Published On:Monday, March 15, 2010

By REUBEN SHEARER

Tribune Features Reporter

rshearer@tribunemedia.net

PERSONS touched by kidney disease know 'hemodialysis' to be their life saving treatment. The dialyzer machine takes over the kidney, and does for the patient what the kidney can't do for itself.

March is National Kidney Month, making it the perfect time to learn more about this vital organ of the body that pumps blood and oxygen.

Getting screened for kidney disease is also the best time to be tested for diabetes or high blood pressure, which if left untreated can lead to kidney failure. A simple blood and urine test can determine whether your kidneys are in good shape.

Dr Ava Thompson, a specialist in internal medicine and kidney disease says dialysis treatment is mandatory if the patient is not suited for a transplant.

For those who can't find a match and need time to regain strength, this is their only viable option. Until they find a donor match, kidney function is maintained through this blood cleaning process until a suitable kidney donor is found.

It's the cleansing and washing of the blood, and putting it back into the body," said Dr Thompson.

Dialysis offers the patient life, and relief of symptoms like pain and tiredness. "It offers a convenience than some other treatment methods like diet modification, and medication," said Dr Thompson.

Over 300 kidney patients in the Bahamas undergo this grueling medical procedure every week, said Dr Thompson, where "the patient is hooked up to the machine for nearly four hours, for up to three times a week."

When the dialysis patient comes in for treatment, an artery and vein is joined surgically in the leg or arm and is connected by tubes to an artificial kidney machine or dialyzer.

The patient is hooked up to two compartments. One contains blood from the patient carrying excess fluids and waste materials. The other contains a cleaning fluid called dialysate.

The compartments are separated by membrane--a porous material with thousands of holes per square inch.

The blood cells are too large to pass through the pores in the membrane. But some waste molecules pass through and are carried away by the dialysate.

In some cases of uremia, the blood is deficient in certain chemicals. If these are added to the dialysate, they pass through the membrane into the blood.

"Having to be hooked up on a machine several times a week, and going through the grueling process of cleaning the blood is no picnic," said Dr Thompson.

While on the dialyzer, they kill time by reading or sleeping while the blood is being cleaned.

Aside from "the lost time," kidney failure patients report having less energy as a major side effect of dialysis.

And that's because the dialyzer circulates and cleanses the blood outside the body. Inside the machine, there are two compartments. One contains blood from the patient carrying excess fluids and waste materials. The other contains a cleaning fluid called dialysate.

In recent years, the rate of persons with kidney failure has grown particularly in woman.

Dr Thompson says hypertension and diabetes, which are prevalent diseases among Bahamians are known to be the most common causes of kidney failure.

"If not treated, high blood pressure causes a degeneration of the small arteries in the kidneys and impairs efficiency of the organ.

"If these diseases are not contained, the patient can develop kidney failure, and have to undergo treatment until a match can be found," said Dr Thompson.

"Because the process of dialysis can be a very uncomfortable one, marked with the use of needles, most patients go through the treatment with hangups.

Treatment for kidney failure has changed significantly over the years, Dr Thompson said.

"In the old days, you would've had to find a twin with your kidney match. But now, you can get a kidney from somebody who's been in a fatal accident, and signed documents for their organs to be replaced in another's body."

There's a transplant list where you can donate your kidney in the Bahamas and it'll go someone in a different country.

"We were the first country to start dialysis for kidney failure patients," said Dr Thompson. "Puerto Rico always had it, and soon they started doing seminars and taking blood pressure in the supermarkets.

Patients struck by kidney disease, the organ has failed them as a result of the body not excreting enough water, salt and other substances to sustain itself.

The volume of water increases and tissues swell. And without specialized treatment the composition of body fluids change steadily until it becomes so abnormal that death may occur.

Fortunately, if one kidney is lost, or if both are partly damaged, the remaining tissue is usually strong enough to do the job.

In certain cases, a diseased kidney may be surgically removed from a patient and replaced by a healthy one from a donor.

When the transplanted kidney comes from a closely matched living, related donor, chances for long-term functon of this kidney are over 90 per cent. Chances for good kidney function when a transplanted kidney is taken from a cadaveric donor are about 70 per cent after one year from the transplant.

A healthy kidney processes about 200 liters of blood every day, and produces around two liters of urine. The kidneys are also useful since they make hormones that keep the bones strong and your blood healthy.

Thankfully, if one kidney fails you can still function, as you only need one kidney to survive.