The question of whether dialysis qualifies as “life support” is common. While it differs from some emergency interventions, dialysis serves a continuous role in sustaining life for individuals whose kidneys can no longer function independently. Understanding its mechanisms helps clarify its impact on patient well-being.
What Dialysis Does for the Body
Dialysis is a medical treatment that takes over the functions of failing kidneys. Healthy kidneys remove waste products like urea and creatinine, excess fluids, and help balance electrolytes such as potassium, sodium, and calcium. When kidneys fail, these substances accumulate in the body.
The two main types of dialysis, hemodialysis and peritoneal dialysis, filter the blood differently. Hemodialysis diverts blood to an external machine, called a dialyzer, which acts as an artificial kidney before returning it to the body. Peritoneal dialysis uses the natural filtering membrane lining the abdomen, called the peritoneum, by introducing a special fluid into the abdominal cavity to absorb waste and excess fluid, which is then drained.
Why Dialysis is Considered Life-Sustaining
Dialysis is considered a life-sustaining treatment because it performs functions the body can no longer carry out due to end-stage kidney disease (ESKD). Without these functions, harmful substances and excess fluid would rapidly build up, leading to severe symptoms and ultimately, death.
For individuals with ESKD, dialysis replaces lost kidney function, preventing the accumulation of dangerous waste products. It also manages fluid overload, which can cause swelling and breathing difficulties, and helps regulate electrolyte levels, preventing imbalances that could affect heart function and other bodily systems. This ongoing intervention allows patients with kidney failure to survive and maintain health.
Distinguishing Dialysis from Other Life Support
While dialysis is a life-sustaining treatment, it differs from other interventions typically labeled “life support,” such as ventilators or extracorporeal membrane oxygenation (ECMO). These other interventions are used in acute, short-term, or unconscious states to support failing organ systems, often with limited patient mobility or awareness. Dialysis, in contrast, is a long-term treatment patients receive for years or even decades.
Patients undergoing chronic dialysis can maintain a relatively normal quality of life, engaging in daily activities, working, and traveling. For example, hemodialysis involves sessions lasting about four hours, three times a week, while peritoneal dialysis can be done at home, even overnight. This allows for a level of independence and participation in life not often seen with more aggressive, short-term life support measures.
The Impact of Stopping Dialysis
Discontinuing dialysis for individuals with end-stage kidney disease has direct and severe consequences. Without the regular removal of toxins and excess fluid, these substances quickly accumulate in the body, leading to a condition called uremia. This buildup causes a range of symptoms, including increasing fatigue, nausea, vomiting, and difficulty breathing due to fluid overload.
For most patients, stopping dialysis results in death within days to a few weeks, depending on any remaining kidney function and overall health. The decision to stop dialysis is made after careful discussion with medical professionals and family members, often as part of end-of-life care planning. Hospice care can be provided to manage symptoms and ensure comfort during this period.