For Patients & Families: Dialysis and Treatment

dialysis and treatment

about dialysis

overview and introduction

When a patient's kidneys are in a state of failure, they require some form of medical treatment to help their body complete the work their own kidneys can not perform on their own. Dialysis is a common treatment option for such patients.

 

When a patient is treated using dialysis, a machine is used to perform some of the functions normally managed by a healthy kidney. This machine cleans and filters a patient's blood, removes extra fluid, and clears away the body's excess waste and build up.

 

There are two types of dialysis: 

 

  • Hemodialysis (HD). A treatment in which blood is removed from the body and filtered through a machine to remove waste, toxins and fluids.

  • Peritoneal Dialysis (PF). A treatment in which your blood is cleaned inside your body. In PD, patients undergo a small surgery to have a soft plastic tube called a catheter placed into the abdomen (belly). The catheter makes it possible for a patient to easily connect to a special tubing, which allows PD treatments to be performed. During the treatment, a fluid called dialysate is put into the belly through a permanent catheter.  The fluid is left inside the body for a period of time, pulling waste through the belly lining.  Then, the fluid and the waste are removed through the catheter, and disposed of.

 
 

types of dialysis

learn how treatment works

In peritoneal dialysis, your blood is cleaned inside your body. A doctor places a soft plastic tube called a catheter into your (belly) to make an access. During the treatment, your abdominal area (the peritoneal cavity) is slowly filled with dialysate through the catheter. The blood stays in the arteries and veins that line your peritoneal cavity, and extra fluid and waste products are drawn out of your blood and into the dialysate.

 

There are two major kinds of peritoneal dialysis:

 

Continuous Ambulatory Peritoneal Dialysis (CAPD). Is the only type of PD that is done without machines. You do this yourself, usually four or five times a day at home and/or at work. You put a bag of dialysate (about two quarts) into your peritoneal cavity through the catheter. The dialysate stays there for about four or five hours before it is drained back into the bag and thrown away.

 

Automated Peritoneal Dialysis (APD). Is usually done at home using a special machine called a cycler. This is similar to CAPD except that a number of cycles (exchanges) occur. Each cycle usually lasts 1.5 hours and exchanges are done overnight, while you sleep.

In 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, usually to your arm (though it can also be done with the leg).

 

The dialyzer, or filter, 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 fluids remain in your blood because they are too big to pass through the membrane. Smaller waste products in the blood, such as urea, creatinine, potassium and extra fluid pass through the membrane and are washed away.

 

Hemodialysis can be done in a hospital, in a dialysis center that is not part of a hospital, or at home. You and your doctor will decide which place is best, based on your medical condition, and your wishes.

find a dialysis clinic

search your area for a nearby loaction

Medicare 

Medicare has data you can use to compare dialysis facilities (centers) based on the quality of patient care they provide. You can also compare their patient experience survey results..

Dialysis Finder: By DaVita 

The most comprehensive online dialysis center directory - DaVita has mapped every dialysis center found in the US and has associates available to field phone calls, and answer questions.

 

LEARN ABOUT LIVING WITH KIDNEY DISEASE

dialysis: fast facts

How long can you live on dialysis?


If your kidneys have failed, you will need to have dialysis treatments for your whole life unless you are able to get a kidney transplant. Life expectancy on dialysis can vary depending on your other medical conditions and how well you follow your treatment plan. Average life expectancy on dialysis is 5-10 years, however, many patients have lived well on dialysis for 20 or even 30 years. Talk to your healthcare team about how to take care of yourself and stay healthy on dialysis.




Where is dialysis done?


Dialysis can be done in a hospital, in a dialysis unit that is not part of a hospital, or at home. Where you have your treatment performed will depend on your unique diagnosis and overall health. You will work with your doctor to decide which place is best, and you will make a plan based on your medical condition and your wishes.




Will dialysis help cure kidney disease?


In some cases of sudden or acute kidney failure, dialysis may only be needed for a short time until the kidneys get better. However, in the case of chronic kidney disease - if your CKD progresses to kidney failure over time, usually, a your kidneys will continue to lose more and more function, and you will thus need dialysis for the rest of your life (unless you are able to receive a kidney transplant).




How long has dialysis been available?


Hemodialysis and peritoneal dialysis have been done since the mid 1940's. Dialysis, as a regular treatment, was begun in 1960 and is now a standard treatment all around the world. CAPD began in 1976. Thousands of patients have been helped by these treatments.




Is kidney failure permanent?


Usually, but not always. Some kinds of acute kidney failure get better after treatment. In some cases of acute kidney failure, dialysis may only be needed for a short time until the kidneys get better. In chronic or end stage kidney failure, your kidneys do not get better and you will need dialysis for the rest of your life. If your doctor says you are a candidate, you may choose to be placed on a waiting list for a new kidney.




When is dialysis needed?


You need dialysis when you develop end stage kidney failure --usually by the time you lose about 85 to 90 percent of your kidney function and have a GFR of less than 15. Click here to learn more about the stages of Chronic Kidney Disease and GFR.




Is dialysis uncomfortable? Does it hurt?


You may have some discomfort when the needles are put into your fistula or graft, but most patients have no other problems. The dialysis treatment itself is painless. However, some patients may have a drop in their blood pressure. If this happens, you may feel sick to your stomach, vomit, have a headache or cramps. With frequent treatments, those problems usually go away.




Is dialysis expensive?


Paying for dialysis on your own, without the benefit of insurance or government assistance, is an expensive treatment, yes. However, you should not need to pay for dialysis entirely on your own, as the federal government pays 80 percent of all dialysis costs for most patients. Private health insurance or state Medicaid programs also help with the costs. Click here to learn more about insurance options




Do dialysis patients live normal lives?


Many patients live normal lives except for the time needed for treatments. Dialysis usually makes you feel better because it helps many of the problems caused by kidney failure. You and your family will need time to get used to dialysis.




Do dialysis patients have to eat special diets?


Yes. Generally speaking, patients on dialysis are advised to increase their protein intake and limit the amount of potassium, phosphorus, sodium, and fluid in their diet. Patients with diabetes or other health conditions may have additional diet restrictions. It's important to talk with you dietitian about your individual diet needs. Click here to learn more about diet for dialysis patients




Can I travel if I am on dialysis?


Yes. Dialysis centers are located in every part of the United States and in many foreign countries. The treatment is standardized. You must make an appointment for dialysis treatments at another center before you go. The staff at your center may help you make the appointment. Click here to learn more about traveling on dialysis




Will I be able to work if I am on dialysis?


Many dialysis patients can go back to work after they have gotten used to dialysis. If you have a job involves a lot of physical labor (heavy lifting, digging, etc. ), your doctor may recommend you consult with your employer about adjusting your existing work duties. If that is not possible, your may need to consider explore new employment opportunities altogether. Click here to learn more about working with kidney disease





 

transplant / donor resources

In addition to dialysis, receiving a kidney transplant is an excellent treatment option for combatting kidney disease and kidney failure. Please explore the links below to learn more about kidney transplantation.

further reading

read more about topics related to dialysis

To learn more about topics related to dialysis and treatment for kidney disease, please visit our national office's Kidney A - Z Health Guide by clicking the links below. 

NKFI kidney health resources

The information shared on this website has been reviewed by staff at the New York City headquarters of the National Kidney Foundation. Please note: material contained here are intended solely for reference. This material does not constitute medical advice; it is intended for informational purposes only. If you feel you need professional medical care, please consult a physician for specific treatment recommendations.

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