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Living Day to Day with Kidney Dialysis

How Dialysis Works continued...

Children often do a similar type of dialysis called Continuous Cycling Peritoneal Dialysis (CCPD). Their treatments can be done at night while they sleep. A machine warms and meters dialysate in and out of their abdomens for 10 hours continuously. Then they are free from treatments during the day.

As a college student in the spring of 1985, Kris Robinson chose CAPD when her kidney (she was born with only one) began to fail.

Doctors quickly determined Robinson would need dialysis until a kidney transplant could be done. Robinson's father was willing and able to give her one of his kidneys, and for several months before the operation was arranged, she drained dialysate in and out of her abdomen five times a day. She became adept at draining it out in the shower, putting fresh fluid in during breakfast, and so on throughout the day.

"I'm extremely independent," Robinson says. "This let me be in charge of my own dialysis. I knew I could do it, and I wanted to be responsible for my own care. I didn't like to have to sit for four hours, three times a week, and I didn't like the idea of dealing with my own blood in such an open way as in hemodialysis."

The transplant from her father was successful and today Robinson, now 32, still has her kidney transplant and is the executive director of the American Association of Kidney Patients in Tampa, Fla., a nonprofit organization dedicated to patient education about dialysis and kidney disease.

One thing all dialysis patients must know a great deal about is diet. They need a good amount of protein and lower amounts of potassium and phosphate, which tend to accumulate in the blood and cannot be removed very well with treatment. French fries, for example, are off-limits, and ice cream and cheese must be eaten with caution. Dialysis patients also must limit fluids because the treatment removes only a certain amount of water. Excess fluids make body tissues swell.

Dialysis in the Future

The first successful artificial kidney was developed in the 1940s by a Dutch physician, Willem J. Kolff. Because of World War II and the Nazi occupation of his country, he improvised many materials. For example, he used sausage-link casing for the semipermeable membrane. Since then, the process of dialysis has been fine-tuned over the years, and semipermeable membranes and dialysate have improved.

Still, dialysis is not a cure. If a person's kidneys are temporarily damaged, dialysis can give them a rest and a chance to recover. But for chronic, end-stage renal disease, a kidney transplant is the only long-term solution that frees a patient from dialysis.

Living relatives can donate a kidney if their remaining organ is healthy. Even with a kidney from a close relative, however, a transplant recipient must take drugs to suppress the immune system from rejecting the organ. There are about three times as many people waiting for transplants as there are kidneys available.

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