Dr. Shaun W. Jackson, MD, PhD

A properly working immune system identifies foreign substances in the body that might cause illness, such as bacteria and viruses. The immune system then creates antibodies which attack the foreign substances, neutralizing them and keeping the body safe. In people with autoimmune disorders, something goes wrong with this process. For reasons that are not fully understand, the immune system creates antibodies to attack the patient's own tissues.

Symptoms of an autoimmune disorder depend on which tissue is being attacked by the immune system, but common symptoms of autoimmune disease include fever, fatigue, and a general feeling of just not being well. Autoimmune disorders are more common in women than in men, and they may run in families. Autoimmune disorders can affect various parts of the body such as blood vessels, connective tissue, endocrine glands, joints, muscles, red blood cells, skin, and many others.

It is common to have more than one autoimmune disorder at a time. Most are chronic, or life-long illnesses, although they may come and go in flares. Treatment for autoimmune disorders depends on which part of the body is being attacked. For example:

• A type 1 diabetic whose pancreas has been damaged will need insulin.
• A person with Hashimoto's whose thyroid has been damaged will need replacement thyroid hormones.
• Someone with Sjogren's syndrome will need eye drops and mouth rinses to replace tears and saliva.

Many autoimmune disorders of all kinds are treated with immune-suppressing medications, such as corticosteroids (e.g. prednisone) to reduce the effect of the immune system.

For hemodialysis (the more common form of dialysis), a patient will visit a hospital or clinic and be connected to a dialysis machine by a needle attached to a tube that draws blood from the arm. The drawn blood is transferred to the dialysis machine, where it is filtered and separated until clean. Waste products from the blood pass into a fluid called dialysate, which is pumped out of the machine into a waste receptacle. The machine also measures and helps ensure the blood has the appropriate level of fluid, electrolytes, and pH. A tube delivers the cleaned blood back into the patient's body. A dialysis session like this will typically last for three to four hours, with a patient undergoing dialysis around three times per week.

A second method of dialysis is known as peritoneal dialysis. Unlike hemodialysis, peritoneal dialysis can be performed at home by oneself after an initial surgery. To start, a physician (generally a surgeon) will make a small incision in the lower abdomen and insert and surgically attach a catheter (thin tube). At home, the patient connects a pump to the abdomen catheter, delivering dialysate (dialysis fluid) from a bag hanging on a wheeled stand. This fluid enters the peritoneal cavity (greater abdomen area containing the stomach, liver, and intestines) and collects waste through osmosis, where waste in the blood moves across a membrane and into the dialysate. This process continues for several hours until the fluid concentration is equal between the blood and dialysate, at which point the fluid can be drained. The fluid can then be passed through a machine called a cycler, which removes waste and allows for the dialysate to be reused. This process is repeated about four times per day. Dialysis patients must limit the amount of fluid they consume prior to receiving dialysis and should also avoid eating salty foods. The cycler cannot filter more than a certain amount of waste products from the blood.

Kidneys are important organs, and dialysis treatments are vital for those with renal dysfunction. For many, dialysis is not so much a medical procedure but a part of their normal life.