Healthy kidneys are hard workers and filter about a half cup of blood every minute, removing waste and extra fluids from the body. A good balance of water, salts, and minerals in the blood is considered a job well done.
Sometimes kidneys lose their ability to clean blood and can slowly become increasingly damaged leading to a condition called Chronic Kidney Disease(CKD). In many cases, people show no symptoms until the disease has advanced to a much later stage. Which is why early testing is advised. Simple blood and urine tests can detect CKD. People with diabetes and high blood pressure – risk factors for CKD should get tested regularly. Early treatment may prevent CKD from getting worse and usually involves a dietary change and medication.
However, when kidneys lose 90% of their ability to function then we classify it as kidney failure or End-Stage Kidney Disease(ESKD). ESKD is the final, permanent stage of CKD and the patient will need either Dialysis or a Kidney transplant to survive.
In this article we will attempt to bring all the aspects of dialysis and kidney transplant that will help you cope with the situation and choose the one better for you.
Dialysis is a treatment that temporarily takes over the job of a kidney. When kidneys fail to function normally, it stops filtering the blood of its waste. The toxins that build-up in the body can lead to high blood pressure, heart disease, stroke, and early death. Regular Dialysis can help you go on with your life although with varying levels of disruptiveness. Your doctor can help you choose the type of dialysis that is better suited for you.
There are two types of kidney dialysis procedures:
- Haemodialysis: Here, the entire blood is circulated outside the body in a machine or an artificial kidney, also known as hemodialyzer, to filter it from toxins, chemicals and fluid. This is usually done through a minor surgery in the arms or legs to get access to the blood vessels for blood extraction. In general, the procedure may take around four hours and will need to be repeated thrice a week.
Pros and cons: There will be restrictions on the amount of fluids you can drink. A diet plan suitable for the patient will be drawn up by a dietician. On the plus side the patient will have 4 dialysis-free days a week.
- Peritoneal dialysis: In this method, blood is filtered within the body by using the lining of the abdomen, also known as Peritoneum. A few weeks before the procedure a surgeon places a soft tube known as a catheter in the belly. During the treatment, water with salt and additives from a bag are flown into the belly through the catheter until the bag becomes empty. After that the bag is disconnected by placing a cap on the catheter to enable the patient to perform regular activities. The dialysis solution inside the belly absorbs the wastes and extra fluid from the body and is later drained out into an empty bag. This needs to be done 4 to 6 times a day depending on the patient’s requirement.
Pros and cons:Regular visits to a dialysis unit is not required and once trained this can be carried out at home. There are generally fewer restrictions on diet and fluid intake compared with Haemodialysis. But this can vary from patient to patient. It is a big disruptor as it has to be done everyday.
Dialysis can be discomforting and painful for patients since it has to be repeated at regular intervals. Dialysis has its limitations and can cause side-effects because of the way it is done and the fact that it only partially compensates for the loss of kidney function. It can lead to fatigue, low blood pressure, weight gain, muscle cramps, blood clots, infections such as blood poisoning, and even mental conditions such as anxiety and depression.
A lifelong treatment of dialysis can be expensive. A transplant is better as it can give you freedom from the painful and recurrent process of dialysis. provided you are eligible for the transplant. A kidney transplant can improve your quality of life by giving you freedom from dependency on dialysis centres and units. Patients undergoing dialysis cannot travel to places where there are no good dialysis centres. A kidney transplant is also more economical and the price is quite less in India. After a successful transplant you can go back to your normal life and even to physically demanding activities such as swimming. It can also improve your longevity as compared to being on dialysis. As per reports, the longest surviving kidney transplant patient celebrated 50 years of active life post the procedure.
Apart from giving you freedom and a better life quality, transplant makes work and travel easier. It also puts less restrictions on diet and your energy levels are high. However, kidney transplant needs proper care and long-term health management post surgery. It is a major surgical procedure and is not devoid of risks during or after the surgery. It may cause infection, bleeding, damage to surrounding organs, and even death in some rare cases.
There are certain health conditions like severe obesity, history of cancer, drug abuse, diabetes, poor compliance with medications, etc., that can prevent you from easily getting a kidney transplant done.
In India, due to the lack of organ donation awareness and other legalities associated with the transplant, getting a kidney is the biggest challenge.
However, despite all this the current success rate of kidney transplants in India stands at 90%. A key factor is choosing the right hospital, the expertise of the surgeons, and the post-operative care they provide.
Regular check-ups and maintaining a healthy lifestyle can help stem the progression of CKD. A well-balanced diet, adequate water intake, limited salt and sugar intake, regular exercise, and timely check ups will help. However, if you are diagnosed with severe or end-stage kidney disease or failure then a transplant can be a much better option over dialysis.
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