Patients require a form of renal replacement therapy once they have progressed to end stage kidney failure. This typically occurs when kidneys retain only 10 to 15% of their healthy function. If patients are suitable candidates, they may be placed on a waiting list to receive transplantation of a healthy kidney. However, until the patient receives this transplant, or if they are not a suitable candidate, patients who have progressed to end stage renal disease require dialysis to remain alive.

Dialysis Treatment

Patients have a choice between various modalities, or treatment options, for dialysis. These could include dialysis at home or in centre, and peritoneal or haemodialysis. The most appropriate option typically depends on a combination of the patient’s health, support network, and personal preferences.

Today, around 90% of patients receive in-centre haemodialysis treatment. The usual schedule for in-centre haemodialysis treatments is three times a week, either Mon/Wed/Fri or Tues/Thurs/Sat. Treatments are typically four hours in length, but may vary depending on the physician prescription. Travel time to and from the centre, as well as any waiting time before or after the treatment, are additional.

Dietary Adjustments and Restrictions

One of the biggest changes for patients starting dialysis is the need to adjust to a more restrictive diet. This includes proactively managing intake of both food, and fluid quantity.

Healthy kidneys control fluid balance in the body. When the kidneys lose this ability, dialysis is needed to help remove excess fluid build-up. Fluid overload can cause shortness of breath and high blood pressure. However, removing too much fluid too quickly during a haemodialysis session can cause cramps and low blood pressure. Over a longer term, too much fluid damages the heart by making it work harder. For these reasons, it’s very important for dialysis patients to limit their fluid intake between dialysis sessions.