Kidney dialysis uses a machine to do some of the work that your kidneys normally do. The kidneys are inside your belly, on either side of your spine just above your waist. They make urine by removing waste products, extra salt and other minerals, and water from the blood.
Cleans your blood by removing wastes
Removes extra water, which helps control blood pressure and swelling
Helps your body keep the right balance of minerals, such as potassium, sodium, and calcium
When is it used?
Dialysis may be used when you have kidney failure. If kidney failure is not treated, you will have too many waste products in your blood and you will not have a healthy balance of water and minerals. These problems are life-threatening. Dialysis is generally started when your kidneys are working at less than 15% of their normal function. There are 2 kinds of kidney failure: acute (sudden) and chronic (slow-developing and life-long).
If you have acute kidney failure, you may need dialysis until the cause of the kidney failure is treated.
If you have chronic kidney disease, dialysis can help you live longer. If you are otherwise healthy, dialysis may allow you to keep working and enjoying the things you like to do. You may need dialysis for the rest of your life. If your kidney failure is treated with a kidney transplant, you will be able to stop dialysis after the transplant.
How is it done?
There are 2 types of dialysis: hemodialysis and peritoneal dialysis.
Hemodialysis is the most common method of dialysis. Your blood is filtered through a machine. The machine takes wastes and extra water out of your blood and then returns the cleaned blood to your body. Before you have dialysis, an access to your bloodstream must be made. It provides a way for blood to be moved from your body to the dialysis machine and then back into your body. The access can be created in different ways:
If you have acute kidney failure, a plastic tube (catheter) will be inserted into a large vein in your neck, chest, or leg near the groin. This is called a venous catheter. The catheter will be removed when you no longer need dialysis.
If you have chronic kidney disease, you may have minor surgery to create a connection between an artery and a vein. The connection is usually in your forearm. A connection can be made using your own blood vessels or a synthetic tube. Your provider will give you more details on which type of access might work the best for you. You will be given an anesthetic before the access is created so the procedure will not be painful. You may need to have more than one surgery during your life to create a new connection.
When you have hemodialysis, dialysis is usually done about 3 times a week in a dialysis clinic. Each treatment takes about 3 to 5 hours. During treatment, you can read, write, sleep, talk, or watch TV.
Peritoneal dialysis (PD) uses the lining of your abdomen (the peritoneal membrane) to filter your blood. A catheter is used to fill your abdomen with a cleansing liquid called dialysis solution. Wastes, chemicals, and extra water move into the dialysis solution while it is in your abdomen. After a certain time, the solution is drained from your abdomen through the catheter, taking the wastes with it. Your abdomen is then filled again with new dialysis solution. Each cycle of filling and draining is called an exchange.
Before your first treatment, the catheter used for peritoneal dialysis is put into your belly through a small cut near your belly button. You will be given a local anesthetic to numb the area, and then your healthcare provider will make the cut and insert the catheter. The catheter will be closed with a clamp or valve when you are not having dialysis.
Your provider will give you a schedule for dialysis. You will have frequent weigh-ins and lab work to make sure the dialysis is helping you get rid of wastes and keeping a good balance of minerals.
Your healthcare provider will teach you how to care for your access site to prevent infection and to keep the site working.
Can dialysis be done at home?
Most states allow both hemodialysis and peritoneal dialysis to be done at home. The benefits of dialysis treatments at home are:
You can work around your treatment schedule.
You can avoid travel to and from the clinic.
You can do your treatments in the privacy and comfort of your home.
The disadvantages are:
You need space for the equipment.
Your electric and water bills will go up.
You may need to add more wiring in your house or have a backup electric supply in case of power failure.
You will need special training to learn how to do your treatments properly. If you are having hemodialysis at home, it’s very important to have a trained helper.
Ask your healthcare provider if home dialysis might be a good choice for you.
What are the risks of dialysis?
Possible problems with hemodialysis include:
Problems with the access to your blood vessels, such as infection, blockage from clotting, and poor blood flow
A sudden drop in blood pressure, which can make you feel weak, dizzy, or sick to your stomach
The most common serious problem with peritoneal dialysis is an infection inside the belly called peritonitis. The infection can be treated with antibiotics, but can be life threatening if it is not found early and treated.
How can I take care of myself?
Before you decide to start dialysis, some of the questions you may want to discuss with your healthcare provider include:
Which type of dialysis is the best for me?
How long will I need dialysis?
What follow up visits will I need to make?
What happens if dialysis stops working?
How will dialysis change my normal activities?
Can I still go to my job or school?
What will I need to do to have dialysis in my home?
What training do I need to do home dialysis?
Once you have started dialysis:
Follow the dialysis schedule as prescribed.
Carefully follow your healthcare providerâ€™s instructions for caring for the access site.
You may need to make changes in your diet. Carefully follow the diet prescribed by your healthcare provider or dietitian.
Donâ€™t drink more liquids than your provider recommends.
Take medicines exactly as prescribed by your provider.
Ask your provider:
If there are activities you should avoid and when you can return to your normal activities
How to take care of yourself at home
What symptoms or problems you should watch for and what to do if you have them
Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.
Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth. Last modified: 2015-01-28 Last reviewed: 2015-01-28
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
HomeDialysis Central. Everything you need to know about doing dialysis at home. Feb., 2012. Accessed 1/31/2012 from http://www.homedialysis.org/.
National Kidney and Urological Diseases Information Peritoneal Dialysis and Dose Adequacy. US Dept of Health and Human Services, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. NIH Publication No. 07â€“4578. December, 2006. Accessed Jan. 28, 2010 from http://kidney.niddk.nih.gov/Kudiseases/pubs/peritonealdose/.