that is supposed to hold it, especially in the abdominal or groyne region.

It forms a lump between the abdominal and upper thigh, and surgeons may remove it surgically.

While on peritoneal dialysis, the body achieves weight gain from dextrose and other sugar containing substances in the dialysis solution.

Advances and Alternatives in Kidney Dialysis

Latest Advancements in Kidney Dialysis

According to Orlando Research Clinical Center, about 808,000 people in the United States are suffering from end-stage renal disease (EDRD).

Among these, 69% of the population requires dialysis. However, dialysis is a life-saving procedure, and it has essentially remained so for years.

Fortunately, the latest advancements in kidney dialysis technology make the process easier and more accessible.

The recent updates in hemodialysis include an improved dialyzer membrane for better toxin removal, a precise fluid management system, and wearable dialysis devices to increase mobility.

Additional advancements in automation and dialysis sensors also enhance patient safety and treatment procedures.

These are some of the latest advancements in the technology of kidney dialysis treatment methods.

Wearable Artificial Kidney (WAK)

A wearable artificial kidney is one of the exciting developments in dialysis technology.It is a portable battery power design that can easily be worn on a belt.

It is very effective because it provides continuous dialysis, similar to natural kidney function. Its advantages include

Allows patients to move around more freely and be more independent.
It improves the fluid balance of the body and controls metabolism.
It removes the need to use large amounts of dialysis fluid.

Implantable Artificial Kidney

An implantable artificial kidney is another advancement in the treatment of kidney failure. It is a surgically implanted device that works continuously.

It uses the patient's blood pressure for a filtration process that eliminates the need for external pumps. Further research is ongoing to develop and implement it.

It comprises a hemofilter made of silicon nanopore membranes for delicate filtration.

It also contains a bioreactor with cultured renal tubule cells responsible for electrolyte balance. Implantable artificial kidney provide the following benefits:

It eliminates the need for external dialysis treatment.
It provides continuous treatment results that improve outcomes.

Besides advantages, it also has some challenges, like

Biocompatibility and long-term functionality.
Prevention of blood clotting and infection.

Advancements in Haemodialysis

There are more recent advances in hemodialysis for effective treatment and better outcomes. It includes

Hemodiafiltration (HDF): Hemodiafiltration (HDF) combines diffusion and convection to increase faster solute removal. Some studies have shown it to improve cardiovascular outcomes.
High-Flux Dialyzers: The improved membrane technology allows for better removal of middle molecules and shortens treatment duration, resulting in improved outcomes.
Expanded Haemodialysis (HDx): In expanded hemodialysis, medium cut-off membranes are used to remove a wider range of uremic toxins. This has the potential to improve clinical outcomes and quality of life.

Improvements in Peritoneal Dialysis (PD)

The recent advances and improvements in peritoneal dialysis are listed below.

Automated Peritoneal Dialysis (APD) Systems: The APD system introduces advanced cyclers with improved user interfaces and remote monitoring techniques. These systems help integrate data and telemedicine with smartphones for data tracking and telemedicine.
Wearable PD Devices: These wearable PD devices are compact and convenient for continuous ambulatory peritoneal dialysis (CAPD). They improve mobility and reduce the burden of multiple exchanges.
Novel PD Solutions: It provides biocompatible solutions with reduced glucose degradation products, preserving the peritoneal membrane's ability to function better.

Nanotechnology in Dialysis

The nanotechnology in dialysis includes

Nanostructured Membranes: The advancement in nanostructured membranes enhances the selectivity and permeability to remove toxins. This results in reduced dialysis treatment duration and improved efficiency.
Nanoparticle-based Sorbents: They ensure highly specific removal of toxins by using functionalized nanoparticles. They have the potential for targeted removal of toxins, specifically uremic toxins.

Artificial Intelligence (AI) and Machine Learning in Kidney Dialysis

In the world of AI, recent advancements have grown in dialysis technology. It includes

Predictive Analytics: AI algorithms aid in predicting further complications and optimising treatment parameters at an advanced level. It also allows patients to make personalised treatment plans based on individual patient history and diagnosis.
Automated Fluid Management: Machine learning algorithms help with precise control of ultrafiltration, which has the potential to improve hemodynamic stability during dialysis treatment.
Remote Monitoring and Telemedicine: AI-powered systems allow real-time monitoring for home dialysis patients. They also play a major role in the early detection of diagnoses and treatment plans.

Improvements in Vascular Access

Over the past 60 years, dialysis vascular access was restricted only to fistula, graft, and central venous catheter (CVC). The improvements in vascular access over time include

Bioengineered Blood Vessels: A recent development in dialysis access is tissue-engineered vascular grafts, which have the potential to reduce complications and improve the longevity of dialysis procedures.
Novel Catheter Designs: The new technique of vascular access uses novel catheters with antimicrobial coatings to reduce infection risk. The unique and improved designs also reduce thrombosis and improve its flow characteristics.

Portable and Mobile Dialysis Systems

The portable and Mobile Dialysis Systems is another advancement in dialysis treatment that includes

NxStage System One: It ensures a compact hemodialysis system for home and travel use and provides flexibility in treatment schedules and locations.
Tablo Haemodialysis System: This is an all-in-one dialysis machine with a simplified user interface. It is designed for use in various settings, including homes and skilled nursing facilities.

The advancements in dialysis technology are experiencing rapid improvement with new ideas in bioengineering, materials science, and artificial intelligence.

These advancements lead to better, easier, and more comfortable dialysis treatments for patients.

Moreover, wearable and implantable artificial kidneys are changing the way kidney treatment is done, giving patients more freedom and a better quality of life.

Frequently Asked Questions (FAQs)

How Does Dialysis Work?

There are two main types of dialysis: hemodialysis and peritoneal dialysis. In hemodialysis, the blood is filtered with a machine known as a dialyzer.

In peritoneal dialysis, fluid is introduced into the abdominal cavity to absorb waste, which is then removed from the body.

How Often Do I Need Dialysis?

The frequency of dialysis depends on the type. Hemodialysis requires three sessions a week, while peritoneal dialysis is usually performed daily, but it can be done at home while you sleep.

Can I Live a Normal Life on Dialysis?

A person on dialysis can live a normal life, but their energy levels may fluctuate. Many people continue working, exercising, and enjoying hobbies while on dialysis.

What Are the Side Effects of Dialysis?

Common side effects of dialysis are fatigue, muscle cramps, low blood pressure, and nausea. Other symptoms, such as infections or other issues related to the dialysis access point, may also appear over time.

How Long Can Someone Live on Dialysis?

Many people can live for years on dialysis with proper care and balancing life. Life expectancy depends on individual health conditions, age, and treatment process.

Is dialysis painful?

The dialysis procedure is generally not painful. However, some discomfort can occur at the site of dialysis access, where needles are inserted during hemodialysis.

Am I Supposed to Follow a Special Diet on Dialysis?

Yes, dialysis patients are required to follow a specialised diet. They need to restrict sodium, potassium, phosphorus, and fluids.

A renal dietitian helps patients customise a meal plan to suit their specific needs.

Can I Travel While on Dialysis?

Yes, people can travel with proper planning. Peritoneal dialysis allows people to travel. Always coordinate with your healthcare provider before planning a trip.

Summary:

Kidney dialysis allows renal patients to continue their daily activities, remain passionately engaged, and stay connected with their loved ones. It provides a necessary means to filter waste and excess fluids from the body. Renal failure is not the end of life. Dialysis is an affordable treatment method for those facing kidney failure.

While the dialysis process is challenging, many patients adapt to it and find ways to maintain their quality of life. Dialysis is not suitable for everyone, such as those who are much older or have other severe medical conditions.