Hemodialysis: how to live with it. “Without dialysis a person dies from intoxication”: How I live with kidney failure

When only kidney dialysis can help the body, how long do people with this problem live? This question worries exclusively all patients who are faced with various diseases that led to this situation, but not many know the answer. Typically, this procedure is prescribed for acute renal failure, for which there are not so many treatment methods.

According to encouraging forecasts from doctors, if all recommendations are strictly followed and regular attendance at dialysis procedures, a person can live quite a long time - about 20 years. Kidney dialysis, or hemodialysis, is a fairly modern method of cleansing the blood of toxins, completely replacing this function of the urinary system. The only alternative to this procedure is transplantation of a donor organ - relatively Long procces, which does not always end in a positive result. Hemodialysis is a lifelong and permanent procedure, the cancellation of which can lead to death in patients with renal failure.

In the natural and healthy state of the body, the removal of toxic waste products is entrusted to the urinary system. With any violation of its functions, intoxication occurs - poisoning with waste and various toxins that accumulate inside the body, which can lead to death. In case of kidney failure caused by certain causes, including diabetes mellitus, hemodialysis is used to cleanse the human body of pathological waste products.

In acute renal failure, toxic metabolites are removed through the mucous membranes of the body and the skin. The skin becomes covered with urea crystals, and irreversible inflammatory processes begin in the gastrointestinal tract. If the patient's blood is not cleared of decay products in time, the patient may die from multiple organ failure caused by uremia. Kidney dialysis allows you to free the nervous and cardiovascular systems of the body from pathological products of protein breakdown and significantly reduce intoxication of the entire body.

Hemodialysis is an artificially created system for filtering and purifying blood in the body. Several double-ended catheters connected to a hemodialyzer are inserted into the patient's vein. Through one of them, a special medical solution, dialysate, is supplied to the blood, and through the second, the blood itself passes. Due to the different densities of substances passing through the dialyzer, the blood is purified and the level of biological components is balanced. As a result, the amount of toxins in the blood is significantly reduced. In case of kidney failure, the patient not only cleanses the blood of toxins, but also reduces the volume of fluid in the body, which prevents the appearance of edema, especially in the lungs.

After dialysis, side effects may occur, which are expressed in a sharp decrease in the level of red blood cells in the blood, the development of anemia and a drop in blood pressure. In some cases, dialysis causes nausea and vomiting, and may cause seizures. Patients with heart disease may experience neurological problems, dizziness, and weakness. They may develop a disease called pericarditis, an inflammation of the heart sac. Dialysis is carried out in a hospital setting, in intensive care wards, so the occurrence of side effects or unexpected complications is under the control of specialists who will be able to notice the pathology in time and take appropriate measures to eliminate it. It must be remembered that the occurrence of side effects after hemodialysis significantly reduces life expectancy. Such a response from the body may also indicate possible rejection of the donor organ that was transplanted into the patient.

How long can you live on dialysis?

The earlier replacement therapy—hemodialysis—starts, the greater the patient’s chances of extending his life. Kidney dialysis should begin when all their functions are reduced to a pathologically critical level - neither a fairly strict diet nor medications will help restore the activity of dying organs. The earlier dialysis is prescribed and performed, the longer the patient’s life expectancy becomes. The intensity of the procedures depends on the age, weight and degree of the patient’s disease, as well as the presence of concomitant pathologies. Under normal conditions, dialysis is carried out 3 times a week for several hours. Sometimes the patient's death occurs initial stages hemodialysis - this blood purification procedure is not suitable for everyone. But if the first hemodialysis sessions went fairly well, the patient has an increased chance of prolonging his life and making it full.

Thanks to the development of modern medicine, hemodialysis helps sick people with quite serious pathological kidney diseases to significantly extend their lives. Just a few decades ago, a patient forced to undergo hemodialysis procedures lived only 5-6 years. Most patients died not only from kidney problems: the weakened body was “attacked” by all sorts of diseases, which became the cause of death. This is explained by the fact that the human body without the normal functioning of organs, especially the kidneys, is deprived of natural immunity. In addition, the dialysis process itself caused patients a lot of trouble and discomfort. Today, the procedure has been simplified so much that during its implementation, patients can simply sleep, listen to music or watch movies on a laptop.

Hemodialysis equipment can be installed at home, which greatly simplifies the accessibility of the procedure. However, it is not cheap, so not everyone can afford it. With a timely and competently performed hemodialysis procedure with the elimination of all emerging side effects, patients with pathological kidney diseases, as well as patients with acute renal failure, can have the same life expectancy as a healthy person. Renal hemodialysis saves enough a large number of human lives and significantly prolongs them. A patient who constantly undergoes kidney dialysis will be able to live as long as the artificial blood purification procedure is available to him. Hemodialysis is not a panacea for kidney failure; transplantation of a donor organ successfully solves problems with kidney diseases. But in cases where transplantation is not possible, or the patient's body rejects the organ, kidney dialysis remains the only hope for life and a normal future for most people with such diseases.

Every year, tens of thousands of new cases of chronic renal failure (CRF) are diagnosed worldwide. The disease has a chronic, progressive course, and there are not many ways to effectively treat it. One of them is hemodialysis, a treatment method that successfully replaces healthy kidneys and allows one to cleanse the blood of substances that are unnecessary and toxic to the body. Despite the advantages, the procedure also has its difficulties. Let's try to figure out how long life can last on hemodialysis, how often it should be performed, and what patients with chronic renal failure must know.

When you can't do without blood purification

Hemodialysis is blood purification that occurs outside the kidneys. The main goal The procedure is to maintain a constant internal environment, as well as rid the body of:

urea – the final product of protein metabolism in the body;
creatinine - a substance formed during active energy metabolism in muscle tissue;
substances that poison the body (for example, strontium, arsenic, plant and animal poisons);
medicines– preparations of salicylic acid, barbiturates, sedatives, sulfonamides, etc.;
ethyl alcohol (alcohol);
“extra” electrolytes (potassium, sodium) and liquid.

The main indications for hemodialysis are:

chronic renal failure with symptoms of uremia (occurs when the functional activity of the kidneys decreases to 20-30%);
acute renal failure arising from inflammatory diseases (pyelonephritis, glomerulonephritis), acute urinary retention, crush syndrome, etc.;
poisoning by poisons, toxic substances, alcohol, drugs and medications;
overhydration – “water poisoning” of the body;
disturbances in the ionic composition of the blood in case of extensive burns, dehydration, prolonged intoxication, intestinal obstruction.

Although in many of the conditions listed above the patient’s kidneys partially retain their functional activity and do not require hemodialysis, in some cases only this procedure can save the patient’s life.

Clear criteria for the need for hemodialysis include:
oliguria (daily diuresis is 500 ml or less);
the kidneys filter less than 200 ml of blood within 1 minute, their functional activity is lost by 80-90%;
the level of urea in a biochemical blood test exceeds 33-35 mmol/l;
plasma creatinine level above 1 mmol/l;
potassium concentration – more than 6 mmol/l;
increasing signs of uremia, cerebral edema and internal organs.

Operating principle of a hemodialysis machine

Hemodialysis is a relatively “young” treatment technology: it recently turned only 40 years old. Over the years, it has become widespread throughout the world and has even grown into a separate branch of medicine.

The “artificial kidney” device is simple and consists of two interconnected systems:

for processing (purification) of blood;
for dialysate preparation.

Venous blood is collected from the patient, which is supplied through a soft catheter to the filtration system. The main component of the filtration system is a semi-permeable membrane consisting of cellulose or synthetic materials. Pores of a certain size allow the separation of substances harmful to the body, as well as excess liquid and plasma with branded elements. The purified blood is returned to the patient, and the dialysate containing unnecessary substances is disposed of. On average, this procedure lasts 4-5 hours and is carried out in an intensive care unit.

During hemodialysis, the doctor carefully monitors the patient's blood pressure and other vital signs. If they deviate sharply from the norm, the procedure is suspended. Before blood is drawn, the patient is given heparin or other antiplatelet agents to prevent the formation of blood clots, which invariably form on the vascular wall when using a soft catheter.

Note! Today it is possible to perform hemodialysis at home. To do this, the patient needs to purchase a portable “artificial kidney” device, the cost of which ranges from 15-25 thousand dollars, and undergo a training course in how to use the device independently.

The distinctive features of home hemodialysis include:

convenience and comfort for the patient;
no risk of contracting blood-borne infections (HIV, hepatitis B, C);
lack of medical supervision, the possibility of complications from the procedure.

Negative consequences of hemodialysis

Hemodialysis is a procedure that is quite traumatic for the body. It may cause the patient the following side effects:

loss of essential mineral salts, electrolyte disturbances;
muscle pain, cramps, spasms caused by a lack of sodium, magnesium, chlorides, potassium and other elements in the blood;
heart rhythm pathology, atrial fibrillation, extrasystole, right or left bundle branch block;
hypotension;
anemia caused by the destruction of red blood cells during the procedure;
bone pain.

How long does this therapy method allow you to live?

Kidney dialysis remains the main method of symptomatic treatment of chronic renal failure: How long patients live with it largely depends on the course of the pathology and the characteristics of the body.

If the hemodialysis schedule is followed (with a persistent decrease in the functional activity of the organ - usually 2-3 times a week) and there are no progressive signs of cerebral edema, the patient feels well and can maintain his usual lifestyle for years.

On average, the life expectancy of patients with chronic renal failure who regularly undergo blood purification procedures is not inferior to the life expectancy of healthy people. Hemodialysis can be performed until a donor kidney is found for the person. Sometimes this takes years: on average, 1,000 transplant operations are performed in Russia annually, while there are at least 24 thousand patients waiting in line.

Every hemodialysis patient should understand how important blood cleansing sessions are for him. Compliance with medical recommendations and regular visits to the clinic where the “artificial kidney” device is located will allow a patient with chronic renal failure to live a long and active life, and patients with acute disorders will quickly regain their health.

Healthy kidneys are a blood filter. Its entire volume passes through the kidney filter more than 1000 times per day. In 1 minute, 1 liter of blood is purified. In a short period of time, the kidneys, our natural filter, remove molecules of substances toxic to the body and excess water from the blood, which enter the urinary tract and leave the body. Beneficial substances that circulated in the blood return to the bloodstream.

Unfortunately, for various reasons, the kidneys can become damaged and lose their functions, which leads to the retention of toxic substances in the body. If the blood is not cleansed of toxins, the person will die from self-poisoning. About 50 years ago, people with kidney failure died at a young age. on hemodialysis at the present time, depends on the availability of proper equipment, the professionalism of the medical staff, concomitant diseases, but to a greater extent on the person himself, his lifestyle and adequate attitude towards his health.

Artificial kidney filter

In the mid-18th century, using the laws of physics, a scientist from Scotland developed a blood purification system. He studied it on dogs deprived of kidneys. The device did not live up to expectations due to the development of many complications.

The first hemodialysis procedure in humans was performed by a German doctor at the beginning of the 19th century. 15 procedures were performed on different people, who did not live long after that. This is due to the development of thromboembolism. They used leech hirudin, a blood-thinning protein, which was quickly neutralized by the patients’ immune system and the blood thickened to form blood clots. A positive result of the method was achieved in 1927 with a procedure using heparin, but the patient still died.

In the fall of 1945, a Dutch doctor improved the device used at that time and successfully brought the patient out of her uremic state, finally proving the effectiveness of hemodialysis. In 1946, the doctor published a manual on treating patients with uremia using hemodialysis.

How the magic filter works

Hemodialysis is a system of blood purification without involving the kidneys. To perform the procedure, access to the vein and artery is necessary. Systems are inserted into these vessels and shunts are formed, which are connected to the hemodialyzer. From the arterial shunt, blood flows into the apparatus, where there are capillaries with semi-permeable membranes. The capillary is surrounded by a cavity containing dialysate fluid, where, according to the law of osmosis, harmful molecules are released from the blood. From the dialysate, substances necessary for life enter the capillary and enter the patient’s bloodstream. In order to prevent blood clots, an anticoagulant is introduced into the system. The processed dialysate is removed and the purified blood is returned to the patient. The procedure lasts from 4 to 12 hours and is repeated 3 times a week, and in some cases every day.

How long do people live on hemodialysis? Statistics show an average of 15 years, but in history there is evidence that there were patients who lived for 40 years. The Russian book of records describes a woman who spent 30 years on dialysis.

The method of extracorporeal blood purification carries many costs. Over a million rubles are spent per person per year. Currently, there is a government program through which the costs are paid by the government. Scientists are trying to improve the devices themselves, so that in the near future this procedure will become available to everyone suffering from kidney failure. Let's consider what types of hemodialysis machines exist.

By functionality

Classic - a device with a small membrane area. Only small molecules pass through the filter. Blood flow rate up to 300 ml/min. The procedure lasts 4 hours.
Highly efficient. The area of the semi-permeable membrane is 1.5 - 2.2 sq.m. Accelerates the blood flow rate to 500 ml/min, which reduces the duration of the procedure to 3 hours. In the opposite direction of the blood, dialysate moves at a speed of up to 800 ml/min.
High flow. Allows you to cleanse the blood of anything, allowing even large molecules to pass through.

By type of dialyzers

Capillary. They are closest to the physiology of a healthy kidney.

Disc (plate)

Portable devices

There are portable blood purification devices. They are common in Western countries. More than half of patients with chronic renal failure use these devices. The equipment is expensive, estimated at $20 thousand. Portable devices have their advantages:

No queue;

The possibility of contracting blood-contact infections (hepatitis, HIV) is excluded;

You can move freely with them during the procedure.

The disadvantage of such devices is that an unpredictable reaction may occur and emergency assistance will be required.

Peritoneal dialysis

Fluid (dialysate) is injected into the abdominal cavity through a puncture on the anterior abdominal wall. The volume is about 2 liters. One end of the tube is in the stomach, and the other is closed. No dialyzer required. membrane in in this case is the peritoneum, through which toxic substances pass into the dialysate solution. The liquid is kept for 4-5 hours, after which the liquid is removed through the catheter, and a clean solution is refilled in the same volume. There is a risk of inflammation of the peritoneum, which may lead to additional treatment methods, including emergency surgery. When performing any type of hemodialysis, sterility rules must be observed. This procedure is contraindicated for overweight people (abdominal obesity) and people who have adhesive disease.

What are the reasons for hemodialysis

This procedure became the only salvation for thousands of patients whose kidneys were unable to perform their functions.

Hemodialysis is prescribed to people with the following health problems:

1. Acute and chronic and chronic renal failure). It is characterized by low 24-hour urine output and a laboratory-confirmed decrease in glomerular filtration rate (GFR). How long they live on kidney hemodialysis depends on the tolerability of the procedure and the patient’s compliance with the doctor’s recommendations. Dialysis is carried out to replace completely lost kidney function and remove nitrogenous waste from chronic renal failure. In acute renal failure, hemodialysis is carried out to remove toxic substances from the body that caused acute renal failure and to release excess fluid.

2. Diabetic nephropathy. It is a late vascular complication of diabetes mellitus. The capillaries of the kidney filters become sclerotic due to constantly elevated glucose levels. The renal threshold for blood glucose levels is 10 mmol/l. When the sugar level is above this indicator, glucose begins to be filtered into the urine. The molecules are large and damage the delicate walls of the capillaries. How long can you live on hemodialysis with diabetes mellitus, depends on the degree of compensation of the pathology, the level of glycated hemoglobin, and the presence of other severe types of complications. For diabetics over 70 years of age, hemodialysis is contraindicated.

3. or ethyl). Metabolites of some alcohols cause the formation of crystals that damage kidney tissue and cause acute kidney failure. How long people live on hemodialysis after poisoning depends on the degree of damage to the kidney tissue. There is a chance of restoring kidney function, and hemodialysis will no longer be needed.

4. Toxic effects of drugs and poisoning. There is a direct damaging effect on the kidneys. Hemodialysis is performed to remove poison and medicinal metabolites from the body. If the body is able to cope, then hemodialysis is carried out until kidney function is restored. How long they live on kidney hemodialysis in this situation depends on the type and amount of the damaging agent.

5. A state of overhydration, when the body contains a large amount of water ("water poisoning") and there is a risk of developing cerebral and pulmonary edema. The purpose of the procedure will be to remove excess water, lower blood pressure and reduce swelling.

6. Violation of the ratio of electrolytes in the body. Occurs when fluid is lost with frequent vomiting, diarrhea, intestinal obstruction, and prolonged fever. Special dialysates with the necessary electrolytes are used to replace or remove them. Carry out until the electrolyte balance is restored.

7. Kidney transplantation. Until the transplanted kidney starts working, it is supported. How long do they live after kidney rejection on hemodialysis? The same amount of time as they would live without a transplant. About 20 years.

Indications for the procedure

Certain indicators for which an “artificial kidney” is indicated:

Daily urine output is less than 500 ml. Normally - 1.5-2.0 liters.
Decrease below 15 ml/min. The normal value is 80-120 ml/min.
The creatinine value is above 1 mmol/l.
Urea level is 35 mmol/l.
Potassium above 6 mmol/l.
A bicarbonate level below 20 mmol/l is metabolic acidosis.
Increasing edema of the brain, lungs, heart, refractory to standard therapy.

Contraindications to hemodialysis

Infectious process. Microorganisms circulate in the bloodstream. The hemodialysis procedure increases blood flow throughout the body and there is a huge risk of pathogenic flora entering the heart, which can cause inflammation. Dangerous by the development of sepsis.
Acute cerebrovascular accident. The procedure may increase blood pressure levels and make the situation worse.
Mental disorders and epilepsy. Hemodialysis is stressful for the body. A slight change in blood pressure can cause headaches and mental illness or seizures. For high-quality therapy, it is necessary to calm the patient and comply with the medical requirements of the working staff of the dialysis center during the procedure.
Foci of tuberculosis in the body. This type patients are a source of infection and cannot attend hemodialysis centers. Even if you create a specialized dialysis department, there is a risk of contamination of the body with Mycobacterium tuberculosis.
Malignant tumors. Dangerous due to the spread of metastases.
Chronic heart failure, acute myocardial infarction and the first days after it. Hemodialysis affects the electrolyte ratio and any change in it can lead to cardiac arrhythmias, even cardiac arrest. In chronic heart disease, blood flows through the vascular bed at a lower speed and there are areas of thickening, and the dialysis procedure can provoke the movement of a blood clot and blockage of an artery.
Severe arterial hypertension. There is a risk of a hypertensive crisis.
Age over 80 years. The reason is that the cardiovascular system of older patients undergoes involution. Veins and arteries become fragile, making it difficult to access hemodialysate. It has been noted that people over 60 years of age live on hemodialysis for as long as the capabilities of their cardiovascular system allow.
Blood diseases. The administration of heparin can aggravate bleeding disorders, and the hemodialysis procedure can destroy some red blood cells, which worsens the course of anemia.

Hemodialysis complications

Inflammation and purulent complications at the site of vascular access.
Muscle pain and discomfort.
Contact dermatitis.

System:

Violation general condition in the form of weakness, headache, malaise, nausea, muscle pain.
Generalized allergic reaction to membrane components.
Violation of blood pressure levels (decrease or increase).
Air embolism.
Sepsis. In case of non-compliance with the rules of asepsis against the background of weakened immunity in this category of patients.
Iatrogenesis - infection with viral hepatitis and HIV. A high degree of sterilization is required. In conditions of a large flow of patients and a small amount of equipment, an insufficient level of processing of systems is possible. It all depends on the work of the medical staff.

Who performs

Hemodialysis in a hospital should only be performed by healthcare workers. IN last years The practice of performing hemodialysis at home has spread. This is much more convenient for the patient, since he remains with his family. The procedure can be performed at home by anyone (not a healthcare professional) who has undergone training. How long the average person lives on hemodialysis depends in this case on how sterile the person performing the procedure is. If he does not wash his hands thoroughly enough (this must be done first with soap, then with a disinfectant solution, for example, Betadine), or does not observe sterility when applying a bandage at the site where the fistula is inserted into the patient’s body, the infection that enters the patient’s body can kill him in a matter of months. If everything is done correctly, the patient will live as long as a person who does not have kidney problems.

Diet for hemodialysis

How long you can live on hemodialysis largely depends on how the patient monitors his health. He should not drink, smoke, eat smoked foods, pickles, marinades, flour sweets, or fried foods. The menu of such a person should consist of fresh, high-quality products containing vitamins and proteins (chicken, rabbit, lean beef, boiled eggs). You should limit yourself to foods such as milk, beans, nuts, and cheese.

Hemodialysis is a medical hardware procedure through which patients are artificially restored to lost functions of the renal system.

Hemodialysis is considered a relatively new technique, which has been used in practice for no more than forty years.

Thanks to this procedure, the blood of sick people who lack a kidney or have poor functioning of this organ is cleared of toxins. If indicated, unfortunately, patients are prescribed a lifelong course of hemodialysis. How long they live with this treatment method is of interest to all sick people. Hemodialysis is based on the principle of an artificial kidney. In most cases medical practice It is thanks to this procedure that patients can live with acute and chronic renal failure.

Of course, there is another method of dealing with this condition - a kidney transplant, however, organ transplantation in our country is considered a very expensive procedure, and a sick person can wait for the organ itself for years.

If we look at the statistics, the hemodialysis procedure (no doctor can say for sure how long such patients live) prolongs a person’s life by decades. Despite this, each case is individual and largely depends on the patient’s lifestyle, his initial diagnosis and condition.

Hemodialysis itself is a special filter system that has several catheters and one outlet for supplying a dialysate solution, which filters the blood using special membranes.

Passing through these filters, the blood is purified, so most of the dangerous toxins are eliminated from it.

It should be noted that with an advanced form of renal failure, the patient needs not only to cleanse the blood, but also to control the level of fluid in the body in order to reduce the likelihood of edema.

The number of hemodialysis sessions is selected for each patient individually. There is no a certain scheme, since each patient's case is considered separately. Typically, three hemodialysis procedures are performed per week.

The duration of one session is about five hours. Despite this, due to the fact that modern membranes may already be more effective, hemodialysis can be carried out twice a week for two hours (provided that the blood is purified more strongly).

In the event that the patient’s kidneys restore their functions, the procedure may be performed less frequently (based on the indications and the person’s condition). That is why a patient with kidney failure needs to undergo regular tests and be examined by a doctor.

Most often, hemodialysis is practiced in a hospital setting, but there are already modern portable devices that allow this procedure to be performed at home.

Hemodialysis can be practiced not only in case of kidney failure, but also in case of poisoning with severe poisons. This method can also save a person’s life in case of drug overdose. Moreover, it is important to note that hemodialysis is vital when traditional drug therapy cannot maintain normal kidney function.

At the same time, it is important to dispel the myth that this method should be practiced even when the kidneys have completely failed. In fact, this is not so, because the longer a patient delays hemodialysis, the more damage his body receives. As for the procedure itself, in addition to the main indications, the number of sessions is also determined taking into account the weight, age and presence of additional chronic diseases of the patient.

Kidney dialysis: how long do they live and what does it do to the body?

Hardware dialysis is used when the patient’s kidney function is impaired and their failure at different stages.

Many patients are afraid of dialysis, explaining that this procedure has a high risk of mortality. Of course, this method can cause the formation of a blood clot in the catheter, an incorrectly prepared solution or a malfunction in the device, but much more often the cause of death is inaction in treatment, that is, when a person delays starting hemodialysis and dies from the main problem - renal failure. If we consider kidney dialysis and how long people live when performing this procedure, then we can say for sure that this method prolongs the patient’s life by at least another ten years. At the same time, there is still no precisely deduced life expectancy for a person undergoing kidney dialysis; how long patients live depends on the severity of their condition and the initial functions of the kidneys in the body.

Kidney dialysis has the following effects on the body:

Cleanses the body of toxins and waste, preventing their accumulation.
Clears the blood of excess salt and fluid.
Controls the level of important microelements in the blood.
Adjusts the patient's blood pressure.
Eliminates anemia.
Almost completely replaces the functions of the kidneys, that is, it performs their “work” in the body.

Thanks to the fact that modern medicine is constantly improving, today a person’s need for dialysis is not a death sentence at all, but only a necessary measure of life. And if ten years ago patients were tremblingly awaiting their next dialysis procedure, now during the procedure they can listen to music or watch a movie.

Moreover, for a certain financial support a person can install dialysis equipment at home and go to the doctor only for a follow-up examination. While patients wait for a kidney transplant, which can take years, they are forced to undergo regular dialysis. As practice shows, the average life expectancy of people with complete refusal kidney life during dialysis is 12-15 years.

If the patient’s condition is advanced, this period can be shortened to six years. This statistic is justified by the fact that when the kidneys fail, a person has practically no immunity, so any infectious disease, even not a dangerous one, can become a death sentence for a person. This is also confirmed by the fact that patients with renal failure usually die not from it, but from concomitant diseases.

At the beginning of dialysis, death has a greater chance of death, since this blood purification procedure itself is not suitable for everyone. That is why a person must understand that if the first dialysis was successful, then there is a high probability that he will live for at least another six years. In our country, people can live on dialysis for up to twenty years, although in the world patients can lead a full life for more than thirty years.

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What is dialysis

Kidney dialysis is a procedure that helps cleanse the human body of harmful substances, waste, toxins, that is, performs the same role as the kidneys. The procedure consists of injecting a person with a special solution to cleanse his body using a special device.

The solution is passed through semi-permeable membranes with pores; it is through these membranes that various unnecessary substances are removed from the blood. The specifics of the procedure and the membranes used depend on the type of dialysis.

Cleansing the body requires quite a lot of time - from several days to several weeks, but there are solutions that speed up this process. Depending on how damaged the kidneys are, people live on dialysis either for a short period or for the rest of their lives.

Dialysis classification

Depending on the characteristics of the conduction and the devices used, there are different kinds dialysis

Hemodialysis is a procedure performed using a machine called an “artificial kidney.” The principle of its operation is as follows:

Blood that requires purification passes through a filter into a container (dialyzer) with a special solution.
The dialyzer purifies the blood.
Purified blood goes back into the body.

Hemodialysis is reserved for patients whose veins and arteries are clearly visible, and is performed under the supervision of a doctor who monitors that the machine does not remove too much fluid from the body. This procedure is carried out for 3-4 hours 3 times a week. Under no circumstances should you miss a session even once.

Peritoneal dialysis involves inserting a special catheter into a person's abdominal cavity. The abdominal cavity in this case is a dialyzer; a solution is injected into it several times a day. Further, the cleansing process is similar to the previous one. Peritoneal dialysis can be constant (the solution is changed every 4-10 hours) or automatic (a special liquid is changed while the patient sleeps). The second option gives top scores. Complications may occur with peritoneal dialysis abdominal cavity.

Intestinal dialysis. The essence of this technique is that instead of a membrane, the intestinal mucosa is used, and the cleansing technique is the same as for kidney disease - toxins pass through the mucosa into the dialysis solution, cleansing must be carried out repeatedly. Before dialysis, an enema is given with an active solution. Intestinal dialysis is prescribed if the two previous types are contraindicated for some reason.

Pros and cons of different types of dialysis

Both hemodialysis and peritoneal dialysis have the following positive effects on the body:

perfectly remove accumulated waste and toxins;
prevent the accumulation of excess salts;
maintain the “purity” of the blood;
regulate blood pressure.

Peritoneal dialysis also has the following advantages:

allows you to set a schedule;
the kidneys remain functional;
not contraindicated for diabetics;
requires little time.

The main disadvantages of hemodialysis:

it can only be carried out in a hospital;
requires a lot of time;
cannot be carried out for patients with diabetes;
high price for the devices needed for the procedure.

Disadvantages of peritoneal dialysis:

it needs to be done frequently;
there is a high risk of introducing an infection into the body;
is not suitable for all patients (this is especially true for those who have abdominal pathologies).

Indications for dialysis

In medicine, this method of treatment is prescribed to patients whose body cannot cleanse itself of unnecessary substances due to any pathologies, the most common of which are:

glomerulonephritis;
renal failure (determined by the results of laboratory blood tests);
alcohol poisoning (methyl or ethyl);
damage to the body by poisons;

drug overdose;
coma state
swelling of the brain and lungs due to excessive hydration;
disturbance of the electrolyte composition of the blood;
Excessive water content in the kidneys (in case conventional therapy fails and the risk of death increases).

This is a list of those diseases that, without blood purification, threaten a person with death.

What conditions should be observed during dialysis?

Kidney dialysis is a complex procedure that requires special conditions and compliance with mandatory rules:

the patient must be treated in a hospital setting under the supervision of a physician (especially for hemodialysis);
in case of chronic renal failure, blood purification is carried out at least 3 times a week;
a diet based on a large amount of protein and a restriction in the intake of salt, some spices and water (this condition is necessary to prevent the development of thrombosis and anemia due to the procedure);

swelling signals the need to reduce the amount of fluid consumed;
the patient must take vitamins prescribed by the doctor, their dosage is also determined by the specialist;
life on dialysis requires regular testing for the presence of iron in the blood, as it can increase due to frequent blood transfusions;
the doctor has the right only to recommend this method, and the patient decides whether to do it or not;
the doctor must notify the patient how long they live on dialysis;
Before treatment, the psycho-emotional state of a person must be checked;
often this method of treatment requires supervision by a psychiatrist and neurologist, who help the patient mentally prepare for the procedure and undergo it without harm to the mental state;
When agreeing to treatment, the patient must remember that this procedure must be carried out according to the schedule; if it is not followed, there will be no result.

An important and monetary issue: the patient must find out how much the procedure costs and be prepared for significant expenses. However, there are hospitals that receive funds from the local budget, and treatment in them can be provided cheaper, and in some cases, free.

Life expectancy on dialysis

People with kidney problems first of all have questions about what are the indications for kidney dialysis and how long they can live with this procedure.

At the first stages of the introduction of this procedure into medicine, the life expectancy of patients was 3-7 years. Today, devices for blood purification, and the process itself, have been improved, and people can live much longer - from 22 to 50 years, this depends on additional factors (the presence of other diseases, the patient’s lifestyle).

Contraindications

There are a number of contraindications for hemodialysis and peritoneal dialysis. The reasons for refusing peritoneal dialysis are:

adhesions in the abdominal cavity;
excess weight, due to which blood purification may not be effective;
skin diseases in the abdominal area, especially if they are accompanied by inflammatory and purulent processes;
drainage in the abdominal cavity;

nervous system disorders;
inflammatory processes in the abdominal cavity.
serious pathologies of the cardiovascular system.

Hemodialysis is contraindicated in the presence of the following factors:

diabetes;
pathologies of the vascular system;
nervous disorders;
if it is difficult to “find” veins and arteries;
heart diseases.

Kidney dialysis is a complex procedure for which a person must be prepared, first of all, mentally. Before agreeing to such treatment, carefully weigh the pros and cons, and also consult a specialist. If you agree, then, if you carefully follow all the specialist’s conditions, you will live for many more years without much discomfort.

pochki.guru

What is dialysis?

Kidney dialysis - what is it? This is the name given to the procedure of filtering toxic substances from the bloodstream. It is carried out using a semi-permeable perforated membrane, which is part of the “artificial kidney” device. In simple words, hemodialysis is a cleansing of the body without the participation of the kidneys.

With the help of an “artificial kidney,” the following harmful metabolic products are removed from the patient’s body:

urea, which is formed due to the breakdown of protein during digestion;
creatinine - a substance that is the end product of energy exchange in muscle tissue;
various toxins of exogenous origin - strontium, arsenic, etc.;
tranquilizer medications, barbiturates, substances based on boric acid, sulfonamides, etc.;
inorganic substances such as sodium, calcium, potassium, etc.;
excess water.

A licensed hemodialysis device must consist of the following functional elements:

A system for working with blood, which includes pumps for pumping blood and heparin supply, a mechanism for eliminating air vesicles from the bloodstream, and a sensitive element for measuring pressure in blood vessels.
System for mixing the working solution - dialysate. It consists of mechanisms that control the temperature of the solution, the hemodynamics in it and the filtration process.
Filter-dialyzer - in the form of a special membrane of natural or synthetic origin.

The procedure is carried out as follows. A needle is inserted into a patient's vein, and his blood enters the machine, pooling on one side of the membrane (dialyzer). On the other side of the filter, the working solution is introduced through the tube. The dialysate “pulls” toxins, excess water, cations, anions, etc. from the bloodstream, thereby cleansing it. It is important that the working solution is selected individually for each patient.

Dialysis is designed to perform the following functions:

Blood purification from secondary metabolites. Kidney failure leads to an increase in the concentration of toxic compounds in the patient's bloodstream. They are completely absent from the dialysate solution. The transition of secondary metabolites from the body to the artificial kidney apparatus occurs due to the physical mechanism of diffusion: substances from a highly concentrated solution pass into a less concentrated liquid.
Bringing the number of electrolytes back to normal. Electrolytic elements - sodium, potassium, calcium, magnesium, chlorine, etc. - are necessary for the normal functioning of the whole body, but their excess must be removed by the kidneys of a healthy person during urination. During dialysis, absolutely all electrolytes do not transfer into the working solution - the amount necessary for functioning remains in the patient’s blood.
Balance of acid-base environment in the body. To perform this function, a special buffer substance, sodium bicarbonate, is introduced into the dialysate. This compound is absorbed into the blood through the membrane of the device and penetrates into red blood cells. As a result of several chemical transformations, the blood pH increases towards slightly alkaline, approaching normal.
Removing excess water. This effect is achieved by the ultrafiltration mechanism. Under pressure provided by the pump, the patient's blood passes through a perforated membrane into a container containing dialysate. In the latter, the pressure is low. The pressure difference ensures that excess water passes into solution. This function of the “artificial kidney” apparatus helps relieve swelling in various parts the patient's body: lungs, joints, pericardium, brain.
Prevention of thrombosis. This property is ensured by the introduction of heparin into the dialysate, which “thin” the blood plasma.
Prevention of air embolism. The tube through which purified blood returns to the patient's body is equipped with special device, which creates negative pressure in a certain area. With its help, air bubbles formed during transport are removed from the bloodstream.

To understand how effective the dialysis session was, an analysis is performed to determine the urea content in the bloodstream. When completing 3 sessions per week, the percentage of plasma purification should exceed 65. When performing the procedure twice a day, the blood should be purified from urea by 90% or higher.

What side effects are possible with dialysis?

Unfortunately, cleaning the blood from toxins using hardware is stressful for the body, and therefore kidney dialysis can cause some disturbances in the functioning of internal organs and systems. The probability of their occurrence is small, but it cannot be completely neglected. The following conditions may occur:

anemia, as the number of red blood cells sharply decreases;
reaction from the central nervous system in the form of temporary numbness of the limbs;
pressure surges in blood vessels;
damage to bone tissue;
inflammation of the membranes of the heart muscle.

The above cases are rare, however there are side effects of dialysis that can happen to every patient from time to time:

feeling of nausea;
vomit;
increased or slow heart rate;
muscle cramps;
spasm of the bronchial tree;
deterioration of vision and hearing;
pain in the chest or back.

Cases have been described in medicine where patients during hemodialysis developed an allergic reaction to any component of the dialysate solution. Is it possible to restore balance in the body in another way if dialysis has so many side effects? To date this is the only effective method maintaining normal life for people with kidney failure.

Classification of dialysis procedures

Different types of kidney dialysis are distinguished depending on several factors: the location of the procedure, the functionality of the “artificial kidney” device, the design of dialyzers, etc. In these cases, the differences are small. Let us dwell in more detail on peritoneal-type dialysis, which replaces conventional hemodialysis for a certain category of patients.

Peritoneal dialysis is necessary when:

The patient does not have the opportunity to undergo blood purification in a specialized center due to the lack of one.
There are serious contraindications to the standard procedure.

This type of procedure is required on average in 10% of patients with chronic renal failure. It is carried out as follows. The patient is given a puncture in the abdomen, into which a catheter is inserted. It is necessary to wait several weeks before the first procedure can be carried out. It consists of injecting 2 liters of dialysate solution into the peritoneal cavity through an installed catheter. This manipulation must be performed 4 times a day, each time draining the “used” liquid and introducing a new one.

In the case of the peritoneal method of the procedure, harmful and excess metabolic products are eliminated through the small blood vessels of the abdominal cavity. In this case, there is no need to install a perforated membrane - the peritoneum acts as a natural barrier through which substances diffuse.

The advantage of this type of cleansing is the ability to perform the procedure at home, reduced load on the blood vessels and heart, since 1 session takes a whole day, and blood filtration does not occur as quickly as with standard hemodialysis. A significant disadvantage is the high risk of infection of the abdominal cavity. In addition, this method of dialysis is undesirable for people who are overweight and have adhesions in the intestines.

Who is contraindicated for hemodialysis?

The issue of contraindications to performing blood purification with the “artificial kidney” system was raised above. Let us take a closer look at which patients should not undergo hemodialysis.

People with an active infectious disease, since during dialysis the blood flow circulates intensively, rapidly spreading the infectious agent throughout the body.
Those who have suffered a stroke and have mental disorders (epilepsy, schizophrenia, etc.).
Patients with acute tuberculosis.
Cancer patients.
Patients who have recently experienced a heart attack, as well as people with chronic heart failure.
In severe forms of hypertension.
To people old age(80 and older).
Patients with pathologies of the circulatory system (leukemia, anemia, etc.).

But if there is a mortal danger, hemodialysis must be carried out, despite all contraindications.

Diet

To live with failing kidneys, regular hemodialysis alone is not enough. To improve the condition of the body, the patient needs long time stick to a certain diet. A diet for kidney dialysis helps to avoid side effects during the procedure, because the “cleaner” the body is from all kinds of toxins and metabolic products, the easier the hemodialysis procedure will be for the patient.

Back in the 20th century, special therapeutic diets were developed, which are still prescribed today for patients with certain pathologies of internal organs. In case of renal failure, the so-called table No. 7 is indicated. It implies that nutrition during kidney dialysis is based on reducing the daily protein intake. In addition, patients should give preference to protein foods of plant origin. Animal proteins are allowed, but in a smaller percentage.

Since one of the goals of hemodialysis is to remove excess fluid from the body, the patient should limit the amount of drinking to the necessary minimum. Doctors recommend that most patients drink an average of 1 liter of liquid per day.

Since salt promotes fluid retention in the body, it must be abandoned during diet therapy. Maximum amount- 2 g per day. Foods rich in potassium, calcium, sodium and other electrolytic elements should also be limited in the menu.

During treatment, the doctor works out a diet for each case individually to achieve the maximum effect from hemodialysis sessions so that the patient lives as long as possible.

nefrol.ru

How long can you live on dialysis?

The earlier replacement therapy—hemodialysis—starts, the greater the patient’s chances of extending his life. Kidney dialysis should begin when all their functions are reduced to a pathologically critical level - neither a fairly strict diet nor medications will help restore the activity of dying organs. The earlier dialysis is prescribed and performed, the longer the patient’s life expectancy becomes. The intensity of the procedures depends on the age, weight and degree of the patient’s disease, as well as the presence of concomitant pathologies. Under normal conditions, dialysis is carried out 3 times a week for several hours. Sometimes the death of a patient occurs in the initial stages of hemodialysis - this blood purification procedure is not suitable for everyone. But if the first hemodialysis sessions went fairly well, the patient has an increased chance of prolonging his life and making it full.

Hemodialysis equipment can be installed at home, which greatly simplifies the accessibility of the procedure. However, it is not cheap, so not everyone can afford it. With a timely and competently performed hemodialysis procedure with the elimination of all emerging side effects, patients with pathological kidney diseases, as well as patients with acute renal failure, can have the same life expectancy as a healthy person. Renal hemodialysis saves a fairly large number of human lives and significantly prolongs them. A patient who constantly undergoes kidney dialysis will be able to live as long as the artificial blood purification procedure is available to him. Hemodialysis is not a panacea for kidney failure; transplantation of a donor organ successfully solves problems with kidney diseases. But in cases where transplantation is not possible, or the patient's body rejects the organ, kidney dialysis remains the only hope for life and a normal future for most people with such diseases.

When the functioning of internal organs in the human body is disrupted, medical intervention is required. Kidney dialysis is prescribed when the kidneys stop functioning normally and removing toxic substances and toxins from the body. When is this procedure prescribed and what are the indications for it, how long does the method last, and what recommendations should the patient follow in order to improve the condition?

General information

Kidney dialysis is a method by which a person with problems with the normal functioning of the kidneys uses a machine that performs the functions of removing fluid and waste products from the body and blood. The hemodialysis procedure is prescribed and performed only after a thorough diagnostic examination and an accurate diagnosis. Dialysis does not heal the kidneys or eliminate inflammation. It performs the function of the kidney and helps get rid of unnecessary waste products that are carried by the blood throughout the body.

Indications for use

In acute renal failure, dialysis is prescribed.

With timely detection of the pathology of renal failure and adequate treatment, organ functions are restored. Blood flow in the organ is normalized and it is able to filter and pass fluid and blood through itself. In this case, hemodialysis is not performed and is cancelled. Such situations occur when renal function is damaged by exposure to large doses of toxic substances, after an infectious disease or bacteriological complication, in which renal failure develops.

With more difficult situations the kidneys reduce their efficiency, resulting in the development of chronic renal failure. This leads to the accumulation of many toxic and poisonous substances in the blood, which lead to intoxication of the body and the patient becomes ill. In this case, it is impossible to restore the functioning of the organ. Renal hemodialysis is prescribed in the following cases:

for acute and chronic renal failure;
in case of poisoning with alcohol and other toxic substances;
in case of poisoning with pesticides and toxic chemicals;
in case of mushroom poisoning;
in case of poisoning with heavy medications;
when there is an imbalance of electrolytes in the body.

Types of kidney dialysis

With severe kidney pathologies, people live as long as possible to resort to dialysis. This procedure is not cheap, but in modern medical institutions it is possible to perform hemodialysis and ordinary people. There are types of dialysis such as peritoneal and hemodialysis. Which method is more preferable is determined by the attending physician, since both peritoneal and hemodialysis have their advantages and contraindications. Let's take a closer look at the characteristics of the types of kidney dialysis.

Hemodialysis

Hemodialysis is carried out using a special machine called a dialyzer, which filters the blood. Circulating blood enters a device in which excess salts, toxins and wastes are separated from it, and then in its pure form enters the main bloodstream. Hemodialysis lasts about 6 hours and, depending on the state of organ failure, is carried out at least 2 times a week. The attending physician decides how many times to use this type of dialysis.

The hemodialysis procedure is performed at home, the person does not need to be in the hospital, in addition, you can control the duration of the procedure yourself, while getting a better effect. It is convenient and costs less; the patient does not need to constantly travel to the hospital. For the first time, a tube is inserted into a person through a vein through which blood will circulate. This method is used when the duration of hemodialysis is short. With the development of kidney failure, when the need for dialysis increases, a special fistula is made through surgery, which helps to gain painless access to the vein.

Peritoneal dialysis involves a surgical procedure in which a section of the abdominal cavity is dissected and the person is connected to a machine that will filter the blood. With peritoneal dialysis, there is no danger that bleeding will begin to develop, since the blood vessels are not damaged, and the additional load on the heart does not increase, as happens with hemodialysis.

More than 1.5 liters of special liquid is poured into the abdominal cavity using a catheter. Further, after some time it is eliminated from the body along with toxins and harmful impurities. There are 2 methods of peritoneal dialysis - continuous outpatient and automatic, which have differences in implementation. With continuous peritoneal dialysis, the solution is introduced into the human body for 6-10 hours, then it is removed, and then the abdominal cavity is filled again. This is done 3 to 6 times a day. Automatic peritoneal dialysis involves changing the solution only at night, while the person experiences minimal discomfort.

Methodology and necessary conditions

The duration of dialysis is prescribed by the attending physician.

If kidney dialysis is performed using an artificial machine, then this procedure is carried out only in a hospital. The amount and duration of dialysis is prescribed by the attending physician, depending on the patient’s health condition. If the patient has developed chronic kidney failure, then the procedure is performed at least 3 times a week. The device that performs the function of the kidney is: a system for pumping blood; a device that injects a special solution into the body (the liquid may have a different composition, depending on the person’s health status); a system of membranes that filter blood. When the blood is purified, it enters the human body again.

Diet for dialysis

In order for dialysis to be effective and a person to feel normal, you need to maintain a drinking regime and follow a diet. The amount of liquid drunk per day is regulated by the attending physician, since the condition of the genitourinary system must be strictly taken into account. The diet involves reducing the amount of salt consumed. The menu should be rich in proteins, fats and carbohydrates. Fatty meats and broths based on them, sweets and sweet pastries, sweet soda, black tea, pasta, white bread, spicy and fatty sauces and seasonings, and mayonnaise are excluded from the diet. The menu should be dominated by vegetarian food with an abundance of fruits and vegetables, which are prepared using minimum quantity fat It is useful to eat vegetable soup, use honey and dried fruits instead of sweets, replace white bread with whole grain bread, and ordinary clean water is suitable for drinks.

Complications and their prevention

More often, complications of this procedure appear after the first procedures, then the body gets used to it and the person does not experience such discomfort. Dialysis causes complications such as nausea and vomiting, blood pressure decreases, red blood cells decrease due to cleansing procedures, and the patient suffers from anemia, which manifests itself as dizziness, weakness, loss of consciousness, headaches, and arrhythmia.

Scheme of the peritoneal dialysis method.

The peritoneal method of dialysis causes a complication in the form of peritonitis, when inflammation of the abdominal cavity occurs with the addition bacterial infection. This provokes disturbances in the functioning of the excretory system, which worsens the situation and the patient’s well-being. Complications are caused by the development of a hernia on the peritoneal organs. To avoid serious complications, you must strictly follow the doctor’s recommendations and instructions, and if your health changes, immediately notify you.