Dialysis: Procedure, Types of Dialysis and Cost of Dialysis

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Dialysis is a life-saving medical procedure that plays a crucial role in managing kidney failure or chronic kidney disease (CKD). When the kidneys are unable to perform their vital functions of filtering waste products and excess fluid from the blood, dialysis serves as a substitute to help maintain the balance of essential substances in the body. This procedure is a lifeline for millions of people worldwide, providing them with an opportunity to continue living and maintaining their health despite kidney dysfunction.

The medical procedure assists in the removal of waste products, excess fluids, and toxins from the blood when the kidneys are unable to perform this function adequately.

During dialysis, blood is circulated through a special machine called a dialyzer or artificial kidney. The dialyzer contains a semipermeable membrane that allows waste products and excess fluids to pass through while retaining essential substances such as red blood cells and proteins.

How is Dialysis Done and What are the Types of Dialysis?

Dialysis can be performed in two primary ways: hemodialysis (HD) and peritoneal dialysis (PD).

Hemodialysis (HD) is a type of dialysis that involves the use of a specialised machine called a hemodialyzer or dialysis machine. It is one of the primary treatment options for individuals with kidney failure or chronic kidney disease (CKD) when the kidneys are unable to adequately filter waste products and excess fluids from the blood.

During hemodialysis, the patient is connected to the dialysis machine through an access point, which can be an arteriovenous fistula (AVF), arteriovenous graft (AVG), or a central venous catheter (CVC). The access point allows blood to be safely withdrawn from the body and returned after purification.

Peritoneal dialysis (PD) is a type of dialysis that involves the use of the peritoneal membrane in the abdomen as a natural filter. It is an alternative to hemodialysis for individuals with kidney failure or chronic kidney disease (CKD) when the kidneys are unable to adequately remove waste products and excess fluids from the body.

During peritoneal dialysis, the process takes place within the patient’s abdomen.

Both hemodialysis and peritoneal dialysis require training and education to ensure proper technique and adherence to safety protocols. The choice between the two methods depends on various factors, including the patient’s health status, lifestyle, and medical considerations. Healthcare professionals work closely with patients to determine the most suitable dialysis modality for their individual needs.

It’s important to note that the specific details of dialysis treatment can vary, and patients receive guidance and instructions from their healthcare team on how to perform the procedure correctly and manage their dialysis sessions effectively.

What is Dialysis Process?

The dialysis process involves several steps and considerations to effectively remove waste products and excess fluids from the body.

Here is a general overview of the dialysis process:

Preparation:
- Access: Before each dialysis session, the appropriate access point needs to be established. For hemodialysis, this may involve using an arteriovenous fistula (AVF), arteriovenous graft (AVG), or a central venous catheter (CVC). In peritoneal dialysis, a catheter is surgically placed in the abdominal cavity.
- Sterilization: Sterile conditions are essential to minimise the risk of infection. Healthcare professionals ensure that all equipment, supplies, and the dialysis area are clean and sterile.
Hemodialysis (HD):
- Connection to the dialysis machine: The patient is connected to a dialysis machine via the access point, typically in a dialysis centre or hospital setting.
- Blood circulation: Blood is gradually withdrawn from the patient’s body using the established access point. The blood is then circulated through the dialyzer, a specialised filter, inside the dialysis machine.
- Dialysate preparation: At the same time, a special fluid called dialysate is prepared. The dialysate contains specific concentrations of electrolytes and chemicals necessary for the purification process.
- Purification process: Inside the dialyzer, the patient’s blood and the dialysate flow alongside each other but remain separate. Waste products, excess fluids, and toxins in the blood pass through the semipermeable membrane of the dialyzer, while essential substances such as red blood cells and proteins are retained.
- Blood return: The purified blood is then returned to the patient’s body through the access point, completing the circulation loop.
- Monitoring: Throughout the process, the dialysis machine continuously monitors parameters such as blood pressure, blood flow rate, and dialysate composition to ensure proper treatment.
Peritoneal dialysis (PD):
- Dialysate infusion: For peritoneal dialysis, the patient performs the procedure at home. Dialysate, a sterile solution, is introduced into the abdominal cavity through the catheter using gravity or a mechanical device.
- Dwell time: The dialysate remains in the abdominal cavity for a specific dwell time, allowing waste products and excess fluids from the bloodstream to pass through the peritoneal membrane and into the dialysate.
- Drainage: After the dwell time, the used dialysate is drained out of the abdomen through the catheter into a drainage bag and discarded.
- Fresh dialysate infusion: Following drainage, a fresh batch of dialysate is infused into the abdominal cavity for the next cycle, and the process is repeated multiple times throughout the day.
- Monitoring: Patients are typically instructed to monitor their vital signs and watch for any signs of infection or complications during peritoneal dialysis.
Completion and post-dialysis care:
- Evaluation: After the dialysis session, healthcare professionals assess the patient’s well-being, monitor vital signs, and evaluate any potential complications.
- Follow-up care: Regular follow-up appointments with the healthcare team are crucial to review dialysis effectiveness, address concerns, and make any necessary adjustments to the treatment plan.

It’s important to note that the specific details and variations of the dialysis process may differ depending on factors such as the type of dialysis (hemodialysis or peritoneal dialysis), individual patient needs, and healthcare provider preferences.

Is Dialysis Painful?

Dialysis itself is generally not painful. However, there can be some discomfort or mild pain associated with certain aspects of the dialysis process. Here are a few factors to consider:

Insertion of Needles or Catheter: For hemodialysis, the insertion of needles into the access site (such as an arteriovenous fistula or graft) can cause temporary discomfort or a sensation of pressure. The insertion is typically done using local anaesthesia to minimise any pain. Similarly, for peritoneal dialysis, the initial placement of the catheter during surgery may cause some soreness or tenderness in the abdomen, which should subside over time.
Access Site Complications: Occasionally, complications may arise at the access site, such as infections, clotting, or discomfort due to poor blood flow. These issues can cause localised pain or discomfort, which should be promptly addressed by the healthcare team.
Muscle Cramps: During hemodialysis, some patients may experience muscle cramps, particularly in the legs. These cramps can be caused by changes in fluid and electrolyte levels during the procedure. Proper fluid management and adjustments in the dialysis prescription can help minimise the occurrence of cramps.
Discomfort during Fluid Infusion and Drainage: In peritoneal dialysis, patients may experience a sensation of fullness or discomfort during the infusion and drainage of dialysate fluid into and out of the abdomen. However, this discomfort is usually temporary and tends to decrease over time as patients become accustomed to the procedure.

Overall, while dialysis may involve some transient discomfort or mild pain related to specific aspects of the procedure, it is generally not considered a painful experience. The primary goal of dialysis is to improve the patient’s overall well-being and quality of life by effectively managing kidney failure and maintaining the balance of essential substances in the body.

Dialysis Cost in India

Here is a general range of the cost of dialysis in India:

Hemodialysis (HD):
- The cost of hemodialysis sessions at dialysis centres in India can range from approximately INR 1,000 to INR 3,500 per session.
- The frequency of hemodialysis sessions is typically three times a week, so the monthly cost can range from INR 12,000 to INR 42,000.
- The cost may include charges for the dialysis procedure, dialysis equipment, consumables, nursing care, and medical supervision.
Peritoneal dialysis (PD):
- The cost of peritoneal dialysis in India can vary depending on whether it is continuous ambulatory peritoneal dialysis (CAPD) or automated peritoneal dialysis (APD).
- The monthly cost for CAPD in India can range from approximately INR 15,000 to INR 25,000, which covers the cost of dialysate fluid, catheter care, consumables, and periodic medical evaluations.
- The cost for APD, which involves the use of a machine, may be higher and can range from approximately INR 25,000 to INR 40,000 per month.
- These costs may also include additional expenses related to training, supplies, and follow-up visits.

The dialysis cost in India can vary depending on various factors such as the type of dialysis (hemodialysis or peritoneal dialysis), the location and type of healthcare facility, the choice of treatment modality, the frequency of sessions, and any additional services or medications required.

Factors Affecting the Cost of Dialysis in India

The dialysis cost in India can vary due to several factors. Here are some key factors that can influence the cost:

Type of Dialysis: The cost can differ depending on whether the individual undergoes hemodialysis or peritoneal dialysis. Hemodialysis generally involves visiting a dialysis centre, while peritoneal dialysis allows for home-based treatment.
Treatment Modality and Frequency: The frequency of dialysis sessions and the chosen treatment modality can impact the cost. For instance, hemodialysis sessions typically occur three times a week, while peritoneal dialysis may require daily exchanges.
Healthcare Facility: The choice of a healthcare facility can affect the cost. Private hospitals or specialised dialysis centres often have higher charges compared to government hospitals or charitable institutions.
Location: The cost of dialysis can vary depending on the location within India. Metropolitan cities and urban areas may have higher expenses compared to smaller towns or rural regions.
Dialysis Equipment and Supplies: The cost can be influenced by the type of dialysis equipment used, the quality of consumables, and the availability of specialised dialysis products. Some advanced dialysis machines or specific dialysate fluids may incur additional expenses.
Medications and Tests: Additional costs can arise from prescribed medications, laboratory tests, and diagnostic imaging required to monitor the patient’s condition during dialysis treatment.
Support Services: Ancillary services such as nursing care, medical supervision, dietary counselling, and transportation assistance may contribute to the overall cost.
Insurance Coverage and Schemes: The availability and extent of insurance coverage, government healthcare schemes, or dialysis subsidy programs can significantly impact out-of-pocket expenses for individuals undergoing dialysis.

It’s important to note that the cost estimates can vary significantly based on these factors, and it is advisable to consult with healthcare providers, dialysis centres, or hospitals in the desired location for accurate and detailed cost information. Additionally, exploring financial assistance programs or insurance coverage options can help individuals manage the expenses associated with dialysis treatment.

Conclusion

In conclusion, dialysis is a critical treatment option for individuals with kidney failure or chronic kidney disease. The two primary types of dialysis, hemodialysis (HD) and peritoneal dialysis (PD) offer different approaches to meet patients’ needs.

HD involves regular sessions at dialysis centres, while PD provides the flexibility of home-based treatment.

However, it’s important to consider the cost factors associated with dialysis. The expenses can vary depending on the type of dialysis, treatment modality, healthcare facility, location, equipment and supplies, medications, support services, and insurance coverage.

Being aware of these factors and consulting with healthcare providers can help individuals plan and manage the financial aspects of dialysis effectively. It’s also beneficial to explore available financial assistance programs or insurance schemes to alleviate the financial burden. Ultimately, understanding the types of dialysis and the associated costs enables individuals to make informed decisions and ensure access to this life-sustaining treatment.

Ketto Crowdfunding

Dialysis is a crucial procedure and one that requires special care. Ketto assists in raising funds for those in need of such medical procedures. Ketto can be used to raise funds for those who are seeking dialysis but can not afford the treatment costs.

The first step in using the Ketto crowdfunding platform to raise money for dialysis expenses is to register for an account on the website. After logging in, select “Start a Fundraiser” and provide the emergency medical information, such as the patient’s name, condition, necessary treatments, and other pertinent details. Establish a reasonable fundraising target that covers the costs, and post eye-catching photos and videos of the crisis. To reach a larger audience, promote the campaign using social media, email, and private networks. Update the campaign page frequently with milestones and progress reports. Respond to letters from donors as soon as possible and thank them for their support.