What do the kidneys do?
The kidneys filter the blood, taking excess water, salt and toxins out to become urine. Clean blood comes out of the kidneys and back into the body.
What is End-Stage Kidney Disease?
End-stage kidney disease (ESKD), also known as end-stage renal disease (ESRD), happens when the kidneys stop working well enough to keep a person alive. The extra water, salt, and toxins stay in the blood and the person stops urinating.
This makes the person bloated. Blood pressure goes up. The toxins and salts act as poisons. Without treatment, ESKD will cause death.
What is dialysis?
Using a mechanical, artificial kidney to remove excess water, salts and toxins is called dialysis. Sometimes this can be done at home, but most commonly, an ESKD patient will go to a dialysis clinic about three times a week. The patient’s blood will go through a tube inserted in the arm into the dialysis machine. For about three or four hours, the patient will be hooked up to the machine, which can be the size of a mini fridge all the way to the size of a washing machine. In that time, all of the patient’s blood will be circulate through the machine and back into the body through another tube.
And that takes care of the problem right?
Wrong. Having dialysis three times a week is like being able to urinate only three times a week. Between treatments, the fluids, salts and toxins build up, causing a lot of problems until the next treatment. The patient’s blood pressure can get very high and cause pneumonia. Having the entire body’s blood volume pumped out and back in within the space of 3-4 hours is very hard on the body. Patients get very fatigued. They get cramps and pains and many other side-effects. Infections and blood clots are also common.
The dialysis machines used today can’t clean up all of the toxins the way that a natural kidney does. So the patients have to be very careful not to eat certain foods like orange juice, bananas, pizza, anything with added salt, and a long list of other foods. Because those foods will produce toxins that the dialysis machine can’t clean up. The patients also have to take a lot of pills every day to handle some of the toxins that the machines can’t remove.
So, why don't they all just get kidney transplants?
To get a transplant, a patient has to get a donor. There simply aren’t enough organ donors available for all the people who need it. In 2018 more than 100,000 people were on a waiting list for a kidney transplant, but only about 20,000 transplants were actually performed.