A dialysis machine serves as an artificial kidney. The kidney removes toxins that are constantly given off as all our body’s cells use oxygen and nutrition to produce the energy they need to function. If the kidneys don’t work well, toxins accumulate, the immune system weakens causing immunocompromise, and the person eventually dies (see Kidney Failure). Dialysis was invented after World War II, and became widely used in the 1950’s and 1960’s. When Medicare began in 1965, it guaranteed coverage for everyone who needed it.
Dialysis is cumbersome. The most common type is called “hemodialysis,” performed at special centers. Patients require it 3 times a week, around 4 hours each session. During that time, the patient’s blood is diverted from the body through the machine that filters it across a special artificial membrane. Since a large I.V. needle is required, surgeons fuse an artery to a vein in the arm, called a fistula. Once this heals (“matures”) in a few months, it serves as a strong entry port for repeated use.
More and more, patients are opting for “peritoneal dialysis,” which uses as the filter our body’s own peritoneal membrane that covers abdominal organs in the belly. Peritoneal dialysis is performed every night at home, as patients hook themselves up to a portable machine while they sleep. There’s a small risk of serious infection, but it leaves the person free to live a more normal life, without committing lots of time to attend a hemodialysis center.
Dialysis of any kind is no fun at all. If your kidneys don’t work, it’s necessary for the rest of your life, until a kidney transplant may be available. But dialysis allows you to live all those many years longer. Before dialysis, kidney failure meant certain suffering and death.