All You Need To Know About “Renal Dialysis”

Kidneys are among the important organs in our body. These small two bean-shaped organs are located in the renal system. They help our body filter the blood, removing waste and extra water in the process.

The kidneys perform many crucial functions in the body including maintaining fluid balance, regulating minerals from the blood, creating hormones to produce red blood cells and promoting bone health. Kidneys also act as a cleaning agent to filter waste materials from foods, medications and toxic substances.

When kidneys perform lower than 15% of its expected function, you may encounter what we call kidney failure. During the initial stage, people with kidney problem will see no symptoms until the doctor diagnosed them with the disease.

Based on the research by Singapore Renal Registry in 2018, 2.3% of Singapore residents aged between 18 and 69 years old were diagnosed with renal impairment. These numbers have increased from 8.6% in 2010 to 11.3% in 2018. Alarmingly, most of these people are unaware that they have kidney failure.

What is kidney failure?

Kidney failure is alternatively known as end-stage kidney disease. It is a medical condition in which the kidneys no longer function as expected. Confusion, vomiting and feeling tired are some of the tell-tale signs the kidneys are failing to do its job.

What causes kidney failure?

In most cases, health problems such as uncontrolled diabetes lead to failing kidneys. People with uncontrolled high blood pressure, Autoimmune Disease (a condition in which the immune system mistakenly attacks the body), Genetic Disease (kidney problem since birth), Nephrotic Syndrome (kidney disorder that causes the body to excrete too much protein in the urine) and recurrent urinary tract problems are at higher risk of suffering from kidney failure.

What is the symptom of kidney failure?

Early stages of kidney failure gives no obvious signs until symptoms starts affecting one’s health.

The patient may experience nausea, vomiting, a loss of appetite, weakness, increasing tiredness, itching, muscle cramps (especially in the legs) and anemia (low blood count).

The Stages of Kidney Failure

Glomerular is a test used to determine your kidney function. This test is used to measure the level of creatinine (a compound produced by metabolism of creatine and excreted in the urine) and the results will be shown in eFGR or GFR.

There are 5 stages of kidney failure or Chronic Kidney Disease (CKD), from mild damage (stage 1) to complete kidney failure (stage 5). The determination of the stage will depend on how well your kidneys function. You may be advised to see a doctor and undergo a health screening if your experiencing kidney problems.

Stage 1 – Kidney damage eFGR greater than 90.
This stage is known as early damage. Usually, you don’t feel any symptoms at this stage. However, it is still important to see a doctor to get a medical checkup and get health tips on how to prevent kidney damage. On this stage, the kidney is still healthy and working well.

Stage 2 – Kidney damage eFGR between 60 and 89
In stage 2, the kidney problem is still in its mild stage and there’s still no obvious symptoms. However, when the kidney disease is in stage 2, this means that you have unknowingly elevated the kidney damage.

Usually at this stage you would be advised to control blood sugar intake, keep your blood pressure within the range. This can be achieved healthier choices of food by eating less salt, consume healthy foods like vegetables and fruits, do regular exercise, maintain a healthy weight and avoid smoking.

Stage 3 – Kidney damage eFGR between 30 and 59
Stage 3 kidney problem means the kidney is moderately damaged and not working well. It can be categorized into two (2) sub-stages which are Stage 3A (eFGR between 45 and 59) and Stage 3B (eFGR between 30 and 44).

At this stage you may start to feel some discomfort such as back pain, urinating less than normal and swelling in hands and feet.

You are also advised to visit a nephrologist to discuss your treatment plan and with a dietitian about a kidney-friendly meal plan.If you do not control your kidney problem at this stage, it will lead to high blood pressure, anemia and bone disease.

Stage 4- Kidney disease eFGR between 15 and 30
The kidneys are severely damaged at this stage and are not working well. You will be advised to take action seriously. It’s the last stage of kidney disease before having a kidney failure.

Normally, you will experience common symptoms like those you experience in stage 3 including but are not limited to swelling in the hands and feet, having back pain and urinating less than normal.

You will be scheduled for a regular appointment with a nephrologist for the best treatment possible.

This is the stage where the patient should prepare themselves for renal dialysis and transplant.

Stage 5- Kidney disease eFGR less than 15
This is the last stage of kidney disease, a stage when the kidneys completely fail to fully functions. With kidney failure, you will often feel itchy, muscle cramps, nausea, loss of appetite, back pain, urinating less than normal, having sleeping difficulty and breathing problem.

With you kidney failing, you would need to consult your nephrologist to discuss suitable treatment plan, such as undergoing renal dialysis.

What is dialysis?

Dialysis is a clinical way of purifying the blood by removing unwanted substances and extra water – a function that kidneys normal do.

Dialysis is generally advised when the kidneys couldn’t do more than 10% of its normal function. There are two (2) types of kidney failure:

  1. Acute (sudden) – This has an abrupt onset and is likely reversible. Patients with acute kidney failure can undergo dialysis until the kidneys are back to normal.
  2. Chronic (slow-developing and permanent) – This is a complete opposite of the first one and progresses slowly over time leading to permanent kidney failure. Patients with chronic kidney failure can undergo scheduled dialysis.

Kinds of dialysis
Depending on the degree of kidney failure, you’ll be advised to go through either Hemodialysis or Peritoneal dialysis.

  1. Hemodialysis is the most common method where the blood is filtered through a machine. The machine will be attached to the body with a needle. During the treatment, the patient can read, write and/or even sleep.
  2. On the other hand, Peritoneal Dialysis (PD) or dialysis via the abdomen is a type of dialysis treatment which uses your peritoneum as a filter and dialysate, a cleaning solution that absorbs waste and fluid, to clean your blood.

Life expectancy
Life expectancy may vary depending on the patient’s medical conditions. Average life expectancy could be 5 to 10 years, but many patients lived well on dialysis for 20 to 30 years!

What are the side effects of dialysis?

The side effects of dialysis treatment depends on the type of treatment taken. As for Peritoneal Dialysis (PD) treatment, the patient may feel:

  1. Hernia – the feeling of weakness in the muscles due to the insertion of the catheter that is positioned in the body and the dialysis solution that go in and out of the abdomen.
  2. Feeling too full – the feeling of fullness in the stomach impacted by the dialysis solution.
  3. Bloating and weight gain – the weight gain that comes from the sugar in the dialysis solution being absorbed by the body.

While Hemodialysis patients may feel:

  1. Low blood pressure – due to too much fluid removed from the blood during the treatment.
  2. Muscle cramp – caused by the fluid taken out from the body at a fast rate.
  3. Dry skin – caused by the high level of phosphorus in the body.

Other side effects include loss of sexual desire, vaginal dryness and erectile dysfunction. The series of treatments could also impact mental state which makes you feel worried and depressed.

The key thing to addressing kidney problem is to take immediate action the moment you feel irregularities in your body. Don’t hesitate to reach out to a doctor near you for consultation and guidance.

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