To start the whole procedure you will need an access into your bloodstream so that the needles for hemodialysis could be placed. There are three possible types of access for the needles. The first one is known as fistula, which is always a recommended option.
To create fistula you will need to have a minor surgery. During the surgery your blood vessel will be made bigger by joining an artery to a nearby vein under the skin. This kind of access doesn’t cause many problems and lasts for a long period of time.
Sometimes, the patient’s physical condition doesn’t allow to create fistula and a different access is created then. Also, even if you have another kind of access, you may try to switch to fistula later, for example, when you feel better and stronger.
The second type of access for hemodialysis is known as graft. It is used when the blood vessels are not suitable for creating a fistula. In this procedure an artery and a nearby vein are joined with a small and soft tube made of a special synthetic material. As a graft is placed beneath your skin, you need a small operation to create it.
The third option is known as a catheter and it’s used when you need dialysis for a short period of time only or when a fistula or a graft cannot be created for some reasons. A catheter is inserted into your large vein in the neck or chest and the end of the tube is visible outside your body.
3. Peritoneal Dialysis (PD)
Peritoneal dialysis is a kind of treatment which you can follow at home on your own. Actually, you can do it everywhere or even when you sleep, but you need to do it every day. Firstly, you need to undergo a minor surgery, during which a catheter is inserted into your abdomen.
The peritoneum, which is your abdomen lining, serves as a natural filter. During the procedure so called dialysate, which is a cleansing solution, flows into your belly through a special, soft tube known as peritoneal dialysis catheter.
All the extra fluids and waste leave your blood into the cleansing solution. After a few hours you need to drain the used solution from your belly and refill it with a fresh cleansing solution so that the whole process can start again. It will take you about a half an hour to remove the used solution and add a fresh one. This step is known as “an exchange”.
As you can see there are various possible treatment options to chronic kidney disease. All of them have some pluses and minuses. You must thoroughly discuss all the possible therapies with your doctor and together choose the best option for you.
However, you need to understand that if you choose one type of treatment, it doesn’t mean that you have to stick to it. In fact, if you don’t feel good with your current treatment, you can switch to a different one if of course your doctor lets you do it. Moreover, as chronic kidney disease often lasts long years, it is common that sufferers have more than one kind of treatment.
Stage 4 Chronic Kidney Disease and Dietary Changes
In case of stage 4 of chronic kidney disease a proper diet is a crucial part of any treatment. Thus, a consultation with a dietitian is highly recommended. He will examine your lab work results and then prepare for you an individualized meals plan. A proper diet can positively contribute to the functioning of your kidneys.
1. Avoid Phosphorus-Rich Foods
For patients with stage 4 of chronic kidney disease the recommended dosage of phosphorus is between 800 – 1000 mg a day. The reason for that is that your kidneys can have some difficulties with removing phosphorus, which consequently accumulates in your blood.
The accumulation of phosphorus in your blood may lead to problems with the absorption of calcium and parathyroid hormone production. Thus, you need to cut down on such products as yogurts, nuts, chocolate, milk, ice cream, or cheese.
2. Less Potassium-Rich Food
For people in the stage 4 of chronic kidney disease the recommended dosage of potassium is estimated between 2000 and 3000mg a day. Too much potassium may lead to a disorder known as hyperkalemia, which may disturb the rhythm of your heart.
Therefore, you should avoid food products which are rich in potassium, such as grapes, apples, oranges, bananas, mushrooms, carrots, potatoes, and spinach. Instead, go for tofu, rice, or pumpkin, but these products should also be consumed in moderation.
3. Cut Down on Protein
When there is too much protein in your organism, your kidneys need to work more intensely and in case of stage 4 of chronic kidney disease you need to save your kidneys as much as possible. Of course, you shouldn’t avoid protein at all, but only limit the food products which are rich in this element.