Essay on Renal Failure: Causes, Effects & Treatment Options

Renal failure occurs when kidneys fail to function normally. Kidneys can fail to work as they should due to a lack of enough blood to filter. Kidney failure can be caused by various conditions such as high blood sugar (diabetes), high blood pressure, chronic glomerulonephritis (damage of kidney filters), blocked urinary tract, kidney infection, and polycystic kidney disease. These conditions result in chronic renal failure leading to a permanent impairment of kidney function. When normal kidney function is impaired, dialysis is often needed to manage the condition. Thus, this paper aims to explore dialysis as a treatment option for renal failure.

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Dialysis is an alternative treatment for patients with end-stage kidney disease. Dialysis is urgently required when a patient loses about 90 percent of the normal kidney function. A kidney transplant is the suitable alternative to treat renal failure, but kidney replacement is not always possible. As such, dialysis makes it possible to filter blood while a patient awaits a donor's kidney. Through dialysis, a machine filters out the waste in the blood and returns filtered blood back to the body. Dialysis is essential as it keeps the body in balance through the removal of salt, excess water, and waste materials, thus preventing the accumulation of toxic substances in the body (Krans & Gotter, 2019). Also, dialysis helps balance the body by regulating chemicals in the blood such as sodium, potassium, and bicarbonate. Likewise, dialysis is important as it helps to control and manage blood pressure. However, the effectiveness of dialysis usually depends on various factors, such as the existence of other medical conditions, dialysis preparation, medication, and dietary recommendations. In the absence of other medical conditions, a well-prepared dialysis can allow a patient to continue living with renal failure for many years.

Dialysis mainly consists of two types. The different types are peritoneal dialysis and hemodialysis. The choice of dialysis is dependent on various medical factors and personal preferences as well. Hemodialysis uses an artificial kidney to filter the blood and remove excess chemicals and waste. In hemodialysis, blood is pumped out of the body into a machine (hemodialyzer) where it is cleaned using dialysis fluid. Blood is pumped through an access or entrance, which consists of tubes joined into the blood vessels. Hemodialysis requires an operation to be done to create a passageway and access to the bloodstream. Surgery is required to short circuit blood circulation using an arteriovenous fistula into which a dialysis cannula is inserted (InformedHealth.Org, 2018). This procedure requires to be done several weeks before hemodialysis is started since the fistula takes a while to develop fully. When it is fully developed, the arteriovenous fistula is the most reliable passageway as it is associated with the least complications.

Typically, hemodialysis is done three times a week, with each session lasting an average of four hours. Hemodialysis sessions are usually carried out at a dialysis center where medical staff ensures that everything is smooth. Home hemodialysis is also possible, which allows for convenience and flexibility. As such, home hemodialysis is flexible as the opening hours are not limited, and is also convenient as it saves the patient the need to travel to a dialysis center. However, home hemodialysis is not always possible due to various constraints such as lack of trained care team and inadequate equipment at home. Further, there is an insignificance difference in life expectancy between patients undergoing home hemodialysis and those in in-center hemodialysis.

In peritoneal dialysis, blood is filtered inside the body. A catheter, a plastic tube, is inserted into the abdomen to make a passageway. During the operation, the peritoneal cavity in the abdominal area is filled with the dialysis fluid through the catheter. The dialysis fluid draws excess chemicals and waste products from the blood, thus cleaning it. After some time, the dialysis fluid is removed from the peritoneal cavity and replaced with new dialysate. There are two major methods of peritoneal dialysis: continuous ambulatory peritoneal dialysis (CAPD) and automated peritoneal dialysis (APD) (InformedHealth.Org, 2018). In the standard method, the dialysate is manually exchanged about four times per day while in the automated dialysis, a cycler which is connected to the catheter, regularly exchanges the dialysate. Since a permanent catheter is implanted into the abdominal cavity, several complications may arise, such as an inflammation of the peritoneum, making it difficult to manage peritoneal dialysis.

A renal diet is recommended for patients on dialysis. A renal diet contains low levels of protein, sodium, and phosphorous (Khatri, 2018). Although a renal diet is low in protein, it emphasizes the need to consume high-quality protein. Patients on dialysis are advised to limit the intake of fluids, potassium, and calcium. Since the patient's dietary needs are diverse, working with a renal dietitian is crucial to help develop a suitable renal diet. The three major electrolytes include sodium, potassium, and chloride, which control the movement of fluids in body tissues and cells. However, in the case of kidney failure, these electrolytes build up in the body, becoming harmful. Excess sodium can cause high blood pressure, which exacerbates kidney failure. A renal diet is necessary to reduce the amount of waste and extra chemicals in the blood, which arise from the food and liquids consumed. When the normal functioning of the kidney is compromised, the waste and in the blood is not properly removed, thus negatively affecting the electrolyte levels. Therefore, adherence to a renal diet is important in promoting kidney function and slowing the progression of kidney failure.

References

InformedHealth.Org. (2018). Dialysis in Chronic Kidney Disease. Institute for Quality and Efficiency in Health Care (IQWiG) https://www.ncbi.nlm.nih.gov/books/NBK492979/

Khatri, M. (2018, December 21). Your Diet and Chronic Kidney Disease. WebMD. https://www.webmd.com/a-to-z-guides/diet-and-chronic-kidney-disease#

Krans, B. & Gotter, A. (2019, February 13). Dialysis. Healthline. https://www.healthline.com/health/dialysis