Healthy kidneys clean your blood by removing excess fluid, minerals and wastes. They also make hormones that keep your bones strong and your blood healthy. But if the kidneys are damaged, they don’t work properly. Harmful wastes can build up in your body. Your blood pressure may rise. Your body may retain excess fluid and not make enough red blood cells. This is called kidney failure. If your kidneys fail, you need treatment to replace the work they normally do. The treatment options are dialysis or a kidney transplant. Each treatment has benefits and drawbacks. Dialysis is an important and very prevalent treatment for renal failure or dysfunctions and there has always been a controversy between conventional dialysis and intensive dialysis regarding which out of the two is better for the patients and leads to more survival rates.
Conventional dialysis done at the clinics is usually done three times per week, for about 3–4 hours for each treatment, during which the patient’s blood is drawn out through a tube at a rate of 200-400 mL/min. The blood is then pumped through the dialyzer, and then the processed blood is pumped back into the patient’s bloodstream through another tube (connected to a second needle or port). During the procedure, the patient’s blood pressure is closely monitored, and if it becomes low, or the patient develops any other signs of low blood volume such as nausea, the dialysis attendant can administer extra fluid through the machine. During the treatment, the patient’s entire blood volume (about 5000 cc) circulates through the machine every 15 minutes.
As against conventional dialysis, intensive dialysis is typically used by those patients who do their own dialysis at home. It is less stressful and gentler but does require more frequent access. This is simple with catheters, but more problematic with fistulas or grafts. The ‘buttonhole technique’ can be used for fistulas requiring frequent access. Daily hemodialysis is usually done for 2 hours six days a week.
It can be said that patients suffering with end-stage renal disease could increase their survival chances by undergoing intensive dialysis at home rather than the conventional dialysis in clinics. Intensive dialysis represents one of the more promising options that have emerged in the last two decades. Intensive dialysis patients also have better blood pressure results and biochemical test values than conventional dialysis patients. Dialysis providers and governments are now recognizing the benefits of home based dialysis.