Dialysis 101: What to expect and how to cope with dialysis

More than 26 million Americans have kidney disease, according to the National Kidney Foundation, and about 430,000 Americans with end-stage renal disease require dialysis.

While our two kidneys are vital in removing waste and extra fluids from the bloodstream, we can actually get by with only one kidney, or even an artificial "kidney" used in dialysis treatment.

Sondra Britton, clinic manager at Cape County Reginal Dialysis in Cape Girardeau, the Southeast Missouri unit of Fresenius Medical Care, says chronic kidney disease is a progressive disease where a person loses the function of their kidneys. Kidney function rarely returns, says Britton, and by the time it progresses to end-stage renal disease, the patient will require either a kidney transplant or dialysis.

The main causes of chronic kidney disease are diabetes and high blood pressure, though other factors may come into play, such as genetics, kidney stones, lupus, smoking, repeated urinary tract infections and being African, Hispanic, Asian or American Indian.

A person with kidney disease may feel tired, lethargic, short of breath and "fuzzy" in their mind and memory, says Britton. Once a doctor writes a prescription for dialysis treatment, Fresenius has a team waiting to educate patients on how the treatment works, answer any questions and set up a treatment schedule.

"We try to teach them from the first appointment what the machine is doing and how it's helping them," says Britton. "With the dialyzer, or 'kidney,' as we call it, blood is pulled from (the patient) and it goes through the 'kidney,' which removes the toxins that are responsible for how they're feeling."

In-center dialysis is usually required three times a week, with four to five hours in each session, says Britton. Most patients start feeling better within a few weeks of starting treatment.

Britton says a common fear among dialysis patients is that treatment will keep them from doing their favorite activities, whether it be bowling or traveling or gardening. This is simply not the case, she says.

"Most of our population is still doing the things they've done before," she says.

The first priority is for patients to get healthy, and after that, she can help make sure their life continues as usual. Fresenius Medical Care has more than 2,100 dialysis facilities in North America, including 49 in Missouri, so patients needn't worry about staying in one place for their treatment.

"They always think their life has to stop or the things they enjoy doing, they won't get to do anymore. We have many opportunities to refer them to what we call a 'visiting appointment' somewhere else," says Britton.

As for the time spent in the dialysis center, staffers do their best to make it enjoyable for patients. People receiving dialysis treatment sit in comfortable reclining chairs and can spend their time watching TV or movies, listening to music, playing games, reading, visiting with friends, family or other patients, napping, or hearing educational programs set up by the Fresenius staff. Patients are even encouraged to bring their own pillows and blankets. In-home dialysis is also an option in some cases.

Education is key to making the dialysis process run smoothly for patients and their families, say Britton and Rebecca Lenderman, patient care manager for the medical intensive care unit and inpatient dialysis unit at Saint Francis Medical Center -- so don't be afraid to ask questions of your doctor and the dialysis center staff!

"Dialysis is a strenuous process for any patient, especially when a patient is critically ill," says Lenderman. "Without proper education of the family and patient, there may be some compliance issues related to the strenuous process. Families must be supportive of the patient and understand the dialysis process. Ongoing education is key for success."