TREATMENT FOR KIDNEY DISEASE
Since another medical ailment usually causes chronic kidney disease,
the most effective way to treat kidney disease is to treat and manage
the disease that originally caused your kidney damage, for instance
diabetes and hypertension.
In Malaysia, some 57% of kidney failure patients are diabetics and
6% hypertensive. Hence, your doctor will use blood and urine tests to
regularly monitor your kidney’s condition. These tests will determine
how your kidneys are functioning and whether any changes to your treatment
plan is required.
Dialysis:
Dialysis is a life-saving process that artificially replaces part of
the functions of the kidney. There are two types of dialysis: haemodialysis
and peritoneal dialysis:-
- Haemodialysis involves removing blood from the body and
filtering it in an artificial kidney (dialysis machine). The patient
is connected by a tube to the dialysis machine, which continuously
draws blood out, cleans it and removes excess fluid and then returns
the blood back to the patient. Haemodialysis must be performed for
3 to 4 hours at least three times a week. It is usually performed
at a dialysis centre, though home dialysis is also possible.
- Peritoneal Dialysis is internal or in-body dialysis. Peritoneal
dialysis entails use of a blood-cleansing solution called "dialysate"
that is introduced into the peritoneal cavity, the region of the abdomen
that is lined by the peritoneum. While in the peritoneal cavity, the
dialysate works to extract toxins and excess fluids from the blood.
After a period of time, the solution is then drained from the body
cavity.
There are three types of Peritoneal Dialysis available:-
- Continuous Ambulatory Peritoneal Dialysis (CAPD)
CAPD requires no machine and can be done in any clean, well-lit place.
With CAPD, your blood is always being cleaned. The dialysis solution
passes from a plastic bag through the catheter and into your abdomen,
where it stays for several hours with the catheter sealed. The time
period that dialysis solution is in your abdomen is called the dwell
time. Next, you drain the dialysis solution into an empty bag for
disposal. You then refill your abdomen with fresh dialysis solution
so the cleaning process can begin again. With CAPD, the dialysis solution
stays in your abdomen for a dwell time of 4 to 6 hours, or more. The
process of draining the used dialysis solution and replacing it with
fresh solution takes about 30 to 40 minutes. Most people change the
dialysis solution at least four times a day and sleep with solution
in their abdomens at night. With CAPD, it’s not necessary to
wake up and perform dialysis tasks during the night.
- Continuous Cycler-Assisted Peritoneal Dialysis (CCPD)
CCPD uses a machine called a cycler to fill and empty your abdomen
three to five times during the night while you sleep. In the morning,
you begin one exchange with a dwell time that lasts the entire day.
You may do an additional exchange in the middle of the afternoon without
the cycler to increase the amount of waste removed and to reduce the
amount of fluid left behind in your body.
- Combination of CAPD and CCPD
If you weigh more than 175 pounds or if your peritoneum filters wastes
slowly, you may need a combination of CAPD and CCPD to get the right
dialysis dose. For example, some people use a cycler at night but
also perform one exchange during the day. Others do four exchanges
during the day and use a mini cycler to perform one or more exchanges
during the night. You’ll work with your health care team to
determine the best schedule for you.
