I’m Starting Dialysis: What Can I Expect?

Your kidneys have the vital job of filtering and eliminating waste from your body, and if the kidneys are damaged in any way, they lose some of the ability to function properly.

Dialysis is a treatment that helps replace some of these lost functions of the kidneys, and is usually needed for patients in the later stages of chronic kidney disease. Here are some of the basics of dialysis—its types, when it’s needed, and what you can expect from treatment if you receive it.

Types of Dialysis

Simply put, dialysis is a process that helps take over many of the kidney’s normal functions when they can’t perform them correctly on their own. There are two main types of dialysis: hemodialysis and peritoneal dialysis.

Hemodialysis:

Hemodialysis is a process in which the blood inside your veins is streamed through a filter that’s connected to your body. The filter cleans your blood, and then returns it to your veins. There’s a step-by-step process to successful hemodialysis:

• Minor surgery: Your doctor will perform a minor procedure that helps create access to your bloodstream. It can be done using a fistula (a surgically made passage joining and artery and a vein in your arm to make a bigger blood vessel), a graft (a plastic tube that helps join an artery and a vein under the skin) or a catheter (a narrow tube inserted through the neck, groin or collarbone). A catheter is only used for people who need to start dialysis very quickly, and it’s usually only temporarily.
• Pump: When using a fistula or graft, needles are placed in your arm at this location. The hemodialysis machine uses a pump to take blood out.
• Filter: The blood is then sent through another machine, known as a dialyzer. The dialyzer replicates the kidneys’ functions by filtering out extra wastes, salts and other fluids.
• Return: Once the blood has been clean and filtered, it is pumped back into the body.

Hemodialysis can be done both at a hospital or treatment facility, or at home. Sessions last from three to five hours in a center three times a week, or two to three hours on six or seven days a week for home treatment.

Peritoneal dialysis:

Peritoneal dialysis uses the lining of your stomach to help filter blood. To do this, a catheter with a bag—containing a solution of water, salt and other nutrients—feeds fluid into the body and helps soak up waste and other fluids. After a few hours, this is drained into a separate bag to complete a process called an “exchange.” People on peritoneal dialysis will go through about four to six exchanges per day.

When It’s Needed

Dialysis is needed when the body has lost between 85 and 90 percent of its natural kidney function. You can also use a rating called GFR, or Glomerular Filtration Rate, to help figure out when you might need dialysis. Many people choose to start dialysis before kidneys lose that much function, or if lab tests show levels of waste that are too high in the blood. Dialysis and kidney transplants are often the only treatment options for certain levels of kidney failure.  

Expectations and Side Effects

Dialysis is a time-consuming process, but it shouldn’t be a painful one—if you do feel pain during or after the treatment, you need to tell your doctor. There are a few potential side effects to be aware of with dialysis:

• Low blood pressure
• Nausea or vomiting
• Muscle cramps
• Dry or itchy skin
• Infection risk for people using hemodialysis

Some of these side effects can be reduced through proper diet and health habits like hand washing, and avoiding alcohol, smoking and drugs.

If there aren’t any complications, dialysis can help people feel more normal while experiencing kidney disease, though it isn’t meant to cure kidney disease. You should be able to continue to work, or travel if necessary, during dialysis treatments.

Are you concerned about your kidney function? Talk with your primary care physician about seeing a nephrology specialist.

 

Sources:

“Dialysis.” National Kidney Foundation. https://www.kidney.org/atoz/content/dialysisinfo

“When Do I Need Dialysis?” WebMD. http://www.webmd.com/a-to-z-guides/kidney-dialysis#1