Hello Friends. My name is Dr. Tanvi Raghuvanshi and I am a consultant Nephrologist, working with Ayu Health Hospitals, Chandigarh.

We’ll start with the first most basic question. What is Dialysis? Dialysis is a purification system in which our body’s excessive metabolic waste or excess fluid or water accumulates in the body of chronic kidney disease patients. So, the process of taking it out is known as dialysis. So, friends Dialysis can be of two types. One is Hemodialysis, second is Peritoneal Dialysis. Hemodialysis means Dialysis of blood and for this, you have to come to the hospital. To start Hemodialysis, doctors will either put a central venous catheter in your throat or will add Fistula or graft to your arm. Blood is taken with the help of a hemodialysis catheter or Fistula from two lines. Blood taken from one line is passed through a hemodialysis machine known as Dialyser. And clean blood is transferred back to the body with the help of a second needle or second line. This whole process of Dialysis is of 4 hours and as per your doctor's advice, you will require two to three sessions per week. For all these sessions you have to visit the hospital. The second dialysis is Peritoneal dialysis which means the dialysis of the stomach. In this you have to put medicated water into your stomach, it is provided by the companies and you have to do 3 to 4 sessions. It takes around 30 to 40 minutes to take out and put water in the stomach. And you have to do 3 to 4 changes as per your doctor's advice. So, what are the Do’s & Don'ts which the patient requires to follow when the patient is on dialysis? First coming to the Don’ts - We should avoid high salt diets, which means your salt intake per day should be less than 3 grams. You also have to take less fluid intake and fluid intake does not include only water but it also includes curd, milk, pulses, etc. So these liquids should be less than 1 or 1.5 liters per day. You have to avoid a high potassium diet. Some things that have high potassium are banana, mango, green leafy vegetables, dry fruits, and coconut water, all of which you have to avoid. You should avoid a very high phosphate diet which includes chocolates, milk, paneer, and curd, all of which are high in phosphate. Things you are allowed to do while you are in dialysis are mild to moderate activity. You can go for a mild to moderate 30 minutes brisk walk every day for about 5 days a week. You can go for a walk, you can go for meeting friends, you can go swimming if your heart condition allows, and if you are a student you can continue studying, going to college, going to school, So, Hemodialysis is a very safe form of renal replacement therapy which we offer to seek any patient with time and advancement this technology of dialysis has evolved and we have a very less complication rate in dialysis. Patients on Hemodialysis or who are going to be start on Hemodialysis need not panic at all about getting the dialysis done. You should consult your physician on time and not delay your dialysis, if the doctor has advised you to start dialysis it is recommended that you should go and talk to your physician and see what kind of renal replacement therapy suits you, Hemodialysis or Peritoneal Dialysis and you should get started with one of the Modalities of dialysis. If you are a dialysis patient and you are thinking of travelling. Firstly you should go and ask your physician if you are fit to travel or not. If you are fit to travel then wherever you are travelling you have to ensure is there a dialysis center near you or not. You should always call the dialysis center before going to that center to inform them that we will be staying for so and so time duration and we will take this many dialysis sessions from you. As soon as you reach your destination, you should inform your new dialysis center about your arrival and that you will require dialysis on a so and so date. Let them know your schedule and also make sure to travel with your full medical history. You should also inform them beforehand about whether your sugar levels decrease while dialysis or your Blood pressure level decreases, not on the day of dialysis. Tell them that you have faced such complications before so that they know everything well in advance. So, who requires dialysis? There are two types of patients who will require dialysis. Patients who have acute kidney injury with certain indications and patients who have chronic kidney disease with certain indications. Here we will be talking about chronic kidney disease patients. When do chronic kidney disease patients require dialysis? So chronic kidney disease has 5 stages. Once the patient reaches stage 5 in which their GFR is less than 15mm/meter per meter square will be there along with the uremic symptoms they will require dialysis. Thank you.

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