Dialysis is a procedure used to treat kidney patients. When the kidneys fail to work properly, dialysis is often used to eliminate waste products and excess fluid from the blood. Dialysis functions as artificial kidneys, it does the job of kidney failure patient’s kidneys which cannot get rid of the toxic substances that it usually does. It involves transferring blood to a machine for the cleaning process and giving blood back to the body. The kidneys normally filter the blood, eliminating toxic waste materials and excess fluid and converting them to urine, which is then transported out of the body.
Table of Contents
Your kidneys may not be able to clean your blood effectively if they are not performing properly, such as if you have advanced chronic renal disease (kidney failure). In your body, waste materials and fluid can accumulate to harmful levels. If left untreated, this can result in death. To prevent these issues, dialysis is performed. Dialysis removes undesirable chemicals and fluids from the blood. Dialysis helps in maintaining fluid homeostasis.
As already stated, Dialysis is a process of removing the toxic products and extra electrolytes. The dialysis mainly acts as filters that filter blood. As it does the job of the kidneys, it removes excess fluid and waste from the blood. The waste products which are removed by the membranes in the machine are nitrogen, urea, and creatinine. Electrolytes are involved in many major physiological functions.
Electrolytes can be defined as minerals that have a charge in them. They are involved in many functions like body fluid balance by renin-angiotensin system, maintaining pH of the blood, heart muscle contractions, etc., The most common electrolytes include sodium, calcium, and potassium. In plasma, the concentration of sodium is 137 to 142 mEq/L (Portion of blood without blood cells – RBC, WBC, and platelets).
When Dialysis is Needed?
- Dialysis is needed when one is diagnosed with end-stage kidney disease that is kidney failure.
- Kidney failure is a stage where the kidneys become nonfunctional.
- Kidney function is measured using glomerular filtration rate abbreviated as GFR.
- Normal GFR is 90 to 120 mL/min filtering 180 liters in one day. When the GFR rate goes down the kidney function is gradually losing.
- When the GFR goes below 15 it is so critical and the patient needs dialysis.
- The frequency of dialysis is normally 3 times in a week.
- The frequency can also depend upon urine output, cardiac function of the patient.
- The patient should never stop dialysis until he/she receives kidney transplantation.
Types of Dialysis
Majorly dialysis is of two types namely
As the name suggests the dialysis is performed on blood (Hemo- demonstrating hemoglobin a part of RBC in the blood). This is one of the most prevalent types of dialysis and the one that most people are familiar with.
- Blood flows through the tube and into an external filtering machine before being returned to the arm via another tube. An external filtering machine removes the waste products from the body.
- This is commonly done three times a week at dialysis centers, with each session lasting around four hours.
- But the frequency and time depend upon the patient to patient depending upon the severity. The nephrologist usually predicts the time based on the GFR (Glomerular filtration rate).
- Hemodialysis involves removing blood from the body and filtering it through a membrane (dialyzer) before returning the filtered blood to the body.
- The dialyzer is sometimes also called an artificial kidney. The normal individual has 4 to 5 liters of blood; however, during dialysis, just 500ml of blood is removed from the body at a time.
- This avoids fluid imbalance and maintains fluid homeostasis. To execute hemodialysis, a tube must be established to transport blood from the body to the dialyzer and back.
Hemodialysis access is divided into three categories:
- Arteriovenous (AV) fistula, The AV fistula is the most popular vascular access option among dialysis patients. When a patient undergoes hemodialysis, a dialysis technician will take their vital signs and weigh them. The patient’s weight growth will determine how much excess fluid needs to be evacuated during treatment
- AV graft, A patient having vascular access (AV fistula or AV graft) will have two needle sticks in their access; one needle will remove blood from the body and the other will return it.
- and Central venous dialysis catheter, The two tubes from the central venous catheter will be attached to the blood tubes that lead to the dialyzer and return to the body in patients who have a central venous catheter.
The peritoneum is a membrane that is filled with a sterile liquid called peritoneal fluid. This method filters the blood in a different way than hemodialysis, which is a more prevalent blood-filtering procedure. A cleansing solution travels through a tube called a catheter and is inserted into a section of your abdomen during peritoneal dialysis.
- Your abdomen’s lining which is commonly called the peritoneum that functions as a filter, removing waste items from your blood.
- The fluid containing the filtered waste items flows out of your abdomen and is eliminated after a certain amount of time. These treatments can be performed at home, at work, or on the road. However, not everyone with renal failure can benefit from peritoneal dialysis.
- The catheter that transports the dialysate in and out of your abdomen will require surgery to place it in your abdomen. Dialysate is a solution containing electrolytes and other salts mixed with sterile water for injection used for dialysis purposes.
- The procedure can be performed under local or general anesthesia. Typically, the tube is put near your belly button.
- After the catheter is inserted, your nephrologist will most likely advise you to wait up to 2 weeks before beginning peritoneal dialysis treatments to allow the catheter site to heal.
- You will also be taught how to operate the peritoneal dialysis machine (Automated peritoneal dialysis machine).
- After the healing period is over the procedure for dialysis begins. The dialysate is injected into your belly and stays for a set amount of time (dwell time), which is usually four to six hours.
- The dialysate’s dextrose helps filter trash, toxins, and surplus fluid from your blood through tiny blood vessels in your stomach cavity’s lining.
- When the dwell time is up, the solution drains into a sterile collection bag, along with waste materials taken from your blood. Exchange is the process of filling and then draining your abdomen. Distinct peritoneal dialysis methods have different exchange schedules. Depending upon the schedules peritoneal dialysis is divided into two types:
You fill your abdomen with dialysate, leave it there for a set amount of time, and then drain it. The fluid is moved through the catheter and into and out of your abdomen by gravity. With CAPD, you can:
- Three to five exchanges during the day and one with a prolonged dwell period while sleeping may be required.
- You can exchange at home, at work, or anywhere else that is clean.
- While the dialysate is in your abdomen, you can go about your daily activities.
This approach, also known as automated peritoneal dialysis (APD), uses a machine (automatic cycler) to make numerous exchanges while you sleep at night. This cycler fills your abdomen with dialysate liquid which is employed in dialysis, the dialysate will be left there for a while, then drained into a sterile bag that you empty in the morning. With CCPD, you can:
- At night, you must stay connected to the machine for around 10 to 12 hours.
- During the day, you are not linked to the machine. However, you begin one exchange in the morning with a dwell period that lasts the entire day.
- Because you connect and disconnect from the dialysis equipment less frequently than with CAPD, you may have a lesser risk of peritonitis (Inflammation or redness in the peritoneum).
- The nephrologist decides which schedule is best for you based on your residual renal function, urine volume, swelling and peritoneal membrane efficiency.
- And also, the nephrologist can modify the schedule according to you.
- Test for peritoneal equilibration (PET) is done to examine patients receiving peritoneal dialysis.
- During a dialysis exchange, this test compares blood and dialysis solution samples. The results show whether waste poisons from your blood flow fast or slowly into the dialysate.
- This information can be used to see if your dialysis would be better if the solution stayed in your abdomen for a shorter or longer period.
Although both hemodialysis and peritoneal dialysis can successfully filter your blood, peritoneal dialysis has the following advantages over hemodialysis:
- More freedom and flexibility in one’s lifestyle. If you work, travel, or live far from a hemodialysis center, these are extremely crucial.
- A diet with fewer restrictions. Peritoneal dialysis is done more often than hemodialysis, resulting in less potassium, sodium, and fluid buildup. This permits you to eat more freely than you could if you were on hemodialysis.
- A residual renal function that lasts longer. Peritoneal dialysis patients may keep their kidney function for a little longer than hemodialysis patients.
If you have peritoneal dialysis, you must avoid:
- Certain prescription and over-the-counter medications, such as NSAIDs (nonsteroidal anti-inflammatory drugs like aspirin, ibuprofen, etc.,), might harm your kidneys.
- Swimming in a lake, pond, river, or ocean, or a non-chlorinated swimming pool, or soaking in a bath or hot tub that increases the risk of infection. Patients are advised to swim in a chlorinated swimming pool. Chlorine acts as a disinfectant and kills the microbes in the pool.
Which Type of Dialysis is the Best?
The type of dialysis you are going to perform depends on your medical condition. The nephrologist will examine you keenly and suggest you a valid dialysis plan and also routine checkup is necessary for schedule change. Generally, for a serious patient, emergency conditions like pericarditis, convulsions, fluid overload, severe metabolic acidosis and high potassium levels hemodialysis is performed. In patients where some residual function of kidneys left can be under peritoneal dialysis.
If you have any of the following conditions, peritoneal dialysis may be the better option for you:
- Cannot stand the frequent shifts in fluid balance that come with hemodialysis.
- Want to keep your routine as unaffected as possible? The risk of getting affected is less
- Want to make it easier to work or travel? So, it can be carried easily at home
- Have some renal function left so that peritoneal dialysis can match it.
If you have any of the following conditions, peritoneal dialysis may not be an option for you:
- You have a lot of surgical scars on your abdomen.
- A wide area of abdominal muscular weakness (hernia)
- A lack of caring help or a limited ability to care for yourself
- Inflammatory bowel disease (IBD) or repeated bouts of diverticulitis are two common causes of diverticulitis.
- Peritoneal dialysis patients are also more likely to see a reduction in kidney function over time, necessitating hemodialysis or a kidney transplant later on.
Peritoneal dialysis also has some disadvantages:
- no days off
- The catheter may affect body image
- Potential for weight gain due to glucose (sugar) in the dialysis fluid
- Blood glucose is difficult to control in diabetes because of the sugar in dialysate.
- Storage space is required at home for supplies and fluid.
- Hence the peritoneal dialysis is suited for patients with mild kidney failure, also if peritoneal dialysis continues the kidney functions can become worse or need hemodialysis.
Advantages of dialysis
- For people with end-stage renal illness, hemodialysis is an effective therapy option.
- Hemodialysis, on the other hand, is not a full treatment for patients with renal failure. Diet and fluid limits must be adhered to, and medications may be required to replace other activities of the kidneys, such as blood pressure regulation and red blood cell stimulation to prevent anemia.
- Those who select in-center hemodialysis benefit from the fact that their treatments will be administered by skilled specialists in a dialysis center.
- They can use their dialysis time in a way they can feel relaxed like reading books, watching movies, or simply sleeping, etc.,
- Those who do nighttime hemodialysis (either at a center or home) say that this feeling of being washed out is less common.
- Furthermore, because nocturnal dialysis is administered during nonproductive sleeping hours, many people remark that their lives are more normal now that they don’t have to schedule dialysis appointments during the day.
- People who opt to do their hemodialysis at home claim it gives them a sense of control over their lives. They can schedule hemodialysis around their schedule rather than traveling to the dialysis center at a specific hour.
- Studies demonstrate that undergoing hemodialysis at home 5-7 times a week has a significant positive impact on all aspects of life, including longevity and survival.
- You and your dialysis partner learn to perform treatments independently of the dialysis center’s staff.
- Dialysis can be performed in the privacy of your own home. There is no need to travel to a dialysis center, and you may do dialysis whenever it’s convenient for you.
- Being self-sufficient and performing treatment on your own gives you a greater sense of control.
- More flexibility and mobility
- Continuous dialysis can improve one’s well-being by making travel easier.
- There is no need for a machine when compared to hemodialysis
- There may be fewer dietary and hydration limitations.
- There are no needles necessary.
- It is possible to live a longer and healthier life when compared with haemodialysis patients.
- It is possible to use it as a stopgap measure before undergoing a kidney transplant.
- Vessels can be preserved for future hemodialysis access.
- PD is daily; however, it takes less time in the long run than coming to a facility (when you consider traveling to and from the center, waiting, recovery time).
Disadvantages of Dialysis
Side effects are common with both hemodialysis and peritoneal dialysis. This is due to the way dialysis is performed and the fact that it can only compensate for a portion of renal function loss. The common side effects of both types of dialysis include fatigue and loss of the kidney’s endocrine function.
Fatigue, or feeling tired and exhausted all of the time, is a typical side effect among persons who use dialysis for an extended period. Fatigue is believed to be produced by a combination of the following factors:
- kidney function deterioration
- The consequences of dialysis on the body
- Dialysis patients are subjected to dietary restrictions.
- Many persons with renal failure experience general tension and worry.
- You should consult a dietician to determine whether your diet may be changed to boost your energy levels.
- Exercise regularly may also be beneficial. Starting a regular workout regimen when you are tired and on dialysis can be difficult.
- However, if you stick with it, you’ll discover that exercising becomes simpler over time.
- Cycling, running, walking, or swimming are all good low-to-moderate aerobic exercises.
- A GP or the dialysis care team will be able to advise you on the best sort of exercise for you
- The endocrine system also includes our kidneys.
- Like pancreas, thyroid, parathyroid, etc., are some of the examples.
- Endocrine glands are the group of organs in the body that produce hormones that do not act on the site of secretion, rather act on the site which are away from the site of secretion.
- For example, the pancreas produces insulin which acts on every cell in the body like muscle cells, adipocytes, etc., Endocrine glands differ from exocrine glands in which the site of action is near the site of secretion.
- The kidney produces and releases hormones into the bloodstream, regulating certain physiological functions. Your kidneys may generate very little or no hormones if they are damaged.
- Unfortunately, dialysis is incapable of replacing or producing these substances.
- Medication will be required to replenish these in the body.
- Examples of the hormones produced by the kidney are calcitriol, erythropoietin, renin, etc.,
- Calcitriol helps in calcium absorption from the food you eat. Even if you take calcium supplements, your body would not be able to get adequate calcium without this hormone.
- Calcium deficiency can cause bones to become brittle and weak. So, long-term dialysis may lead to calcium deficiency which can cause many serious effects.
- Erythropoietin stimulates the bone marrow to produce red blood cells (RBC).
- These are cells that carry out oxygen transportation.
- Your body lacks physiological functions without oxygen, which results in anemia.
- The main function of renin is to keep blood pressure in check.
- Some CKD patients, however, produce too much renin.
- Blood pressure can rise if you have too much renin.
- If you already have high blood pressure, having too much renin in your system can make it worse.
- The second most common cause of CKD is high blood pressure.
- It can also hasten the deterioration of the kidneys.
- Dialysis is the most common treatment for patients with advanced chronic kidney disease.
- To replace enzymes and hormones, however, more medicine may be required. It is critical to follow your health care team’s treatment recommendations. The treatment of your kidney’s absence of renal and endocrine functioning is critical to your overall health.
- Low blood pressure
One of the most prevalent side effects of haemodialysis is low blood pressure (hypotension). The decline in fluid levels during dialysis can cause it. Nausea and dizziness are symptoms of low blood pressure. Maintaining your daily fluid consumption requirements is the greatest strategy to reduce these low blood pressure symptoms. If your symptoms persist, speak with your nephrologist because the volume of fluid used during dialysis may need to be modified.
People who use haemodialysis are more likely to acquire sepsis (blood infection). Bacteria infiltrate the body and propagate through the bloodstream, potentially causing multiple organ failures. Dizziness and fever are both warning signs. If you have a high temperature, call your nephrologist right away for help. If you acquire sepsis, you’ll need to go to the hospital and be given antibiotic shots.
- Muscle cramps
Muscle cramps, commonly in the lower thigh, are common during haemodialysis. The muscles may be affected due to the fluid loss that occurs during haemodialysis. If your muscle cramps become very painful, contact your dialysis care team. You may be able to get medication to help you deal with the symptoms.
- Itching of skin
The build-up of minerals in the body between dialysis treatments causes itchy skin in many patients who receive haemodialysis. If your skin gets itchy, notify your healthcare provider. They may suggest treatments to calm and hydrate your skin.
- The fact that they will have to travel to and from hemodialysis three times a week is one of the disadvantages, as is the fact that traveling and arranging for dialysis in a visiting dialysis clinic requires previous notice.
- Limiting meals high in phosphorus, potassium, and sodium, as well as consuming only a little amount of fluid, are among the dietary limitations.
- After hemodialysis, some people report feeling “washed out” and go home to nap.
- Painful as needle pricking is required.
- Chances of bleeding as blood thinning medicines are being used during hemodialysis.
- Erectile dysfunction
- Bone and joint pain
- Dry mouth and anxiety
- Peritonitis (Inflammation of peritoneum)
If the dialysis equipment is not kept clean, peritonitis might develop. Bacteria can spread to the peritoneum, the thin layer of tissue that lines the lining of the abdomen if bacteria are present on the equipment. Keeping your dialysis equipment clean is the most effective approach to avoid peritonitis.
Peritonitis can cause the following signs and symptoms:
- stomach ache
- fever, feeling nauseous, and getting chills,
- used dialysis fluid becoming murky
If you acquire these symptoms, contact your dialysis unit right away. Antibiotic injections are used to treat peritonitis.
Abnormal bulging of an organ that is usually visible near the abdomen. Peritoneal dialysis patients have a higher chance of getting a hernia. This is because keeping fluid in the peritoneal cavity for long periods puts a strain on the abdominal muscles. The presence of a lump in your abdomen is the most common symptom of a hernia. It’s possible that the lump is painless and will only be noticed during a routine check-up. Certain activities, such as leaning down or coughing, can trigger the lump to form in certain people. A hernia usually requires surgery to repair. The surgeon will reattach the protruding tissue to your abdominal wall during surgery. A synthetic mesh can also be used to strengthen the muscles of the abdominal wall.
- Weight gain
Sugar molecules are present in the dialysate fluid used during peritoneal dialysis, and some of them are absorbed by your body. This can increase daily calorie consumption by several hundred calories. You will likely gain weight if you don’t compensate for these extra calories by lowering your calorie intake and exercising regularly. If you are concerned about gaining too much weight, speak with your dialysis team, who can help you develop a diet and activity plan. Avoid fat diets that promise to help you lose a lot of weight in a short amount of time. Extreme dieting like this can mess with your body’s chemistry and make you sick.
Will Dialysis Help Cure Kidney Disease?
The answer to this question is NO, it cannot cure kidney disease. It is just a procedure to replace a function of the kidneys that is filtering the blood. Dialysis helps your kidneys accomplish some of their work, but it does not cure your kidney illness. Unless you can have a kidney transplant, you will need dialysis treatments for the rest of your life.
In acute renal failure, the kidney’s function is restored but until then dialysis should be performed. Dialysis can be stopped once your kidneys recover. However, chronic renal failure ultimately needs a kidney transplant. Because a kidney transplant is not usually possible right immediately, dialysis may be required until a suitable donor kidney becomes available.
The equipment used for dialysis is called dialyzers. They are generally made out of a polyurethane capsule or shell that contains hollow fibers or parallel membrane plates. Blood and dialysate flow through the fibers or plates, which act as a semipermeable membrane. Between the patient’s intravascular compartment and the dialysis fluid, diffusion occurs for smaller molecules where solutes move across the membrane along a concentration gradient and convection for larger molecules that is solvent drag. Hemodialysis cleans the blood mostly through diffusion. The fluid is removed by a dialysis machine-generated hydrostatic pressure gradient across the dialyzer membrane. The dialysis machine records blood flow, blood pressure, the amount of fluid evacuated, and other crucial data.
The dialysate (consisting mainly of electrolytes and sterile water for injection) is a fluid bath that goes into the dialyzer, and it is mixed here. This fluid aids in the removal of toxins from the blood, after which the bath is flushed.
- Hemodialysis Machine
The blood pump on the dialysis machine keeps the blood moving by providing a pumping action on the blood tubes that convey blood from the body to the dialyzer and back. The dialysis equipment also includes several safety features. You will very certainly hear some of the warning sounds emitted by a dialysis machine if you visit a dialysis center.
Is Dialysis Expensive?
Yes, it is expensive. It costs approximately 50000 INR per month which is for 3 times a week. The cost also depends upon the city and hospital in which your dialysis is performed. In Delhi, the maximum cost for dialysis may reach up to 6000 INR for a sit up, When the frequency and the number of dialysis sit ups increase the cost also increases. But mostly if the patient is insured, the dialysis amount can be reimbursed by insurance companies.
While availing of general health insurance check whether it includes dialysis in its cost. It helps financially to the kidney patients, and also it stops quitting dialysis for no money. Spending 50000 INR for a month increases the burden of the patient, Kidney transplantation is the best choice that can help the patient financially and mentally. Until a person gets a donor dialysis is needed.
How Long do I Need Dialysis?
When you are a chronic kidney failure patient, you need to continue till you get kidney transplantation. You will be completely dependent on dialysis once you start it. Some of the points to delay your dialysis onset are:
- Eat well and you’ll lose weight.
- Exercise regularly
- Smoking is not permitted.
- Excess salt in your diet should be avoided.
- Maintain a healthy blood pressure level
- Diabetes must be managed.
How To Stop Dialysis Naturally?
Some persons have recovered renal function after being diagnosed with ESRD. This recovery could occur in up to 8% of the population. These people were able to quit dialysis without developing uremia, a condition in which toxins accumulate in the blood and lead to death. Patients who have recovered in this way have been on dialysis for an average of two years, however, lengthier periods of dialysis have been observed.
Do Dialysis Patients have to control their Diets?
Your nutrition is a crucial component of your treatment. Because your kidneys are unable to remove enough waste items and fluids from your blood, your body now requires special attention. As a result, you’ll need to limit your fluid intake and alter your diet slightly. Your dialysis center’s kidney dietician will assist you in creating a diet tailored to your specific needs.
Some of the points to be remembered when planning your diet
- Increase your intake of high-protein foods. Dialysis patients must consume extra protein. Protein can help you maintain a healthy blood protein level and enhance your overall health. Protein also aids in the maintenance of muscle mass, the speedy healing of wounds, the strengthening of the immune system, and the improvement of general health. Every meal should include a high-protein item like meat, fish, poultry, fresh pork, or eggs (WARNING: Even though peanut butter, nuts, seeds, dry beans, peas, and lentils are abundant in protein, they are typically limited due to their high potassium and phosphorus content).
- Reduce your intake of high-sodium, high-potassium, and high-phosphorus foods. Reduce your salt intake and consume less salty meals to help manage your blood pressure. Salt stimulates thirst and leads the body to retain (or hold on to) fluid, thus it may assist minimize fluid weight gains between dialysis treatments.
- Find out how much fluid you may safely consume (including coffee, tea, water, and any food that is liquid at room temperature).
- To help you reduce your phosphorus consumption, avoid “whole grain” and “high fiber” foods (such as whole-wheat bread, bran cereal, and brown rice). You can safeguard your bones and blood vessels by reducing dairy-based meals.
- All varieties of milk – skim, low fat, and full – contain the same amount of phosphorus! If you do eat high-phosphorus meals, supplement with a phosphate binder.
How long a Person Lives on Dialysis?
Life expectancy will vary on the patient’s medical conditions and the way a patient follows your treatment set up. The average life expectancy is 5-10 years; however, several patients have lived for twenty to thirty years. Dialyzing frequency depends on the amount of kidney damage, amount of fluid gain, the weight of an individual, etc., A patient undergoing dialysis may die due to several reasons, but health care is focusing on minimizing the death rate in dialyzing patients and give a more life expectancy to the dialyzing patients. And it gets succeeded by the development of a more complex and safe dialyzing unit. The race is still on till life expectancy reaches the maximum i.e., matches with the life expectancy of a normal person. We will succeed.
Where is Dialysis Done?
- Hospitals or dialysis unit
Dialysis is done on a dialysis unit in a hospital. Certain multi-specialty hospitals have a big dialysis unit.
Hence also dialysis can be performed at home. Home dialysis may be a viable treatment choice for you if you are a highly motivated dialysis patient who wants to keep an active lifestyle and take more responsibility for your care. Nephrologists will teach you how to perform dialysis in home, as well as any medical risks associated with it. Naturally, your nephrologist will use his or her professional judgment to decide if you are a good candidate for home dialysis and will help you make an informed decision based on your unique circumstances.
Best Nephrologist for Dialysis
Our nephrologist Dr. Rajesh Goel has helped many patients in getting their dialysis and worked a lot to benefit them. In Delhi, he is the primary option for many renal patients. This makes Kidney Care Centre clinic in Delhi NCR having the BEST NEPHROLOGIST IN DELHI
Dialysis in Pregnancy
Because renal illness can reduce the capacity to generate healthy eggs that can be fertilized, over 90% of women of reproductive age on dialysis are unable to conceive. Furthermore, some dialysis patients may not menstruate or have irregular periods. This is caused by the body’s hormone level irregularity. In women with end-stage renal illness, pregnancy is unusual.
Women on dialysis have a poor fertility rate, and nephrologists commonly advise women with ESRD (End stage renal disorder) to avoid pregnancy. Advances in dialysis and obstetric treatment have resulted in higher live birth rates in dialysis patients, making pregnancy for young women with ESRD more possible and safer. These pregnancies, however, are nonetheless high-risk for both maternal and fetal problems, needing multimodal treatment.
Most Frequent Questions and Answers
Dialysis is a procedure done to renal failure patients, in which blood is filtered using a dialyzer where it removes the toxic compounds/metabolites, excess amount of water, excess electrolytes and functions as an artificial kidney.
Dialysis is done on a dialysis unit, nowadays dialysis is also performed at home in some cases.
No, it’s not uncomfortable. But still may result in fatigue, muscle cramps etc.,
Yes, they feel normal and can be engaged in all the routine works
Yes, with the advice of his/ her nephrologist. Should be aware of the nearby kidney centre.
Yes, they can continue but to get dialysed on time.