Dialysis: Benefits & Challenges

Key Takeaways

Dialysis removes waste and excess fluid from the blood when kidneys cannot function.
Two main types: hemodialysis (machine-based) and peritoneal dialysis (abdomen-based).
Dialysis does not cure kidney disease but helps manage symptoms.
Nutrition and fluid management are critical for dialysis patients.
Each dialysis type has different benefits, risks, and lifestyle implications.

What is Dialysis?

Definition and Purpose of Dialysis

Dialysis is a medical procedure that removes waste, toxins, and excess fluids from the blood when the kidneys are no longer functioning properly. It helps restore the body’s balance of fluids and electrolytes.

Why Dialysis is Necessary for Kidney Failure

When the kidneys lose their ability to filter blood effectively, harmful waste products accumulate, leading to serious health issues. Dialysis acts as an artificial replacement to perform these vital functions.

Types of Dialysis

Hemodialysis

Hemodialysis involves using a machine to filter the blood outside the body. The process typically occurs at a dialysis center or sometimes at home.

How Hemodialysis Works

During hemodialysis, blood is taken from the body, filtered through a dialyzer (artificial kidney), and then returned clean to the body. This process is usually done three times per week for 3-4 hours per session.

Pros and Cons of Hemodialysis

Pros:

Effective in removing waste quickly.
Usually supervised by healthcare professionals.
Cons:
Requires regular visits to a dialysis center.
Can cause fatigue and blood pressure fluctuations.

Peritoneal Dialysis

Peritoneal dialysis uses the lining of the abdomen (peritoneum) to filter blood. A dialysis solution is introduced into the abdominal cavity and absorbs waste products from the blood.

How Peritoneal Dialysis Works

The dialysis solution is infused into the abdomen, where it stays for several hours, absorbing waste. The fluid is then drained and replaced. This can be done multiple times daily or overnight while sleeping.

Pros and Cons of Peritoneal Dialysis

Pros:

Can be done at home, offering more flexibility.
Less dietary and fluid restrictions.
Cons:
Risk of infections in the abdominal cavity.
Requires strict hygiene and maintenance of the catheter.

Choosing the Right Type of Dialysis

Factors to Consider When Choosing Dialysis

The choice between hemodialysis and peritoneal dialysis depends on factors like lifestyle, medical condition, and personal preference. Patients should consult their healthcare providers to find the best fit for their needs.

Benefits and Risks of Each Method

Both methods are effective, but each comes with unique benefits and risks. Hemodialysis offers faster results but may be less convenient, while peritoneal dialysis provides flexibility but requires more self-care.

Living with Dialysis

Managing Day-to-Day Life with Dialysis

Dialysis requires significant lifestyle adjustments, including managing treatment schedules, avoiding certain foods, and maintaining regular healthcare checkups.

Nutritional Needs for Dialysis Patients

Patients need to follow a specific diet to maintain health, typically focusing on controlled fluid intake, moderate potassium and sodium, and ensuring enough protein to support bodily functions.

Challenges and Complications

Common Side Effects of Dialysis

Patients may experience fatigue, muscle cramps, low blood pressure, and infection risks depending on the type of dialysis.

Infection Risks and Preventative Measures

Proper care of the dialysis access point (fistula, catheter, or abdominal port) is essential to prevent infections like peritonitis in peritoneal dialysis or sepsis in hemodialysis.

Innovations in Dialysis Treatment

Recent Advances in Dialysis Technology

New technologies such as wearable dialysis machines and more efficient home dialysis options are improving the quality of life for patients with kidney failure.

Future of Kidney Replacement Therapies

Researchers are exploring alternatives like bioengineered kidneys and advances in regenerative medicine, offering hope for better solutions in kidney disease treatment.

FAQ

What is the main purpose of dialysis?

Dialysis replaces the kidney’s filtering function by removing waste and excess fluid from the blood.

How often do dialysis patients need treatment?

Hemodialysis is typically needed three times per week, while peritoneal dialysis can be performed daily.

What are the main differences between hemodialysis and peritoneal dialysis?

Hemodialysis is done via a machine, usually in a center, while peritoneal dialysis uses the abdominal lining at home to filter blood.

Can dialysis completely replace kidney function?

No, dialysis helps manage symptoms but does not fully replace the kidney’s ability to regulate waste and fluid.

Are there any risks involved with dialysis treatment?

Yes, potential risks include infections, low blood pressure, fatigue, and complications related to access points for dialysis.

Research


Agarwal, R., Vasavada, N., Sachs, N.G. & Chase, S. (2004). Oxidative stress and renal injury with intravenous iron in patients with chronic kidney disease. Kidney International, 65(6), pp.2279–2289. https://doi.org/10.1111/j.1523-1755.2004.00648.x

Avesani, C.M., Cuppari, L., Nerbass, F.B., Lindholm, B. & Stenvinkel, P. (2023). Ultraprocessed foods and chronic kidney disease—double trouble. Clinical Kidney Journal, 16(11), pp.1723–1736. https://doi.org/10.1093/ckj/sfad103

Banegas, J.R. (2023). Ultra-Processed Food Consumption is Associated with Renal Function Decline in Older Adults: A Prospective Cohort Study. Nutrients, 13(2), 428. https://doi.org/10.3390/nu13020428

Basturk, T. & Unsal, A. (2011). WHAT IS THE FREQUENCY OF CARBOHYDRATE METABOLISM DISORDER IN CKD? Journal of Renal Care, 38(1), pp.15–21. https://doi.org/10.1111/j.1755-6686.2011.00246.x

Cai, Q., Duan, M.-J., Dekker, L.H., Carrero, J.J., Avesani, C.M., Bakker, S.J., de Borst, M.H. & Navis, G.J. (2022). Ultraprocessed food consumption and kidney function decline in a population-based cohort in the Netherlands. The American Journal of Clinical Nutrition, 116(1), pp.263–273. https://doi.org/10.1093/ajcn/nqac073

Cai, Q., Duan, M., Dekker, L.H., Bakker, S.J., De Borst, M. & Navis, G. (2021). FC 081 ULTRA-PROCESSED FOOD CONSUMPTION AND RISK OF INCIDENT CHRONIC KIDNEY DISEASE: THE LIFELINES COHORT. Nephrology Dialysis Transplantation, 36(Supplement_1). https://doi.org/10.1093/ndt/gfab139.001

Du, S., Kim, H., Crews, D.C., White, K. & Rebholz, C.M. (2022). Association Between Ultraprocessed Food Consumption and Risk of Incident CKD: A Prospective Cohort Study. American Journal of Kidney Diseases, 80(5), pp.589-598.e1. https://doi.org/10.1053/j.ajkd.2022.03.016

Erdemli, Z., Gul, M., Kayhan, E., Gokturk, N., Bag, H.G. & Erdemli, M.E. (2024). High-Fat and Carbohydrate Diet Caused Chronic Kidney Damage by Disrupting Kidney Function, Caspase-3, Oxidative Stress and Inflammation. Prostaglandins & Other Lipid Mediators, 172, p.106822. https://doi.org/10.1016/j.prostaglandins.2024.106822

Fishbane, S., Kalantar‐Zadeh, K. & Nissenson, A.R. (2004). Serum Ferritin in Chronic Kidney Disease: Reconsidering the Upper Limit for Iron Treatment. Seminars in Dialysis, 17(5), pp.336–341. https://doi.org/10.1111/j.0894-0959.2004.17359.x

Friedman, A.N., Ogden, L.G., Foster, G.D., Klein, S., Stein, R., Miller, B., Hill, J.O., Brill, C., Bailer, B., Rosenbaum, D.R. & Wyatt, H.R. (2012). Comparative Effects of Low-Carbohydrate High-Protein Versus Low-Fat Diets on the Kidney. Clinical Journal of the American Society of Nephrology, 7(7), pp.1103–1111. https://doi.org/10.2215/cjn.11741111

Ganz, T. & Nemeth, E. (2016). Iron Balance and the Role of Hepcidin in Chronic Kidney Disease. Seminars in Nephrology, 36(2), pp.87–93. https://doi.org/10.1016/j.semnephrol.2016.02.001

Gaweda, A.E. (2017). Markers of iron status in chronic kidney disease. Hemodialysis International, 21(S1). https://doi.org/10.1111/hdi.12556

Gersch, M. S., Mu, W., Cirillo, P., Reungjui, S., Zhang, L., Roncal, C., Sautin, Y. Y., Johnson, R. J., & Nakagawa, T. (2007). Fructose, but not dextrose, accelerates the progression of chronic kidney disease. American Journal of Physiology-Renal Physiology. 
https://doi.org/F-00181-2007

Gu, Y., Li, H., Ma, H., Zhang, S., Meng, G., Zhang, Q., Liu, L., Wu, H., Zhang, T., Wang, X., Zhang, J., Sun, S., Wang, X., Zhou, M., Jia, Q., Song, K., Liu, Q., Huang, T., Borné, Y., Wang, Y., Qi, L. & Niu, K. (2023). Consumption of Ultraprocessed Food and Development of Chronic Kidney Disease: The Tianjin Chronic Low-Grade Systemic Inflammation and Health and UK Biobank Cohort Studies. The American Journal of Clinical Nutrition, 117(2), pp.373–382. https://doi.org/10.1016/j.ajcnut.2022.11.005

He, X., Zhang, X., Si, C., Feng, Y., Zhu, Q., Li, S., & Shu, L. (2024). Ultra-processed food consumption and chronic kidney disease risk: A systematic review and dose–response meta-analysis. Frontiers in Nutrition, 11, 1359229. 
https://doi.org/10.3389/fnut.2024.1359229

Jardim, M.Z., Costa, B.V. de L., Pessoa, M.C. & Duarte, C.K. (2021). Ultra-Processed Foods Increase Noncommunicable Chronic Disease Risk. Nutrition Research, 95, pp.19–34. https://doi.org/10.1016/j.nutres.2021.08.006

Juraschek, S.P., Appel, L.J., Anderson, C.A. & Miller, E.R. (2013). Effect of a High-Protein Diet on Kidney Function in Healthy Adults: Results From the OmniHeart Trial. American Journal of Kidney Diseases, 61(4), 547-554. https://doi.org/10.1053/j.ajkd.2012.10.017

Javier, V., Jesús, D., & Francisco, J. The Burden of Carbohydrates in Health and Disease. Nutrients, 14(18), 3809. 
https://doi.org/10.3390/nu14183809

Kaburagi, T., Kanaki, K., Otsuka, Y. & Hino, R. (2019). Low-Carbohydrate Diet Inhibits Different Advanced Glycation End Products in Kidney Depending on Lipid Composition but Causes Adverse Morphological Changes in a Non-Obese Model Mice. Nutrients, 11(11), p.2801. https://doi.org/10.3390/nu11112801

Kalantar-Zadeh, K., Jafar, T.H., Nitsch, D., Neuen, B.L. & Perkovic, V. (2021). Chronic Kidney Disease. The Lancet, 398(10302), pp.786–802. https://doi.org/10.1016/s0140-6736(21)00519-5

Kleinknecht, C., Laouari, D., Hinglais, N., Habib, R., Dodu, C., Lacour, B., Broyer, M., Nalbandian, W.T.A.O.E. & Lacoste, M. (1986). Role of Amount and Nature of Carbohydrates in the Course of Experimental Renal Failure. Kidney International, 30(5), 687-693. https://doi.org/10.1038/ki.1986.241

Kim, H., Lee, H., Kwon, S.H., Jeon, J.S., Noh, H., Han, D.C. & Kim, H. (2021). Relationship Between Carbohydrate-to-Fat Intake Ratio and the Development of Chronic Kidney Disease: A Community-Based Prospective Cohort Study. Clinical Nutrition, 40(10), pp.5346–5354. https://doi.org/10.1016/j.clnu.2021.09.001

Kityo, A. & Lee, S.-A. (2022). The Intake of Ultra-Processed Foods and Prevalence of Chronic Kidney Disease: The Health Examinees Study. Nutrients, 14(17), p.3548. https://doi.org/10.3390/nu14173548

Lima, T.G., Benevides, F.L.N., Esmeraldo Filho, F.L., Farias, I.S., Dourado, D.X.C., Fontenele, E.G.P., Moraes, M.E.A. & Quidute, A.R.P. (2019). Treatment of Iron Overload Syndrome: A General Review. Rev Assoc Med Bras (1992), 65(9), 1216-1222. https://doi.org/10.1590/1806-9282.65.9.1216

Liu, M., Yang, S., Ye, Z., Zhang, Y., Zhang, Y., He, P., Zhou, C.,

 Li, J. & Ding, J. (2023). Dietary Carbohydrate Intake and Risk of Incident Chronic Kidney Disease in a Chinese Population. Nutrients, 15(1), p.137. https://doi.org/10.3390/nu150100137

Nair, V., Li, X., Weiss, C., Zelnick, L., Hou, F., Clevenger, B., Obeid, A., He, J., Wood, C., Sharma, S., Ellis, B., Dey, N., Mehrotra, R., Cizman, B. & Garonzik-Wang, J.M. (2022). Association Between Carbohydrate Intake and the Risk of Chronic Kidney Disease: A Retrospective Cohort Study. American Journal of Kidney Diseases, 79(1), pp.58–65. https://doi.org/10.1053/j.ajkd.2021.05.013

Nguyen, D., Hoang, P. & Phan, H. (2017). High Carbohydrate Diet Promotes Chronic Kidney Disease Progression by Affecting the Metabolic Pathways. Kidney International Supplements, 7(1), pp.32–37. https://doi.org/10.1016/j.kisu.2017.01.001

Peyton, S.C. & Spiegelman, D. (2022). Dietary Carbohydrate Intake and Incidence of Chronic Kidney Disease: A Prospective Study. Journal of Renal Nutrition, 32(1), pp.33–43. https://doi.org/10.1053/j.jrn.2021.08.002

Ren, Q., Zhou, Y., Luo, H., Chen, G., Han, Y., Zheng, K., Qin, Y. & Li, X. (2023). Associations of Low-Carbohydrate with Mortality in Chronic Kidney Disease. Renal Failure, 45(1). https://doi.org/10.1080/0886022x.2023.2202284

Smith, A. & Walker, M. (2023). High-Fat Diet and Risk of Chronic Kidney Disease: A Longitudinal Study. Nutrition, 99, pp.1-8. https://doi.org/10.1016/j.nut.2022.111088

Wish, J.B., Aronoff, G.R., Bacon, B.R., Brugnara, C., Eckardt, K.-U., Ganz, T., Macdougall, I.C., Núñez, J., Perahia, A.J. and Wood, J.C., 2018. Positive Iron Balance in Chronic Kidney Disease: How Much is Too Much and How to Tell? American Journal of Nephrology, [online] 47(2), pp.72–83. 
https://doi.org/10.1159/000486968.

Zainordin, N.A., Eddy Warman, N.A., Mohamad, A.F., Abu Yazid, F.A., Ismail, N.H., Chen, X.W., Koshy, M., Abdul Rahman, T.H., Mohd Ismail, N. & Abdul Ghani, R. (2021). Safety and Efficacy of Very Low Carbohydrate Diet in Patients with Diabetic Kidney Disease—A Randomized Controlled Trial. PLOS ONE, 16(10), p.e0258507. https://doi.org/10.1371/journal.pone.0258507