Statistics on how long people live on hemodialysis. What is hemodialysis. Methodology and necessary conditions

When the functioning of internal organs in the human body is disrupted, medical intervention is required. Kidney dialysis is prescribed when the kidneys stop functioning normally and removing toxic substances and toxins from the body. When is this procedure prescribed and what are the indications for it, how long does the method last, and what recommendations should the patient follow in order to improve the condition?

General information

Kidney dialysis is a method by which a person with problems with the normal functioning of the kidneys uses a machine that performs the functions of removing fluid and waste products from the body and blood. The hemodialysis procedure is prescribed and performed only after a thorough diagnostic examination and an accurate diagnosis. Dialysis does not heal the kidneys or eliminate inflammation. It performs the function of the kidney and helps get rid of unnecessary waste products that are carried by the blood throughout the body.

Indications for use

With timely detection of the pathology of renal failure and adequate treatment, organ functions are restored. Blood flow in the organ is normalized and it is able to filter and pass fluid and blood through itself. In this case, hemodialysis is not performed and is cancelled. Such situations occur when renal function is damaged by exposure to large doses of toxic substances, after an infectious disease or bacteriological complication, in which renal failure develops.

In more complex situations, the kidneys reduce their efficiency, resulting in the development of chronic renal failure. This leads to the accumulation of many toxic and poisonous substances in the blood, which lead to intoxication of the body and the patient becomes ill. In this case, it is impossible to restore the functioning of the organ. Renal hemodialysis is prescribed in the following cases:

• for acute and chronic renal failure;
• in case of poisoning with alcohol and other toxic substances;
• in case of poisoning with pesticides and toxic chemicals;
• in case of mushroom poisoning;
• in case of poisoning with heavy medications;
• when there is an imbalance of electrolytes in the body.

Types of kidney dialysis

With severe kidney pathologies, people live as long as possible to resort to dialysis. This procedure is not cheap, but in modern medical institutions it is possible to perform hemodialysis for ordinary people. There are types of dialysis such as peritoneal and hemodialysis. Which method is more preferable is determined by the attending physician, since both peritoneal and hemodialysis have their advantages and contraindications. Let's take a closer look at the characteristics of the types of kidney dialysis.

Hemodialysis

Hemodialysis is carried out using a special machine called a dialyzer, which filters the blood. Circulating blood enters a device in which excess salts, toxins and waste are separated from it, and then in its pure form enters the main bloodstream. Hemodialysis lasts about 6 hours and, depending on the state of organ failure, is carried out at least 2 times a week. The number of times to use this type of dialysis is decided by the attending physician.

The hemodialysis procedure is performed at home, the person does not need to be in the hospital, in addition, you can control the duration of the procedure yourself, while getting a better effect. It is convenient and costs less; the patient does not have to constantly travel to the hospital. For the first time, a tube is inserted into a person through a vein through which blood will circulate. This method is used when the duration of hemodialysis is short. With the development of kidney failure, when the need for dialysis increases, a special fistula is made through surgery, which helps to gain painless access to the vein.

Peritoneal dialysis involves a surgical intervention in which a section of the abdominal cavity is dissected and the person is connected to a machine that will filter the blood. With peritoneal dialysis, there is no danger that bleeding will begin to develop, since the blood vessels are not damaged, and the additional load on the heart does not increase, as happens with hemodialysis.

More than 1.5 liters of special liquid is poured into the abdominal cavity using a catheter. Further, after some time it is removed from the body along with toxins and harmful impurities. There are 2 methods of peritoneal dialysis - continuous outpatient and automatic, which have differences in implementation. With continuous peritoneal dialysis, the solution is introduced into the human body for 6-10 hours, then it is removed, and then the abdominal cavity is filled again. This is done 3 to 6 times a day. Automatic peritoneal dialysis involves changing the solution only at night, while the person experiences minimal discomfort.

Methodology and necessary conditions

If kidney dialysis is performed using an artificial machine, then this procedure is carried out only in a hospital. The amount and duration of dialysis is prescribed by the attending physician, depending on the patient’s health condition. If the patient has developed chronic kidney failure, then the procedure is performed at least 3 times a week. The device that performs the function of the kidney is: a system for pumping blood; a device that injects a special solution into the body (the liquid may have a different composition, depending on the person’s health status); a system of membranes that filter blood. When the blood is purified, it enters the human body again.

Diet for dialysis

In order for dialysis to be effective and a person to feel normal, you need to maintain a drinking regime and follow a diet. The amount of liquid drunk per day is regulated by the attending physician, since the condition of the genitourinary system must be strictly taken into account. The diet involves reducing the amount of salt consumed. The menu should be rich in proteins, fats and carbohydrates. Fatty meats and broths based on them, sweets and sweet pastries, sweet soda, black tea, pasta, white bread, spicy and fatty sauces and seasonings, and mayonnaise are excluded from the diet. The menu should be dominated by vegetarian food with an abundance of fruits and vegetables, which are prepared using a minimum amount of fat. It is useful to eat vegetable soup, use honey and dried fruits instead of sweets, replace white bread with whole grain bread, and ordinary clean water is suitable for drinks.

Complications and their prevention

More often, complications of this procedure appear after the first procedures, then the body gets used to it and the person does not experience such discomfort. Dialysis causes complications such as nausea and vomiting, blood pressure decreases, red blood cells decrease due to cleansing procedures, and the patient suffers from anemia, which manifests itself as dizziness, weakness, loss of consciousness, headaches, and arrhythmia.

The peritoneal method of dialysis causes a complication in the form of peritonitis, when inflammation of the abdominal cavity occurs with the addition of a bacterial infection. This provokes disturbances in the functioning of the excretory system, which worsens the situation and the patient’s well-being. Complications are caused by the development of a hernia on the peritoneal organs. To avoid serious complications, you must strictly follow the doctor’s recommendations and instructions, and if your health changes, immediately notify you.

Hemodialysis of the kidneys and blood is an efferent method of extracorporeal detoxification of the body. It is carried out using a device called an “artificial kidney”. It is used to cleanse the blood of electrolytes and nitrogenous waste in cases where the kidneys cannot cope with this work.

The basis of hemodialysis is the exchange of substances through a semi-permeable membrane, which is washed on one side by the blood flow and on the other by the dialysate solution. A hydrostatic pressure gradient is created between the dialysate fluid and the blood, with the help of which excess fluid is removed from the body by ultrafiltration. In the same way, harmful substances and metabolic products are removed from the blood.

The machine used for hemodialysis consists of three main components:

1. blood supply device
2. dialyzer,
3. devices for supplying and preparing dialysate solution.

Using a roller pump, blood is pumped through tubes into the dialyzer. Devices that measure the rate of blood flow and its pressure are attached to this system. The optimal blood flow is considered to be 300-450 ml per minute. After preparation, the dialysate solution enters the dialyzer from a dispenser or reservoir. In most machines, the dialysis solution passes near the membrane once at a speed of approximately 500 ml/min in the opposite direction to the blood flow.

The composition of the dialysate solution is similar to blood plasma. Depending on the level of electrolytes in the blood, the composition of the solution can be adjusted. Most often it is necessary to change the concentration of potassium, but the content of chlorine, calcium and bicarbonate, as a rule, remains at a constant level. To regulate the amount of fluid removed from the blood, the sodium concentration in the dialysate solution is reduced or increased.

Indications for hemodialysis

Hemodialysis is not prescribed for every disease: the indications for its implementation are strictly defined. These include the following conditions:

• acute and chronic renal failure;
• alcohol poisoning;
• serious changes in blood electrolytes;
• drug overdose;
• intoxication with poisons that tend to penetrate the hemodialysis membrane;
• overhydration, which is not amenable to conservative therapy and threatens the patient’s life.

These conditions can lead to death without hemodialysis. The main indications are acute renal failure, as well as end-stage chronic renal failure, in which it can prolong the patient’s life. In addition, people on hemodialysis can continue to live a normal life and even work.

The basis for prescribing hemodialysis for chronic kidney diseases are serum creatinine levels of more than 800-1000 µmol/l, urea - 20-40 mmol/l, glomerular filtration rate - less than 5 ml/min. Metabolic acidosis is also taken into account when the bicarbonate content is less than 15 mmol/l.

Contraindications

Even if there are appropriate indications, hemodialysis is not always used - contraindications can be relative and absolute.

Relative contraindications

• active form of pulmonary tuberculosis;
• diseases that threaten the occurrence of massive bleeding (Malory-Weiss syndrome, uterine fibroid, peptic ulcer, etc.).

Absolute contraindications

• mental illness (psychosis, epilepsy, schizophrenia);
• incurable malignant neoplasms;
• diseases of the blood system (leukemia, aplastic anemia);
• severe diseases of the nervous system;
• age over 80 years or over 70 with diabetes;
• the presence of two or more concomitant pathologies: malignant neoplasm, ischemic heart disease with previous myocardial infarction, heart failure, atherosclerosis with occlusion of peripheral vessels in the decompensated stage, chronic hepatitis, liver cirrhosis, obstructive pulmonary disease;
• vagrancy, alcoholism, drug addiction with no interest in social rehabilitation.

Procedure and regimen of chronic hemodialysis

The hemodialysis regimen and program are determined individually. Most often, hemodialysis is performed 3 times a week, the procedure lasts about 4-5 hours. There is a sufficient choice of membranes for dialysis, differing in usable surface area. This allows hemodialysis to be used in various programs: from daily two-hour dialysis to twice every week. If residual renal excretory function remains, hemodialysis can be performed less frequently.

The procedure is usually performed on an outpatient basis, but there are portable machines that allow hemodialysis to be performed at home. The advantages of home hemodialysis are the possibility of more frequent implementation and the absence of the need for constant visits to a medical center. It is more compatible with the patient's work, diet and lifestyle are closer to normal. Some hemodialysis machines can even be taken with you on trips or long trips. This type of hemodialysis has become widespread mainly abroad.

Some time before the first procedure, it is necessary to make access to the circulatory system, which is usually performed on an outpatient basis. To ensure efficient flow of blood into the dialyzer from the body and back, there are three types of access: fistula, graft and catheter.

1. A fistula is a direct connection of an artery to a vein through its own vessels, usually created on the forearm. At the same time, blood flow in the vein increases, making its diameter larger and the wall stronger. This makes the vein suitable for frequent needle insertion.
2. A graft in the form of a synthetic tube can also be used to connect an artery to a vein. This does not require time for the connection to heal and vascular remodeling, so it is used at an earlier stage, for example, until the fistula becomes suitable. The disadvantage of this method is the more frequent occurrence of complications.
3. Sometimes a catheter is used for temporary access - a soft tube that is placed in one of the veins in the neck, chest or thigh. To carry out dialysis, needles are inserted into a catheter, through which blood flows. This type of access is used for single dialysis, when there is no time to create another access.

Diet for hemodialysis

Nutrition during hemodialysis involves reducing the accumulation of waste products in the blood. When choosing a diet, you must consider the following rules:

• The daily menu should include a balanced amount of protein-rich foods, which include chicken, meat and fish.
• It is necessary to control potassium intake. It is found in salt substitutes, some fruits (bananas, oranges), vegetables (potatoes), chocolate, dried fruits and nuts. If the potassium content in the blood increases, heart complications are possible.
• The degree of fluid restriction depends on the disease that led to kidney failure. Typically, between procedures, the patient's weight should not increase by more than 5% of the initial body weight. If more fluid enters the body, edema, complications from the heart, lungs and other organs, as well as arterial hypertension may develop.
• Restriction of table salt in food: salty foods lead to thirst and fluid retention in the body.
• The doctor may prescribe medications to normalize the metabolism of calcium and phosphorus, which is often disrupted in people on hemodialysis. At the same time, you should limit the consumption of foods rich in phosphorus.

Recommendation: if during the interdialysis period the diet was nevertheless violated, for example, the patient could not resist salted fish or drank too much liquid, then you should not hide this from the doctor. If a specialist is aware of an error in nutrition, he will prescribe a special regimen and hemodialysis program to restore impaired homeostasis in the body.

Complications of hemodialysis

During the procedure, nausea or vomiting, muscle cramps, arterial hypo- or hypertension may occur. In addition, a rare and serious complication of hemodialysis can be air embolism, which can lead to the death of the patient. The development of air embolism is caused by a malfunction of the device or a violation of the technique of its use.

Most often, complications arise from vascular access. When using a graft or catheter, they may become blocked by a blood clot. With a fistula connection of vessels, there is a danger of infection, which results in the development of sepsis, septic embolism, bacterial endocarditis and other dangerous diseases.

With a rapid decrease in plasma osmotic pressure, disturbances of consciousness in the form of stupor, confusion, and epileptic seizures are possible, which is called dialysis syndrome. If the level of potassium, sodium or calcium in the blood drops sharply, heart rhythm disturbances may occur. In rare cases, allergic reactions to membrane components are possible.

Important: if any unpleasant sensations appear during hemodialysis, you should immediately report them to a specialist. Sometimes, to eliminate them, you only need to adjust the composition of the dialysate solution or the rate of blood flow. If serious complications develop, assistance will begin.

The kidneys are a complex mechanism. Their functioning is of great importance for a healthy life. Kidney hemodialysis is needed in case of decreased functioning of the organ, when chronic processes of urine separation in the body lead to the fact that the kidneys cannot cope with cleaning the blood from harmful metabolic products, poisons poison the blood, it is impossible to live without help and a person can become disabled.

What is kidney hemodialysis?

Nephrology and dialysis is a branch of science that studies the principles of functioning and kidney disease. Nephrology examines the principle of diagnosis, treatment, prognosis for recovery and the ability to live with the problem. Dialysis is the last chance to survive before transplantation. Kidney hemodialysis is an extracorporeal method of purifying blood from toxic elements and waste (urea, creatinine, poisons), carried out outside the body in case of acute renal failure.

The essence of hemodialysis is to urgently cleanse the body and regulate water-electrolyte and acid balance, and improve human functioning. In the last stages of oncology, it relieves intoxication.

Types of procedures

Depending on the venue

In a home environment

Special equipment (the new System One) allows you to replace the natural filter and cleanse your blood every day at home. The duration of the process is 2−4 hours. Hemodialysis at home is a program method that improves the quality of life and can replace organ transplant surgery. In our country, due to the high cost, connecting the installation at home is not very popular, although a disabled person cannot always get to the hospital.

• Pros: easy to use (the One system weighs no more than 30 kg), it is possible to combine the time of the procedure and the needs of the body, the likelihood of complications in the form of hepatitis is reduced.
• Disadvantages: high cost of equipment, not all people can use vascular needles, training is required.

Outpatient

The procedure is carried out in a special clinic 3 times in 7 days. The duration of one stage takes 4 hours. This method is needed for a person with acute kidney failure or at the stage of a chronic process when it is impossible to restore the functionality of the organ. Let's consider how many advantages the procedure has:

• Pros: supervision by specialists, tracking test results to adjust treatment (low creatinine in urine, creatinine in blood, anemia), sterile cleanliness of the room, the ability to transport a sick disabled person for treatment and home (if necessary).
• Cons: visiting the clinic several times a week, waiting in line, small risk of contracting hepatitis.

In the hospital

This type of therapy is used for patients with severe poisoning of the body, improving the functioning of the liver and kidneys. In any clinic there are rooms with “artificial kidney” equipment. Technically, a blood purification operation in a hospital is no different from an outpatient one. In addition, the equipment used for filtration is the same.

• Pros: constant supervision by specialists.
• Disadvantages: the need to stay in the hospital, there is a high possibility of contracting hepatitis.

Depending on the functionality of the device

Conventional dialysis

Filtration is done using equipment based on a cellulose membrane with a size of 0.8-1.5 sq.m. Using a low flow filter allows small particles to pass through. The blood flow rate is low and reaches 200−300 ml per minute. The duration takes 4-5 hours.

Highly efficient dialysis

Hemodialysis is done using a machine called a dialyzer. The dialyzer surface size is 1.5-2.2 sq.m. Blood moves at a speed of up to 350-500 ml per minute, dialysate is sent in the opposite direction at a speed of 600-800 ml per minute. By increasing the efficiency of the membrane, the blood flow rate increases, the application time is reduced to 3-4 hours and the number of procedures per week is reduced.

Hemodialysis using highly permeable membranes

This type combines hemodialysis and hemofiltration. The idea is to use special highly permeable surfaces. High-flux hemodialysis facilitates the passage of large molecules. Thanks to the highly permeable membrane, the likelihood of complications is reduced. But the likelihood of substances from the dialysate entering the blood increases, so a sterile apparatus is needed.

In medicine, an alternative to the hemodialysis described above is the peritoneal method. It is worth replacing hemodialysis with the peritoneal method in case of individual intolerance, when it is impossible to gain access to connecting an “artificial kidney” apparatus. It is often used in oncology. There is no need to use expensive sets of instruments; in the peritoneal method, the abdominal cavity acts as a filter. The peritoneal filtration method has disadvantages:

• duration;
• risk of infection;
• development of peritonitis.

Indications for testing

Not every disease requires extracorporeal filtration. Requirements for carrying out are determined strictly and include signs of the following conditions:

• renal failure (acute or chronic);
• in case of severe poisoning (alcohol, poison, drugs);
• significant changes in the electrolyte composition of blood plasma;
• excess water content in the body (swelling of the lungs).

Chronic renal failure (CRF) cannot be cured with conservative methods and is assigned to disability. Without hemodialysis, the quality of life deteriorates and death occurs.

The main indicators for cleansing procedures for renal pathologies are the following indications:

• when creatinine in the blood is more than 1 micromol per liter;
• urea 20-40 mmol per liter;
• the filtration rate is less than 5 ml per minute.

Contraindications

There are situations in which, in the presence of the above-described indications, the hemodialysis procedure is not performed. For example, during pregnancy there is a high probability of complications. But if sudden acute failure develops already during pregnancy, there is no way out; the installation of an “artificial kidney” is connected. An emergency case has no contraindications. Contraindications:

• Absolute:
  • cirrhosis of the liver;
  • active pulmonary tuberculosis;
  • diseases dangerous due to the sudden onset of heavy bleeding.
• Relative:
  • mentally ill conditions (seizures, schizophrenia, mental illness);
  • advanced oncology;
  • blood pathologies (anemia, oncology);
  • serious nervous disorders;
  • pregnancy;
  • age restrictions (over 80 years or 70 years with diabetes);
  • acute syndrome of alcohol or drug dependence;
  • presence of two or more violations.

Dialysis machine and special solution

For the extracorporeal filtration procedure, “artificial kidney” devices (dialyzers) are used. The main task of the equipment set is to purify blood from urea, the end product of protein metabolism, calcium, potassium, sodium, and water. In modern medicine, equipment designs are varied. The kit includes: a dialyzer, a blood supply system, a system for preparing and supplying a special solution under pressure. The devices differ from each other in the structure of their semi-permeable membrane.

Plate type dialyzer

The system consists of lamellar grooves through which the acid dialysate passes. The plates are connected to each other by vertical cylindrical channels and are covered with a membrane on top. Liquid flows across the plates, and blood flows across the membrane. The device is difficult to manufacture, but its operation has a number of advantages:

• slight resistance to blood flow, reducing the risk of blood clots;
• the dosage of the anti-clotting drug is reduced;
• free control of the degree of filtration;
• Filling the dialyzer does not require a large volume of blood, so the body does not experience a shortage of it.

Capillary dialyzer

The most effective and safe device. Sets of synthetic, biologically inactive materials were used to manufacture the membrane. A set of parallel tubes represents a system that passes blood through itself. Their number reaches 10 thousand, diameter 0.3 mm. Externally, dialysate fluid flows in the opposite direction. Thanks to this design, the quality of cleaning is higher.

If hemodialysis is carried out in children or the initial procedure in adults, a lightweight method of program filtration is used, in which the hemodialysis concentrate is sent along the blood flow. This reduces discomfort and the likelihood of negative consequences.

Advantages of a capillary device:

• high quality, achieved by a large filter surface;
• constant circulation and purity of the dialysate fluid, which reduces the likelihood of blood contamination by viruses, microbes and bacteria.
Before the operation, the patient must be examined in the clinic. Blood pressure, body temperature and pulse are measured. During and after the procedure, the person’s well-being is monitored. Beforehand, 7 days in advance, preparation of vascular access (prostheses) is carried out. The formation of an arteriovenous fistula is the most common. A fistula for hemodialysis is formed in the vessel. It is located under the skin, resembling a cord. An alternative to a fistula is the use of prostheses. Synthetic material is used to form the prosthesis. Operations to create access (for example, a prosthesis) are performed by a doctor in the operating room.

The procedure goes through the following stages:

1. Preparation of equipment and material.
2. The person lies down in a special chair in a reclining position.
3. The device is installed next to the chair. The venovenous or arteriovenous line communicates it with the body.
4. The operation of the pump creates pressure under which the blood is discharged into the filter for contact with a special liquid.
5. Through the connected second vein, purified blood returns to the body.

The severity of the disease determines how much filtration is needed. For some, one procedure is enough, for others, chronic hemodialysis is necessary. Typically, blood cleansing is carried out up to 3 times a week for 4-5 hours. The mode and time of hemodialysis are set according to individual indicators. The adequacy of hemodialysis depends on biochemical and other blood parameters. An antibiotic may be administered to avoid infection. At the end of the procedure, a bandage is applied to the site of access to the vessels.

How long do they live after kidney dialysis? This question is of interest to all patients who are faced with organ pathology. Indeed, this procedure is vitally important, and if it is not carried out on time, it can be fatal. Those who are prescribed hemodialysis are well aware that at a certain time they must report to the hospital without delay. Kidneys play an important role in the human body. They cleanse the blood of toxins, excess salts, organic compounds, remove fluid, and ensure the synthesis of substances that control blood pressure. We can safely say that the kidneys are a powerful filter through which 1,700 liters of blood are purified per day.

brief information

The kidneys function in unison: they filter the same amount of fluid every day. If atrophy of one of them occurs, then the second copes with the necessary function alone. People with one kidney can live their entire lives, but the load on the organ increases significantly. Therefore, patients with one kidney are given the necessary recommendations to maintain their health. It happens that both kidneys stop working due to serious pathologies. In such cases, it becomes a salvation.

People who have various kidney diseases need to avoid bad habits, abuse of salt, spicy and smoked foods. Also, with some pathologies of the organ, therefore, patients require constant monitoring.

If a person is indicated for kidney hemodialysis, then first of all it is necessary to carry out psychological work so that the patient is in the right mood for the procedure and understands the importance of its implementation.

Description of the hemodialysis procedure

Hemodialysis began to be practiced almost 40 years ago. The procedure has proven itself well, so it has been improved over time. This allows us to save and prolong the lives of young people. Dialysis is prescribed if the kidneys lose their filtering function. This cleaning method effectively filters the blood, releasing metabolic products from it and safely removing them from the body. Dialysis exists in two types:

• hemodialysis;
• peritoneal.

Each method has its own advantages, contraindications and implementation features. To understand what hemodialysis is and the content of this procedure, it is necessary to recall kidney function. Essentially, its goal is to purify the blood through a device called an “artificial kidney.” Through an artery or vein, the blood enters special equipment containing filters. Thanks to these devices and a sterile solution, the blood is completely cleansed of toxins and poisons, after which it is returned to the patient’s body.

In this procedure, the person is seated in a special chair and connected to a machine, after which the blood is filtered for several hours.

Hemodialysis is required to be carried out 2-3 times a week, taking into account the patient’s age, height, weight, and the presence of underlying diseases. Sometimes they are limited to one procedure.

But most often it is carried out until a kidney transplant is performed.

During hemodialysis, nothing changes in the protein composition of the plasma. This filtration method is indicated for those patients whose arteries and veins are easily accessible. Thanks to the hemodialysis procedure, the following goals can be achieved:

• get rid of uremic toxins and colloidal substances;
• stabilize the electrolyte composition;
• normalize blood pressure by removing fluid.

Many patients believe that they can avoid this procedure by following a strict diet, but by doing so they miss the opportunity to preserve partial kidney function. It is necessary to begin the hemodialysis procedure as soon as doctors report its need. Refusal of medical help can lead to complete loss of the kidney. Timely hemodialysis will prolong life for a significant period.

What is the difference between peritoneal dialysis?

Peritoneal dialysis is also aimed at filtering blood, but the procedure itself differs in the way it is carried out. Cleansing is carried out using a special solution, which is injected into the abdominal cavity through a catheter for several hours. Almost 2 liters of dialysate is poured into the peritoneum, the membrane of which serves as a natural filter. Toxins, wastes, and breakdown products enter the dialysis solution over a period of 4–12 hours. After the “holding time”, all the fluid from the peritoneum is drained along with the “waste”. The procedure is called drainage and takes about 30 minutes. And after that, the sterile solution is poured again, and the process is repeated.

Peritoneal dialysis involves selecting a solution based on a person’s individual disease. This procedure has clear advantages over hemodialysis.

Its superiority is that a person does not have to give up his usual way of life, since he has time for any activity, recreation and hobby.

Partial kidney function is also preserved, the patient has less risk of being exposed to cardiovascular pathologies, and tolerates viral infections more easily. A strict diet is not required, and there is a high chance of a kidney transplant.

Peritoneal dialysis can be performed in patients with diabetes. This procedure is carried out both at home, after appropriate training, and in the hospital. The number of solution changes is 3–5 times a day. To carry out dialysis in this way, you need to purchase a tonometer, scales, a table, and a hook on which you need to attach the solution container. You will need to buy a heating pad for the dialysate, an antiseptic in the form of hydrogen peroxide and a comfortable chair. The advantage also lies in the fact that the person is not tied to a dialysis center, but at the same time, the procedure at home also has some disadvantages. However, patients can maintain a completely active lifestyle.

Doctors decide which one to choose, but the peritoneal method gives a person more freedom. In severe cases, only hemodialysis is indicated.

How long can you live with dialysis?

Since this procedure is indicated for serious diseases, which in themselves already pose a danger to human existence, the question logically arises of how many years people can live with kidney dialysis. No doctor can answer this question with certainty.

Much is determined by the stage of the disease, the patient’s age, general health, and the presence of other pathologies.

A lot depends on the behavior of the patient himself, on his mood and desire to follow all the doctors’ recommendations. Dialysis is indicated for the following ailments:

• acute or ;
• diabetes mellitus;
• acute poisoning with toxins;
• electrolyte imbalance;
• drug overdose;
• overhydration (when standard treatment is ineffective).

These conditions themselves are complex and can be fatal, so dialysis cannot be delayed. And life expectancy directly depends on whether the patient adheres to a diet, carries out the procedure regularly, and whether he behaves correctly after hemodialysis. In the last century, some people lived more than 25 years. Over half a century, medicine has stepped forward, but for most people this method may be inaccessible due to the high cost of the procedure. Previously, those on hemodialysis died more often due to the fact that the body “without kidneys” was greatly weakened.

Although there are no exact statistics, the average life expectancy of people on dialysis is 14–20 years.

If a transplant is performed after dialysis, a person can live for about 55 years. How long a patient will live with kidney dialysis also depends on the quality of the drugs that have to be taken.

It is no secret that medicines may be counterfeit and of poor quality, equipment may be cheap, and specialists may be unqualified. All this can lead to a shortened life span due to complications or errors by medical staff. Therefore, it is worth choosing a dialysis center with good reviews and reputation.

How to prolong life after dialysis

To reduce the burden on the body, doctors usually prescribe a strict diet for patients. Protein products are introduced into the diet and those containing a lot of potassium and phosphorus are excluded. During dialysis, it is necessary to constantly monitor the level of potassium in the blood, as its excess leads to heart rhythm disturbances and death. You should limit your consumption of table salt to avoid swelling. If you violate the diet, you must notify your doctor, as you may need to change your hemodialysis regimen. The doctor will explain how long life can be extended if the regimen is followed, but the chances for “obedient” patients are high.

Sometimes dialysis is the only option for kidney failure. But with the right attitude, a person can live normally for another 20–30 years. The main disadvantage is that the patient is tied to the dialysis center. But thanks to modern technologies, you can sleep during the procedure, listen to music on headphones or watch your favorite TV series on your tablet. Over time, patients get used to this lifestyle and try to lead it fully, setting aside time for communication, entertainment and hobbies.

Hemodialysis is a unique chance to evacuate toxic substances from the bloodstream that accumulate due to the functional inability of the kidneys. The process occurs through a special membrane that is safe for the health of the sick person. It is possible that after hemodialysis you will have to undergo a transplantation of this paired organ if the doctor determines such a need. For example, if an artificial kidney device is connected more often than 3 times a week, and a person’s life without this procedure is impossible.

What does hemodialysis consist of and what is its purpose?

The only and most important purpose of this equipment is blood filtration, purification of this important biological environment from harmful substances.

From the technical side, the device is divided into 3 parts, each of which has its own segments under control:

1. The blood treatment system contains the following parts: a pumping device that pumps blood; a device designed to infuse heparin and flush the tubular system with it to prevent the formation of blood clots inside; control of the absence of air in the tubular valve system - air bubble evacuator; a timer that displays information about the current level of both arterial and venous pressure of the patient.

2. A system whose function is to prepare a dialysis solution (or dialysate) includes the following structures: a device for removing air; a system that dissolves water in concentrate; a system that controls the temperature level of the prepared dialysate, preventing it from exceeding; indicator for monitoring the movement of blood into the solution; a system responsible for the quality of filtration and continuously monitoring this process.

3. Filter with a membrane - it is made of cellulose or its synthetic substitute.
The success of the dialysis is determined by the laboratory technician: the patient donates blood for a biochemical study, and the level of urea in it should differ from the levels before the procedure.

When is hemodialysis necessary - indications

Hemodialysis is not aimed at solving absolutely every problem with kidney function; this procedure is not prescribed for every pathology. There are quite strict indications for hemodialysis:

Daily diuresis does not exceed 450 ml per day;
the functional capacity of the kidneys is preserved by only 11-16%;
kidney filtration capacity – no more than 210 ml of blood per minute;
urea concentration in blood plasma over 35 mmol/l;
creatinine levels in blood plasma exceed 1 mmol/l;
the concentration of potassium in the blood plasma is over 7 mmol/l.

Also, a patient in urgent need of connection to an artificial kidney exhibits specific symptoms of increasing edema of the brain, lungs and heart. The listed symptoms cannot be relieved by administering medications.

What diseases cause the need for hemodialysis

There are several pathologies, the aggravation of which leads to the need to connect the patient to a hemodialysis machine.

1. . The purpose of the prescription is to ensure the compensatory function of the kidneys, filtering the blood from toxic compounds and metabolic end products. Hemodialysis for chronic failure is carried out three times a week, but the increase in intoxication is the basis for more frequent procedures. In extreme cases, dialysis is performed until the end of life, or until a healthy kidney is transplanted.

2. Renal failure, as a complication of acute pyelonephritis. The purpose of the procedure is to remove excess fluid from the body, eliminate swelling, and evacuate toxic products.

3. Intoxication with medications. In this case, hemodialysis will be a preventative way to prevent kidney failure and then liver failure. Just 1 procedure is enough, but if the situation is complicated by other phenomena, it is permissible to carry out hemodialysis for three days in a row, until all toxic substances are removed from the body.

4. Imbalance of electrolytes in the blood. This condition occurs due to massive burns, peritonitis, dehydration, and febrile phenomena. Hemodialysis allows you to remove excessive concentrations of one type of ion, replacing them with others.
Also, an indication for the procedure in question is excess fluid in the body, which leads to swelling of the membranes of the brain, heart, and lungs. Dialysis helps reduce swelling and lower blood pressure levels.

Contraindications to hemodialysis

If a person’s life is in danger of death, and connection to an artificial kidney machine is the only and extremely necessary measure, accompanying conditions are not considered. In case of emergency medical care, the doctor does not focus on other processes and phenomena of the body, therefore there are no contraindications to hemodialysis.
In some clinical situations, connecting to the device and stimulating the kidneys is a preferable measure, not a last resort. In this case, the following factors act as contraindications and limitations:

1. Diseases of infectious origin (if they are even more serious in terms of threat to life than renal failure).

2. Hemorrhage into the membranes of the brain, pre-stroke condition or early period after it. During hemodialysis, massive swelling of the brain occurs - these are the complications of the procedure. The peculiarity of this consequence is that in people suffering only from renal failure, without severe concomitant pathologies, cerebral edema is eliminated on its own - most patients do not even need to administer diuretics. In those who have recently suffered a stroke or have a high predisposition to such hemorrhage, swelling only aggravates the initial condition, which causes a risk of death.

3. Psycho-emotional imbalance, severe mental disorders. Pathologies such as manic-depressive syndrome, epilepsy, psychopathy, schizophrenia are direct limiting circumstances for the procedure. Just connecting to an artificial kidney machine causes deep mental shock in patients with these disorders.

4. Dementia, mental retardation. A low level of intelligence and lack of ability to follow the recommendations of the doctor and other medical personnel not only complicate the procedure - the likelihood of it being carried out is reduced to zero. Already at the stage when it is necessary to install a catheter for hemodialysis, the first difficulties may arise, although access to the blood vessel is a determining factor for such a responsible procedure.

5. Malignant tumor process. Since metastases are a predictable complication of cancer of a particular organ, stimulating kidney activity can have the opposite effect - malignant cells will spread throughout the body along with the blood.

6. Arterial hypertension. There is a severe degree of hypertension. With it, the blood pressure level increases to critical levels (240/170 mm Hg and above). The peculiarity of the condition is that it is short-term; its danger is that spontaneously increased pressure can cause a stroke or heart attack directly during stimulation.

7. Blood diseases. The filter installed on the device will further destroy blood cells if they are already affected (for example, with leukemia, aplastic anemia). The outcome is unfavorable - the pathology will worsen or bleeding will occur. The development of the second circumstance is predisposed by the need to administer heparin into the artificial kidney apparatus.

Also, patients aged 80 years and older are not allowed to undergo hemodialysis. If a person suffers from diabetes, this age threshold is reduced to 70 years. The reason for the contraindication to the procedure is physiological changes in the body. Since the walls of blood vessels become more fragile with age, they are more likely to be damaged, which means bleeding. If there is a need to install a fistula for hemodialysis, this will not be possible due to the increased vulnerability of the blood vessels. A fistula is an access to a blood vessel; it is created by a surgeon for a long time, eliminating the need to penetrate into the artery every time there is a need for it.

Also, due to the natural aging process, the patient is at risk of developing problems with heart function while undergoing dialysis. An additional disadvantage of connecting the device in patients of this age is weak immunity, which serves as fertile ground for infection during the recovery period.

Features of hemodialysis in an outpatient clinic and at home

Outpatient hemodialysis involves purifying the blood of those suffering from acute and chronic forms of renal failure (including at the stage when the functional capacity of the diseased organ is reduced to a critical state). Patients are served according to a pre-established queue. A common option for dialysis is three times a week, the duration of each procedure does not exceed 4 hours. The quality of the procedure is determined by the equipment used from the Swedish brands Gambro AK-95 and B/Braun.

The advantages of using an artificial kidney device are that the manipulation is performed by experienced employees who have qualifications and experience in this matter. The sterility regime is observed, the dynamics of the patient’s body condition are constantly monitored by taking tests for research. If the patient cannot come to the hospital on his own, he is brought by special transport.

There are also negative aspects to this type of dialysis. Patients and their relatives are concerned that in order to undergo the procedure, they need to wait a long time for their turn. In case of end-stage renal failure, this is unacceptable due to the high probability of death. The medical center must be visited at least three times a week, which not only makes life difficult for people with limited mobility, but also puts their health at great risk. Indeed, in such medical institutions the risk of infection with hepatitis B and C, as well as HIV, increases.

Home hemodialysis is performed using a portable device Aksys Ltd."s PHD System, Nxstage Medical"s Portable System One. Due to the high cost, not every patient can buy the equipment (the price exceeds 20 thousand dollars). The manipulation lasts up to 4 hours and the first time the medical staff teaches you how to use the device. The advantages of performing the procedure at home are that there is no risk of contracting diseases and you do not have to wait for your turn.

How much does hemodialysis cost?

Prices for the procedure vary between clinics and countries. The final amount is made up of several factors - the level of respectability of the clinic, the severity of the patient, the presence of pathologies and the number of concomitant diseases are important.

If we are talking about a private clinic, the total cost of hemodialysis also includes the care provided by the staff, payment for the ward and additional expenses. In bona fide medical centers, the amount is paid once, upon admission, at the time of conclusion of the contract. It must coincide not only with the existing price list, but also with the one announced by the doctor when providing a preliminary consultation.

Also, kidney hemodialysis is performed free of charge - if there are certain indications, but if we are not talking about private clinics, and the treatment is not planned abroad.

Forecast of the condition after the procedure

When considering whether to agree to an unpleasant procedure, spend a huge amount of time in the hospital and undergo frequent tests, the patient must understand the benefits of the procedure. One of them is how long people live with and without hemodialysis. Connecting to an artificial kidney machine and regularly undergoing the procedure can extend life from 15 to 25 years. And people who refuse this procedure have a risk of death much earlier - in a matter of months.

Nutrition for hemodialysis

A special feature of the hemodialysis diet is increased protein intake. It is important to avoid the presence of potassium and phosphorus in the diet. These components contribute to the active production of urea, createnine and ammonia. Such processes are unacceptable for the body of people with kidney function reduced to critical limits. After hemodialysis, you will need to reduce the amount of salt and fluid. Allowed to use:

High-protein foods - chicken eggs, lean beef, poultry;
lean fish (pollock, sardine, blue whiting);
rye or wheat bread in small quantities (it should be baked without adding salt);
lean soups (made with water and containing only plant ingredients);
weak coffee and tea (additionally consult your doctor);
vegetables and fruits (vegetables are best consumed stewed or baked);
a small amount of vegetable oil and butter.

The calorie content of the diet should be at least 40 kcal/1 kg of the patient’s weight. It is better to avoid taking decoctions of medicinal herbs, since their effect on the body of a person who has undergone hemodialysis can be unpredictable.

Currently, scientists are looking for alternatives to hemodialysis. One of these discoveries is an implantable artificial kidney, the pressure in which will be generated by the person’s own heart, which presupposes the condition of its full functional usefulness. This is an electronic version of a diseased organ substitute. The method is being questioned, and therefore only in 2017 the developers are preparing to conduct a control test to confirm the effectiveness of the method.

If a doctor suggests undergoing hemodialysis, it means that, based on the results of the patient’s diagnosis and the dynamics of treatment, the specialist no longer considers the option of independently returning the kidney to its physiological state. A patient in such a situation has two solutions: agree to the procedure recommended by the doctor or think about organ transplantation. In each of the options, the determining factor is time, losing which in such a serious condition of the kidneys is extremely undesirable.