Chronic Kidney Failure: Why Is Dialysis Necessary
and What Happens If It's Not Done?
By Ayu Purnama Sari and Elfi, S.Pd.I., M.Pd.
Why are many chronic kidney disease patients reluctant to undergo dialysis, even though its impact severely threatens their quality of life? Every day, more than 3 million people worldwide undergo dialysis procedures in an effort to replace the damaged kidney function. Without dialysis, their lives are at risk. However, despite being very important, many kidney failure patients delay or even refuse this method for various reasons, ranging from fear to lack of information about its benefits. This essay will discuss the causes and impacts of kidney failure and the steps that can be taken to avoid kidney failure.
Chronic renal failure is a non-communicable disease that has a high prevalence and poor prognosis (Adhiatma, 2014). This condition arises due to damage to the filtration and secretion processes of the kidneys, which ultimately causes impaired function of the organ (Ervina, 2015). As kidney function declines and the kidneys can no longer function normally, this becomes a leading cause of chronic kidney failure (Aryzki, 2019). Furthermore, this condition is frequently caused by comorbidities such as anemia, hypertension, and diabetes mellitus, all of which put an undue pressure on the kidneys and hasten their demise (Griselda, 2021). Common symptoms encountered by people with chronic kidney failure are changes in the volume and frequency of urination, edema in the legs and hands, and persistently high blood pressure that is difficult to control (Purwati, 2018). This disease has become a major public health concern in Indonesia (Firmansyah, 2022). According to Putri (2014), 6.7% of Indonesia's population suffers from kidney impairment, with up to 70,000 people requiring kidney transplants or dialysis therapy each year. Furthermore, chronic kidney failure is the world's 12th greatest cause of death, accounting for around 850,000 deaths per year (Nasution, 2020).
The low prevalence of management for chronic kidney disease in Indonesia in recent years, along with the increase in chronic kidney disease prevalence among young adults. (Astuti, 2022). Aroound 1.5 million people worldwide must live their lives with a ketergantungan in the process of cuci darah, also known as hemodialisis. According to the ginjal kronis, hemodialisis serves not only to prevent kematian but also to maintain bodily stability by blocking the metabolism and racun of darah, such as ureum, creatinin, and urat, through semipermeable membranes. Even yet, this process cannot fully develop or mimic the ginjal's function, therefore the patient must be fully engaged in the analysis of their daily lives. The hemodialisis process is often carried out two to three times each week, lasting four to five hours each time (Rahman, Kaunang & Elim, 2016).
By observation at Pasar Minggu General Hospital in 2018, three out of five patients declined to undergo hemodialysis owing to anxiety and fear of lifetime reliance, despite the fact that the operation costs were paid by BPJS. Out of 80 kidney failure patients, 32 (40%) did not start hemodialysis right away after being diagnosed. This study also found that various factors influenced the choice to start hemodialysis, including age, gender, insurance ownership, creatinine levels, GFR, and healthcare service support. It was also hampered by a lack of family support, which left patients feeling emotionally or logistically unprepared to face the routine and demanding surgery. Patients with renal failure who refuse hemodialysis have a much higher mortality rate. According to data, unwillingness to engage in the hemodialysis program was responsible for 442 (89%) of the 497 kidney failure patient deaths. This data emphasizes the necessity of educating patients and their families, as well as enhancing the quality of healthcare services, in order to help patients comprehend the benefits of hemodialysis, minimize anxiety, and offer the essential support for this surgery. In fact, some patients feel that it is better for them to avoid the procedure because they do not see a definite way out for the recovery of their kidney function.
Adopting a good lifestyle—that is, drinking enough water, not smoking, avoiding alcohol use, and frequent exercise—helps one prevent kidney failure. Furthermore, eating healthy foods such as fruits, vegetables, and nuts, as well as avoiding foods high in salt and saturated fats, will assist preserve kidney function. (CDC, 2020). Routine health check-ups are strongly suggested, especially for people with concomitant conditions like diabetes and hypertension, to monitor kidney function on a regular basis. (National Institute of Health, n.d.) Excessive use of drugs or supplements without a doctor's approval should be avoided because it can cause substantial kidney damage, as seen in cases of nephrotoxicity caused by long-term supplement usage. (Koraishy, Moeckel, and Geller, 2017). Furthermore, diabetes and hypertension patients should receive frequent therapy based on their doctor's advice to avoid problems that can impair kidney function. (Mayo Clinic. 2021).
Chronic kidney failure is a major worldwide health concern due to its high prevalence and fatal implications if not addressed. Dialysis is a necessary life-saving intervention for individuals with end-stage renal disease, replacing the vital functions of destroyed kidneys. However, many patients postpone or avoid dialysis due to anxiety, fear of lifetime dependence, or a misunderstanding of its benefits. This hesitation has a considerable impact on survival rates, since studies reveal that the majority of renal failure-related deaths are caused by unwillingness to undertake hemodialysis. Preventive interventions such as living a healthy lifestyle, eating a kidney-friendly diet, getting frequent health check-ups, and controlling comorbid illnesses like diabetes and hypertension all play an important role in lowering the risk of chronic kidney failure.
References
Adhiatma. (2014). Analisis Faktor-Faktor Yang Berhubungan Dengan Kejadian Gagal Ginjal Kronik Pada Pasien Hemodialisis Di RSUD Tugurejo Semarang Analysis of Factors Related to Chronic Kidney Disease in Hemodialysis Patients of RSUD Tugurejo Semarang. 1–10.
Aryzki, S. (2019). Pengukuran Kualitas Hidup Pasien Hemodialisis Gagal Ginjal Kronik Di Rsud Ulin Banjarmasin Menggunakan Instrumen EQ5D. Jurnal Ilmiah Ibnu Sina, 4(1), 210–24.