Dear Doctors: A close friend of our family is on the kidney transplant list and undergoing hemodialysis. Could you please explain what that means? Both his wife and I want to help, but we don't want to bother him with too many questions.
Note to readers: Your kidneys play several important roles in maintaining your health and well-being. Perhaps best known for its role in filtering blood as it circulates through the body. Healthy kidneys process about one cup of blood every two minutes, removing waste, salts, toxins, and excess body fluids. The final product is urine, which is sent to the bladder for storage and release.
When kidney failure occurs due to illness or injury, dialysis becomes necessary. This is a treatment that helps the kidney's filtration function. The most common is hemodialysis, which is the treatment your friend is undergoing. This is a medical intervention that takes over the task of filtering waste and excess water from the blood with the help of a machine that acts as an artificial kidney.
To undergo hemodialysis, a minor surgery is required to create a path for blood to travel from your body to the machine and back. This route is called hemodialysis access. The specific type of access used will depend on how long you expect to receive dialysis. For short-term dialysis, a catheter is inserted into a blood vessel in your chest, leg, or neck. A more permanent approach involves surgery to connect an artery and vein, often in the arm or wrist, using an implanted catheter. When two blood vessels join together, blood flows faster and more impurities can be removed in a shorter amount of time.
During dialysis, blood leaves the body through a needle, travels through flexible tubing and through an artificial kidney known as a dialyzer. Dialyzers contain a semipermeable membrane and a special fluid that work together to filter out waste products such as urea, potassium creatinine, and excess fluid. Larger components of blood, such as blood cells and proteins, cannot pass through the membrane. They are passed back into the body through another needle. Sessions usually last 3-4 hours and are carried out 3 times a week.
Undergoing dialysis can be physically challenging. Side effects can occur if too much body fluid is removed during treatment. These include muscle spasms and low blood pressure that cause dizziness and nausea. Some people may experience dry or itchy skin. Fatigue and tiredness are also common. Treatment and the circumstances that necessitate it are often emotionally taxing as well.
By understanding the scope and impact of dialysis, you and your wife can help your friend in a truly helpful way. This includes traveling to and from appointments, being present during sessions, participating in pet and child care schedules, doing yard work and cleaning the house, and simply being available to listen. People living with serious health conditions often feel lonely, and even the smallest actions can help.
Eve Glazier, MD, MBA, is a physician and associate professor of internal medicine at UCLA Health. Elizabeth Coe, MD, is an internal medicine physician and assistant professor at UCLA Health. Send questions to [email protected] or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Due to the volume of emails we receive, we are unable to respond personally.
