Normally, your kidneys help filter wastes and excess fluid from the blood. They also regulate blood pressure and produce hormones.
Your doctor may recommend you start dialysis if your kidney function is declining rapidly or you have severe symptoms. Managing symptoms can delay the time when you need to start treatment.
Dietary Modifications
The kidney diet is key to managing your kidney disease. Your dialysis team can help you plan meals for your special needs. You will need to limit your fluid intake, but eating a well-balanced diet can make you feel better.
Fluid buildup can raise blood pressure and strain the heart. For standard hemodialysis, it’s best to have no more than four to six quarts of fluid per day between treatments.
Patients on hemodialysis may also need to limit their sodium (a part of salt), potassium and phosphorus intake. Phosphorus can build up and lead to an irregular heartbeat, or arrhythmia, and may cause a heart attack.
You’ll need to eat more low-sodium foods, such as fresh fruits and vegetables, lean meats, nuts, dairy products and whole grains. It’s important to eat foods that are low in potassium, such as berries, avocados and bananas. It’s also a good idea to take a calcium supplement every day.
Fluid intake Monitoring
If your kidneys stop working, waste products and extra fluid can build up in the body. Dialysis removes waste and excess fluid from the blood. It does about 10-15% of the work that healthy kidneys do each day.
During dialysis, a tube (catheter) is inserted into the space inside your abdomen (the peritoneal cavity). Fluid is then pumped into the peritoneal cavity through the catheter. When it is empty, it’s drained into a bag and replaced with fresh fluid, usually three times a day.
It’s important to monitor your fluid intake carefully as you prepare for dialysis. You may be asked to limit your fluid intake to 32 oz or less each day. It can help to track your daily fluid intake using a measuring cup and following guidance from your dialysis care team. You may also want to avoid caffeinated, sweetened or alcoholic beverages.
Medication Adherence
If you are not diagnosed with kidney failure yet, a comprehensive conservative treatment plan can help to extend the life of your remaining kidneys. Your doctor can advise you about what steps to take, such as diet, exercise and medication.
If your remaining kidney function is too low to maintain your quality of life, you may choose to start dialysis. Dialysis involves regularly treating your body with a solution that removes waste, extra fluid and other substances that build up in the blood. Private insurance generally covers dialysis if your doctor prescribes it.
It’s important that you stick with your treatment schedule and take all prescribed medications. You’ll need to visit a dialysis center several times a week for about three hours each time. It’s not easy, but it can improve your quality of life and lengthen how long you live with a reduced kidney function.
Blood Pressure Control
Before dialysis, blood pressure needs to be kept under control. High blood pressure can lead to heart and blood vessel problems, which are hard on the kidneys.
Before starting dialysis, it is important to talk about all your treatment options with your doctor and other members of your health care team. Each option has its pros and cons. You can change your choice at any time.
If you choose hemodialysis, your physician may be able to show you around the treatment center and dialyzer before you start so that you are familiar with it. This can help reduce fear and anxiety.
If you choose peritoneal dialysis, your doctor will perform a minor operation to create an access site in your abdomen (called a fistula). You will need to get used to having fluids in your belly for a few weeks before your first treatment.
Anemia Management
The kidneys are responsible for producing a hormone called erythropoietin, which signals the bone marrow to make red blood cells. With declining kidney function, people can develop anemia. If not treated, anemia can cause fatigue and a decrease in oxygen carrying capacity of the blood.
It is important to have regular blood tests so that problems can be detected and monitored early. It is also important to report any change in symptoms to the dialysis team. For example, a change in blood pressure may indicate that too much fluid is being removed from the body or that medication is having an adverse effect.
It is important to be informed about the different types of dialysis available. Once a decision is made it is important to stick with that choice, although patients and carers are encouraged to explore other options at a later stage if desired.
Monitoring Potassium Levels
The kidneys regulate potassium levels and remove it from the blood through urine. Low levels (hypokalemia) cause weakness, muscle cramps, constipation and abnormal heart rhythms. This complication may lead to more serious health problems including heart disease.
Kidney failure can progress to the stage in which the kidneys can no longer eliminate wastes or regulate blood chemistry. This is called chronic renal failure, and it is not reversible.
People with kidney disease can reduce their risk of kidney failure and its complications by managing diabetes and high blood pressure. They also can avoid foods that contain sodium and potassium, and they should attend annual or scheduled visits with their health care provider. These visits are especially important for people with conditions such as high blood pressure and diabetes that can damage the kidneys. Early diagnosis and working closely with a kidney specialist can help prevent or delay the need for dialysis.