An estimated 31 million people in the US, or 10% of the adult population, suffer from kidney disease – making it one of the more common chronic conditions. For patients with chronic kidney disease, the treatment options are either kidney transplants or dialysis.
Dialysis artificially removes waste products and extra fluid from the blood using a tube when the kidneys are no longer able to. The treatment also helps to control blood pressure and to maintain a safe level of certain chemicals in the blood, including potassium, sodium and bicarbonate.
Diabetes is the leading cause of kidney failure, followed by high blood pressure. Other conditions leading to kidney disease and failure include certain autoimmune diseases, such as lupus or IgA nephropathy, and genetic diseases like polycystic kidney disease.
Waiting lists for donated organs are long, and the procedure is extremely invasive. For many patients, dialysis is the optimal choice. Dialysis becomes necessary once patients lose 85-90% of their kidney function and have a glomerular filtration rate of less than 15 and more than 468,000 dialysis patients in the US treated for kidney failure.
Richard R. Teed, M.D., a board certified vascular surgeon with Vascular Specialists of Central Florida, says many of the referrals he sees are for dialysis access. He explains that it’s important for patients to visit a vascular specialist to plan for when they’ll need dialysis before reaching a critical point to ensure maximum effectiveness and minimal disruption.
“Typically we like to see patients six months to a year before we anticipate them requiring the dialysis,” he explains.
As such, it is important for patients to monitor symptoms to identify any kidney-related conditions. Symptoms of kidney disease may include:
- A lower amount or urine than normal
- Swollen legs, ankles and feet from fluid retention due to failure to eliminate water waste
- Unexplained drowsiness and fatigue
- Persistent nausea
- Pain or pressure in the chest
What to Expect from Hemodialysis
Hemodialysis treatment requires visiting an outpatient treatment center three times a week for three to four hours per appointment. Patients will also need to attend appointments before beginning dialysis to ensure their arteries and veins are prepared for the filtration process.
“There are a few ways patients can have their blood filtered for dialysis,” Dr. Teed says. “In an arteriovenous fistula operation we connect the patient’s vein to the artery by sewing them together. Dialysis can begin 90 days after that.”
Another option, he explains, is to use a graft, although he says it’s a bit riskier. “A graft is essentially a synthetic piece of material is sutured between an artery and a vein,” he explains. “While this procedure requires less time before dialysis begins, it comes with a higher risk of infection, and it doesn’t stay open as long as the fistula.”
Once the patient is ready for dialysis to start, the access area will be washed to prepare for the needles that will be inserted to allow the blood to flow in and out. Numbing cream can be administered to the area if the process is uncomfortable. During the first few sessions, it is common to experience nausea, cramping or headaches, but these side effects generally subside after a few visits.
Patients with kidney issues should visit a vascular specialist sooner rather than later if they anticipate needing dialysis now or in the future to ensure they are prepared for the process.