When patients are diagnosed with stage 5 kidney disease (CKD) they have reached the stage of kidney failure, i.e. there is failure to sustain the human body homeostasis, so kidney function has to be done artificially. One way to mimic the job of the kidneys is by hemodialysis, in case the patient does not directly proceed to pre-emptive kidney transplantation (transplantation before starting hemodialysis).
You need to start hemodialysis when you have the following symptoms:
GFR 5 to 9 ml/min per 1.73 m2 and uremia-related
Gastroenteropathy with nausea with or without vomiting
Anorexia and unexplained weight loss
Encephalopathy with increasing confusion
Volume overload/hypertension unresponsive to diuretic therapy
In order to successfully replace the kidney and maintain the body alive, it is vital that dialysis becomes part of patients’ routine and take place certain days and for a specific amount of time, so that blood is adequately cleaned and excess fluid is removed from the body.
According to current guidelines the minimum dialysis schedule is as follows: 3 times a week, for at least 4-5 hours each time. However, the nephrologists’ community has raised the issue of more extended and more often dialysis programs, suggesting sessions 4-6 times a week, or even daily sessions for 6-8 hours each time.
This is because the latest trials suggest that daily dialysis treatments ensure longer survival, not only because there is more extensive clearance of uremic toxins, but also because it comprises a smoother process for patients , similar to normal kidney function.
In any case, it is your doctor who will prescribe how long your dialysis treatment sessions will be and how often they will take place.
Where do dialysis treatments take place?
When it comes to where dialysis treatments take place, there are specific options you can choose from. You can do your dialysis either in a hemodialysis center or at home.
Home dialysis has gained a lot of interest lately, as it can be done with the aid of new technology including water osmosis equipment at home combined with medical monitoring of the patient by a special center.
These centers should be fully equipped with all the necessary technology, such as reverse osmosis systems in order to clean city water, state of the art dialysis machines, while expert medical and nursing stuff specialized in hemodialysis is equally important, in order for the process to be carried out safely and smoothly.