Human body continuously generates waste products which have to be removed regularly.
Dialysis removes these products present at the time of dialysis process. Over the subsequent days, these products will accumulate again and hence need to repeat dialysis again and again.
In Chronic Kidney Disease dialysis is required lifelong.
This process is done for 4-5 hrs on 2-3 occasions every week. While most countries do dialysis thrice weekly, in some only twice weekly dialysis can be done due to constraints of facility, economy or travel.
If dialysis dose is less the following disadvantages may occur:-
The quality of life (ability to live a near normal quality) is poor.
Some of the uremic symptoms may continue to occur. Both appetite is poor and exercise tolerance is limited.
Returning to gainful employment (usually sedentary occupation) is not possible.
Complications are common in cases of underdialysis and are in the form of
- Weight loss,
- Poor nutrition,
- Collection of fluids in chest and abdomen,
- Decreased heart performance,
- Decreased ability to fight infections ,
- Repeated hospital admissions and all resulting in decreased survival
How to measure dialysis dose:
Most newer hemodialysis machines have an option of directly calculating dialysis dose delivered to patient by online KtV monitoring. If this option is not available at your dialysis center patients should have it checked manually at least every 3 months. Estimated dialysis efficacy and delivered dialysis dose may differ. Dialysis efficiency needs to be checked for ensuring that patients get adequate dialysis.