The kidneys play a crucial role in filtering waste products from the blood. Not only does it allow the excretion of these wastes in the form of urine, it also regulates the fluid balance of the human body by adjusting the amount of urine excreted on a daily basis. On hot days, for example, as the body tends to sweat more, less water needs to be excreted through the kidneys; on colder days, however, it sweats far less, which means that there is a need for a greater amount of urine output.
But it’s not just fluid balance that the kidneys need to take care of; there’s also the actual removal of waste products that are produced by the body throughout the day. As the body functions like it normally would, cells use up energy, which in turn produce waste products that need to be removed. If these are not taken care of adequately, they build up in the body, eventually leading to an elevation of waste products, as measured in the blood, called “azotemia.” The accumulation of these waste products causes a sick feeling throughout the body called “uremia,” brought about by urea as well as other nitrogenous waste compounds.
Cases like these mean that the kidneys are not able to filter the blood effectively, and that the buildup of fluid and waste products can reach a critical level to the point where a patient might acquire either diabetes or high blood pressure. When this happens, a patient will be required to undergo dialysis.
Dialysis: What it is and what it does
Dialysis is a procedure that serves as a viable substitute for many of the usual functions of the kidneys, which allows for individuals to live productive and useful lives despite their renal organs not being able to work adequately. A person may need dialysis when the level of waste products contained in his/her body shoots up to the point of getting sick from them. In order to determine whether a patient has to undergo this procedure, nephrologists – doctors who specialize in renal conditions and diseases – will order tests measuring one’s creatinine and blood urea nitrogen (BUN) levels. Increasing levels mean the decreasing ability of the kidneys to cleanse the body free from waste products. It’s not just limited to these 2 factors, however; the nephrologist also utilizes other indicators to decide regarding the need for dialysis: if the patient is experiencing a major inability to rid the body of excess water; or has complaints regarding problems with the heart, lungs, or stomach, or even difficulties with taste or sensation in their legs. Should it be decided that a dialysis is necessary, the next step is to determine which of the two types of treatments – hemodialysis treatment or peritoneal dialysis – would be best.
Hemodialysis? How does that work?
While there are 2 types of methods available, the most common method used in most Asian countries, the Philippines included, would be hemodialysis. But how does it work? When are hemodialysis patients required to undergo such a procedure? Are there any side effects? And the most important question: how much does it cost?
Dialysis patients need to undergo hemodialysis treatment two to three times a week. It is performed in hemodialysis centers, making use of a fluid placed into the patient’s abdominal cavity via a plastic tube, utilizing an external machine and a special filter to remove excess waste products and water from the blood; think of it like water undergoing a filtration process so that it becomes potable. During the procedure, blood passes from the patient’s body to the dialysis machine through sterile tubing and then into a filter, called a dialysis membrane. For this procedure, a specialized vascular tube is placed in between the patient’s artery and a vein in the arm or leg. Some cases would require a direct connection between an artery and a vein in the arm, called a Cimino fistula, be made. Needles are then placed in the fistula, and blood passes to the dialysis machine via the filter, and then back to the patient. Should the patient require hemodialysis treatment before the placement of a graft, a large diameter catheter is placed directly into a large vein in the neck or leg in order to perform the procedure. In the dialysis machine, a solution on the other side of the filter receives the waste products from the patient.
For every treatment session, the patient needs to avail of the following products and services: the dialysis treatment itself, the dialyzer (a special filter that serves as the patient’s artificial kidney for his/her treatment), and the Erythropoietin injection (a medicine that stimulates the production of red blood cells so that patients would not feel so exhausted after treatment).
Potential Side Effects
Like any procedure, hemodialysis treatments are not without any side effects due to the way the procedure is carried out, as well as the fact that it can only compensate partially for the loss of kidney function. These include fatigue, low blood pressure, blood poisoning, muscle cramps, and itchy skin, as well as insomnia, joint pains, loss of libido and erectile dysfunction, dry mouth, and anxiety. However, evidence suggests that regular visits to hemodialysis centers for treatment could help ease some of the aforementioned side effects.
In government hospitals, on average,, the cost of a hemodialysis treatment, including medicines and machine use, is between Php2,000.00 to Php2,500.00 – with one government hospital in every province and/or region required to operate and maintain a dialysis unit in order to provide free treatments to poor patients whose combined annual income does not exceed Php72,000.00 according to House Bill 5503. In private facilities, patients on average would spend Php4,000.00 per session.
Luckily, government institutions such as PhilHealth subsidize 90 dialysis treatment sessions for its members. Other institutions, such as DSWD and PCSO, also provide help to patients in the form of guarantee letters which patients can use to cover for the expenses of their dialyzers and Erythropoietin injections.
So, why undergo hemodialysis?
While it does tend to come at a price tag deemed hefty for the common Juan, undergoing hemodialysis certainly has pros and cons, but with the former outweighing the latter. Despite its possible side effects, it is the best alternative that can be offered in order to help improve quality of life for patients advised to undergo treatment. Patients need not worry as MedLine Dialysis Center, the Philippines’ first and fastest growing dialysis center franchise, brings quality and affordable dialysis treatments closer to you with branches set up at strategic locations, providing Malasakit na Tunay to every Filipino dialysis patient in need.
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