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When the kidney stops working
The kidneys are indispensable in the body for, among other things, the removal of waste products and excess fluid. When the kidneys stop working, people often need a new kidney or need dialysis. Plus Health asked nephrologist (kidney specialist) Chris Hagen 5 questions about kidney dialysis.
1. What is the function of a kidney dialysis?
“A kidney dialysis actually takes the function of the kidneys if they can no longer do this themselves. It removes waste products and excess fluid from the blood.”
2. How does kidney dialysis work?
“There are two methods to dialysis. Hemodialysis uses an artificial kidney. A patient is then connected to a dialysis machine that cleans the blood. Most patients go to the hospital for four hours three times a week, but you can also undergo dialysis at home with a machine and under the supervision of a nurse.
The belly wash is the second way. With a tube you let fluid run into the abdominal cavity. This fluid absorbs waste products and thus purifies the blood. After a few hours, the liquid can be removed again. It is necessary to rinse the abdomen four to five times a day, but this can be done at home. It is also possible to repeat the abdominal dialysis every night with an automatic machine.”
3. Is one of these methods of dialysis preferred?
“The choice for hemodialysis or abdominal lavage is made by the patient together with the nephrologist and a team of advisors. The preferences of the patient play a major role in this, as do his lifestyle, clinical picture and other medical conditions. It is not the case that one method prefers the other.”
4. Can kidney dialysis be postponed? And what about holidays, for example?
“It is not possible to postpone dialysis. Maybe for a day, but certainly not more. In the case of hemodialysis, a place must be available for a patient during the holiday in a dialysis center at the place of the holiday destination.
In addition to being at home, the abdominal lavage can also be performed on holiday. However, a patient needs an average of 8 to 10 liters of flushing fluid per day, which comes down to 8 to 10 kilograms. For a week’s vacation, this is of course a lot to take with you. The company that makes abdominal dialysis possible can therefore also deliver the liquid to the holiday destination.”
5. Is there any diet recommended for people on dialysis?
“Patients who are on dialysis and no longer urinate are advised not to drink more than half a liter of fluid per day. In addition, kidney patients can best limit the amount of phosphate they ingest. Due to the malfunctioning kidneys, the phosphate balance in the body is no longer automatically regulated. Protein-rich products such as milk, cheese, meat and fish contain a lot of phosphate.”
Chris Hagen is an internist-nephrologist and heads the dialysis department at the Meander Medisch Centrum Amersfoort. He is also chairman of the quality section of the Dutch Federation for Nephrology.