Dialysis is a long-term treatment that often consumes significant amounts of time, energy, and resources. While dialysis is sometimes required to sustain life, it is typically reserved for patients who suffer from advanced and irreversible kidney failure. The decision to administer dialysis is not one that should be taken lightly and it is very important that individuals consult with a knowledgeable physician before agreeing to receive treatment. Licensed medical providers who specialize in nephrology are able to review an individual’s unique medical state and outline the reasons for why they feel that dialysis is the appropriate course of action. In addition, patients are encouraged to develop a basic understanding of the different indications for dialysis so that they are better able to appreciate the physician’s logic.
In general, an individual requires dialysis treatment once their kidney function has fallen below 80 – 90% of normal capacity. At this level, the body begins to accumulate excess amounts of water and waste that eventually becomes toxic. A physician will often look for five common signs that an individual is suffering from kidney failure and may be in need of dialysis treatment. The mnemonic ‘AEIOU’ is often used to remember the five common acute indications for dialysis. They include acidemia, electrolyte imbalance, intoxication, overload, and uremia. Acidemia is an abnormal level of acid in the blood, an electrolyte imbalance can result from the inability to filter the blood normally, and the ingestion of intoxicating types of compounds can cause kidney failure and result in the need for dialysis. An overload of fluid that is not resolved with diuretics may indicate kidney failure and uremia is the buildup of waste products.
Although the five acute causes of kidney failure listed above can result in the need for dialysis, chronic conditions such as diabetes, high blood pressure, and a number of different developmental diseases are far more common in treatment facilities. In cases of chronic illness, medical personnel will monitor the patient’s glomerular filtration rate in order to determine if renal function has declined to the point where treatment is required. Physicians will also keep close watch over these patients to see if things like pericarditis, pleuritis, neuropathy, metabolic disturbances, fluid overload, or hypertension develop. Chronic renal decline coupled with these types of concerning conditions are almost always a sign that dialysis treatment needs to be initiated.
Patients who end up on long-term dialysis therapy most commonly suffer from chronic diseases that can be monitored for a prolonged period of time to determine if renal failure is occurring. The most popular metric for staging kidney failure is glomerular filtration rate (GFR). An individual’s GFR is indicative of their ability to remove water and waste from the body. A GFR between 90 and 99 is considered stage 1 renal failure. Patients between 60 and 89 are in stage 2 renal failure. Once a patient reaches stage 2 they are likely to experience signs and symptoms associated with kidney damage. Those between 30 and 59 are said to be in stage 3 renal failure while those between 15 and 29 are classified as stage 4. Anything below 15 is considered stage 5 renal failure and may require dialysis, a transplant, or both.
The kidneys are an extremely important component of human health that can suffer severe damage from a variety of different medical conditions. Those who are faced with the prospect of long-term dialysis treatment can improve the odds of experiencing positive health outcomes by remaining compliant with their treatment protocol and taking time to understand their illness. An informed approach to disease management is often the best way to combat the frustration and anxiety that can develop after long periods of dialysis treatment.