The dialysis unit at the King Edward VII Memorial Hospital is celebrating its 20th anniversary and what better time than during Dialysis Awareness Month.

In Bermuda, over the last 20 years, 500 people have had dialysis treatment and 60 of those have undergone successful kidney transplants.

Almost 50 percent of those patients are diabetic and others suffer from hypertension/high blood pressure.

Carol Hall is one of the many Bermudians who had high blood pressure and a successful kidney transplant. She tells her story.

"I was on dialysis for two years before having a kidney transplant nine years ago.

I had polycystic kidneys which means numerous cysts in the kidney which eventually expanded and stopped the kidney from functioning.'' Mrs. Hall said the first indication to her kidney problem was very high blood pressure.

"Doctors did an ultrasound and found cysts, from then on I had yearly checkups and then every six months and as the kidneys gradually ceased to operate which was over a period of eight years -- they still functioned but they were not purifying my blood -- that is when I started dialysis.'' She added: "I was a very busy person so I felt that dialysis was an inconvenience, to spend three hours three times a week in the dialysis unit.

"I had to plan functions or activities around the dialysis schedule but it didn't stop me from doing things.

"I went to work every day, stayed in for lunch and would leave early for my dialysis.'' Mrs. Hall said dialysis is not painful. "The initial insertion of the needles bothered me but once they were in I felt fine. When I first started dialysis there was a strange sensation, a feeling of being faint but that did not last.'' Mrs. Hall said her dialysis started slowly with once a week sessions then three times a week which most patients start with after kidney failure.

She went to Brigham and Women's Hospital in Boston for transplant surgery and since then has had no problems with her new kidney.

"Right after the initial operation there was some rejection but that was quickly rectified with some medication.'' Mrs. Hall said today she is dialysis free and living without kidney problems.

"Since the operation I have had to keep up with regular exercise, watch my weight and take medication for the rest of my life because the donated kidney is not my organ, so there will always be a chance that my body will reject it.

"My body will always see the kidney as a foreign object and the medications help to fight off the rejection, they help the body to accept the organ.'' Mrs. Hall said her illness and operation took its toll on her children who were in their early teens.

"I always kept them informed about what was going on but at the time they were still frightened about whether the donated kidney would work or whether or not I would live. But we all survived and the experience has brought my family closer. We are also more health conscious.'' Mrs. Hall added that after finding out that polycystic kidneys is hereditary her children have ultrasounds every couple of years to see if there are any growths on their kidneys.

According to information received from the dialysis unit at the King Edward VII Memorial Hospital dialysis is a treatment that does some of the things done by healthy kidneys. It is needed when your own kidneys can no longer take care of your body's needs.

You need dialysis when you develop end stage kidney failure which is usually by the time you lose about 85 to 90 percent of your kidney function.

Like healthy kidneys, dialysis keeps your body in balance. It removes waste, salt and extra water to prevent them from building up in the body, keeps a safe level of certain chemicals in your blood such as potassium, sodium and bicarbonate and helps to control blood pressure.

There are two types of dialysis -- hemodialysis and peritoneal dialysis.

With hemodialysis, an artificial kidney (hemodialyzer) is used to remove waste and extra chemicals and fluid from your blood.

To get your blood into the artificial kidney, the doctor needs to make an access (entrance) into your blood vessels. This is done by minor surgery to your arm or leg.

Sometimes an access is made by joining an artery and a vein under your skin.

This is called a graft.

After the fistula or graft is healed, and dialysis is needed, two needles are placed, one in the artery side and one in the vein side of your fista or graft.

Plastic tubing attached to the needles connects you to the artificial kidney and dialysis begins.

Occasionally, an access is made by means of a narrow plastic tube called a catheter, which is inserted into a large vein in your neck. This type of access may be temporary, but is sometimes used for long-term treatment.

The artificial kidney has two parts, one for your blood and one for a washing fluid called dialysate. A thin membrane separates these two parts.

Blood cells, protein and other important things remain in your blood because they are too big to pass through the membrane.

Smaller waste products in the blood such as urea, creatinine and extra fluid pass through the membrane and are washed away. If your body needs calcium or sugar, it can be put in the dialysate, and it will then move into your body.

Peritoneal dialysis -- which is offered in Bermuda but not often used -- is when your blood is cleaned inside your body.

The doctor will do surgery to place a plastic tube called a catheter into your abdomen (belly) to make an access.

During the treatment, your abdominal area (called the peritoneal cavity) is slowly filled with dialysate through the catheter. The blood stays in the arteries and veins that line your peritoneal cavity.

Extra fluid and waste products are drawn out of your blood and into the dialysate.

LIVING A FULL LIFE -- Nine years ago Carol Hall was the recipient of a kidney after two years of dialysis treatment.

DIALYSIS TREATMENT -- The dialysis unit at King Edward VII Memorial Hospital is in full use due to the number of Bermudians who have kidney problems because of high blood pressure or diabetes.