Doin' Dialysis: The struggle is real

Dialysis sustains life but only partially replaces kidney function, leading to fatigue, fluid restrictions, and complex medication.

Hey everyone!

I think this post will be useful for both newbies and seasoned veterans. It's about what we, as hemodialysis patients who choose to go in-center for treatment, regularly go through. It's why we sometimes struggle with the most basic tasks. So, if you're in the club, be kind to yourself and always practice patience. Also, be patient with people who don't understand our challenges, because they haven't walked in our shoes.

Dialysis is a life-saving machine that cleans your blood when your kidneys fail, but it only does a small portion of the work true kidneys do. It acts like a temporary filter, leaving patients dealing with severe exhaustion, strict daily water limits, highly structured diets and heavy medication schedules(for some). That is how it is for me. [1, 2, 3, 4, 5]

Here is a clearer, simpler look at what this means for patients:

• Healthy kidneys work 24 hours a day, constantly cleaning blood, balancing chemicals, and making hormones. Dialysis usually only cleans the blood for a few hours at a time, a few days a week. This means the body never gets a true, continuous clean, leaving lingering toxins that make patients feel unwell. [1, 2, 3, 4, 5]
• Deep-Seated Fatigue:
  Dialysis does not replace the kidney's job of making hormones that tell the body to create energy-carrying red blood cells, often leading to severe anemia. Additionally, the process of pulling fluid and toxins out of the body in just a few hours is physically draining. This exhaustion often feels like a heavy "brain fog" or deep body weakness that doesn't go away just by sleeping. That is the honest-to-goodness truth! [1, 2, 3, 4]
• Strict Fluid Limits:
  When kidneys fail, the body can no longer urinate to get rid of extra water. Because patients are on dialysis, they have to carefully measure and restrict everything they drink. If they consume too much, extra water builds up in the body, which causes painful swelling, dangerous heart strain, and shortness of breath. [1, 2, 3]
• Complex Medications:
  Healthy kidneys keep vitamins and minerals perfectly balanced. Dialysis cannot do this, so patients often have to take a heavy lineup of daily pills. These might include binders to soak up phosphorus in their food, vitamins to replace what is lost during treatment, and shots to help their body make more red blood cells. [1, 2, 3, 4, 5]

Strategies for Managing Hemodialysis Side Effects:

Patient Adherence to Treatment Protocols

• Limit sodium intake: Keeping salt under 2,000 mg daily reduces extreme thirst, preventing excessive fluid weight gain between sessions.

• Strictly manage fluid limits: Preventing rapid fluid removal helps avoid dangerous dips in blood pressure, nausea, and cramping.

• Attend full sessions: Staying for the prescribed treatment time prevents fluid overload and allows the body to safely adjust.

Lifestyle Adjustments and Medical Consultation

• Stay physically active: Gentle, low-impact exercise boosts circulation and mood, helping to combat dialysis fatigue.

• Communicate with your team: Ask your nephrologist about adjusting "dry weight," lowering dialysate temperature, or slowing the fluid removal rate during sessions. [1, 2, 3, 4, 5, 6]

Resources for Further Information

• Managing these side effects is a team effort.

• You can find detailed strategies and food/fluid planning tools on the National Kidney Foundation site or explore actionable lifestyle tips in this DaVita Kidney Care Guide. [1, 2, 3, 4]

My Humble Opinions, Thoughts and Anecdotes:

I tried to be as comprehensive as possible. I also tried to simplify the wording of medical terminology(when I could). I'll be honest here. I suffer with extreme fatigue. I take anywhere from a 45min- 2hr nap, nearly every day. I'm usually droopy by 1pm. I go to bed nearly every night around 6:30pm and sleep through to 1-2am. On odd mornings like today, I woke up at 4:30am!! But its now 6pm and I'm having a hard time paying attention.

I'm fortunate in that I don't struggle with the fluid restriction (i'm still urinating, a lot)qor take anything for medication except a renal multivitamin (Rena-Vite, you can get it on Amazon) and a phosphorus binder (Sevelamer Carb that I get it through my dialysis center). 

I guess it could be worse, but to be fair I've only been on dialysis for 14 months. I guess time will tell. So  I'm going to keep my reflections short. I hope this day brings you strength and resilience.

Tina

My quote for you:

"Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying 'I will try again tomorrow." -Mary Anne Radmacher

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