Let's Talk Dialysis

As we delve into the topic of dialysis, it's important to understand its purpose and implications for those undergoing this treatment. Dialysis is a procedure used to perform the functions of the kidneys when they are no longer able to adequately filter waste products and excess fluid from the blood.

For many individuals with advanced kidney disease or kidney failure, dialysis becomes necessary to maintain their overall health and well-being. It helps to remove toxins and excess fluid from the body, which can otherwise accumulate and lead to serious complications.

While dialysis can be temporary in some cases, such as during acute kidney injury or while awaiting a kidney transplant, for many individuals, it becomes a lifelong treatment once kidney function has significantly declined. In Jamaica, dialysis is not just a life saving intervention but also a life line, in the absence of a robust kidney transplant programme. Although the gold standard for dialysis frequency is three times per week, the average Jamaican patient on dialysis does two treatments per week, mainly because of financial limitations.

However, it's important to note that dialysis itself does not improve kidney function. Instead, it serves to supplement kidney function by performing the filtration and waste removal processes that the kidneys can no longer adequately perform. Some patients on dialysis may be able to pass urine, but this urine, although it may get rid of excess fluid, does not rid the body of waste substances from the body. As a result, these patients still require dialysis.

Dialysis patients often need to follow dietary restrictions to help manage their condition effectively, which continues to be a challenge in Jamaica. This typically involves limiting foods that are high in sodium, potassium, and phosphorus, as these can build up in the bloodstream and cause complications for individuals undergoing dialysis. (see my post on the renal diet for further information)

When it comes to the type of dialysis, there are different options available, including haemodialysis and peritoneal dialysis. The choice between these methods often depends on factors such as individual health status, lifestyle preferences, and medical recommendations. IN Jamaica, centres offer predominantly hemodialysis, with peritoneal dialysis making up the minority.

Regarding blood pressure, dialysis can help to regulate blood pressure levels by removing excess fluid from the body. However, it may not always lower blood pressure significantly, especially if other factors such as underlying health conditions or medication adherence are at play.

Finally, it's important that I address the misconception that dialysis will "kill you." I cannot count the many times patients with stage 5 chronic kidney disease tell me they do not want any dialysis, as "it will make them dead quicker." While it's true that dialysis is a medical intervention and every medical intervention has its risks and possible complications, it is not inherently lethal. On the contrary, dialysis can significantly improve quality of life and longevity for many individuals by effectively managing the symptoms and complications associated with kidney failure.

In conclusion, while the prospect of undergoing dialysis may initially seem daunting, it's important to recognize that life on dialysis is not only feasible but also offers the opportunity for a fulfilling and meaningful life. Dialysis is a remarkable treatment that allows a person with kidney failure to continue living and pursuing their passions, while spending time with loved ones. By maintaining a healthy lifestyle, adhering to treatment plans, and staying engaged in activities that bring joy and fulfilment, individuals on dialysis can thrive and continue to make meaningful contributions to the

world around them.