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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.

Overview
Types

types of dialysis

learn how treatment works

Peritoneal Dialysis
Hemodialysis

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.

Find a Clinic

LEARN ABOUT LIVING WITH KIDNEY DISEASE

dialysis: fast facts

  • Why are the kidneys so important?
    Your kidneys perform important functions that affect every part of your body. In fact, many other organs depend upon the kidneys to function normally. The kidneys perform complicated jobs that keep the rest of the body in balance. When the kidneys become damaged, your body’s other organs are affected as well. The major job of the kidneys is to remove waste products and extra fluids from the body in the form of urine. The production of urine is a complicated process that maintains a chemical balance in your body. Your kidneys also regulate your body’s salt, potassium and acid content, and make hormones that affect the way your other organs function. One hormone produced by the kidneys is needed to make red blood cells. Others help regulate your blood pressure and help your body use calcium. Your kidneys also: Remove waste products from your body Balance chemicals in your body, such as potassium, phosphorus, calcium, and sodium Balance your body’s fluids Regulate your blood pressure Promote strong, healthy bones
  • How do your kidneys work / function?
    Each of your two kidneys contains about one million functioning units called nephrons. A nephron consists of a filtering unit of tiny blood vessels, called a glomerulus, which is attached to a tubule. When blood enters the glomerulus, it is filtered and the remaining fluid then passes through the tubule. In the tubule, chemicals and water are either added to or removed from this filtered fluid according to the body's needs. The final product is urine, which we excrete. The kidneys perform their life-sustaining job of filtering and returning to the bloodstream about 200 quarts of fluid every 24 hours. Approximately two quarts are eliminated from the body in the form of urine, and about 198 quarts are retained in the body. The urine we excrete has been stored in the bladder anywhere from 1 to 8 hours.
  • What is chronic kidney disease?
    Chronic kidney disease (CKD) means the kidneys are damaged. When the kidneys are damaged, they cannot filter blood and do their other jobs well enough. Protein in the urine for three months or longer is a warning sign of kidney damage. Your level of kidney function is measured by the test for glomerular filtration rate (GFR). A GFR of less than 60 for three months or more indicates CKD.
  • What are some of the types and causes of kidney disease?
    There are many types of kidney disease, and it usually affects both kidneys. If the kidneys' ability to filter the blood is damaged by disease, wastes and excess fluid may build up in the body, causing severe swelling and symptoms of kidney failure. The kidneys may be affected by diseases such as diabetes and high blood pressure. Some kidney diseases are inherited Other diseases are congenital; that is, individuals may be born with an abnormality that can affect their kidneys. The following are some of the most common types and causes of kidney disease: Diabetes is the leading cause of serious kidney disease. High blood pressure (also known as hypertension) is another common cause of kidney disease. Glomerulonephritis is a disease that causes inflammation of the kidney's tiny filtering units, the glomeruli. Polycystic kidney disease is the most common inherited kidney disease. Kidney stones are a common kidney malady that can cause further damage to the kidneys if they are not treated. Urinary tract infections occur when bacteria enter the urinary tract and cause symptoms such as pain and/or burning during urination and more frequent need to urinate. Congenital diseases such as Goodpasture's Syndrome and Reflux Disorder may also affect the kidneys. Overuse of over-the-counter medications and the use and buildup of illegal drugs in the body can cause kidney failure. To learn more about kidney disease, please click here.
  • How is kidney disease detected?
    Early detection and treatment can slow or prevent the progression of kidney disease. Some simple tests can be done to detect early kidney disease. They are: Blood pressure monitoring. High blood pressure is a cause of kidney disease. It may also be a sign of kidney trouble. A test for protein in the urine. Too much protein in your urine may mean that your kidneys’ filtering units have been damaged. A single positive result could be due to a fever or heavy exercise, so your doctor will want to confirm your urine protein test results over several weeks. An estimate of your Glomerular Filtraion Rate (GFR) to show how much kidney function you have. Your doctor uses the results of a blood test, along with your age, gender, and race, to estimate your GFR number. This number tells your doctor how much kidney function you have. As CKD progresses, your GFR number decreases. A completely healthy kidey function is measured at a GFR of around a 100, which means that the kidneys are working at 100 percent. Your kidney function is still considered normal if the GFR number is 90 or greater. Here's a way to understand the GFR scale: If your GFR is 45, you know that your kidneys are working at approximately 45 percent of the normal rate. It is very important that people who are at increased risk for kidney disease have these tests.
  • Can kidney desease be treated?
    Many kidney diseases can be treated. Careful control of diseases like diabetes and high blood pressure can help to prevent kidney disease or slow its progression. Kidney stones and urinary tract infections often can be treated successfully. Unfortunately, the exact causes of some kidney diseases are still unknown, and specific treatments are not yet available. Sometimes these diseases progress to chronic kidney failure, requiring dialysis or kidney transplantation. Changes in diet and treatment for high blood pressure sometimes help to slow the progression of these diseases. Research is being conducted to find more effective treatment for these diseases.
  • If I have chronic kidney disease, do I need dialysis?"
    Ultimately, dialysis is treatment option that is entirely up to the patient. Normally, dialysis is not considered as a treatment option unless a patient is expereincing end-stage kidney failure (which usually occurs when a patient loses about 85 to 90 percent of their kidney function, and they have a GFR of less than 15). If you are not in end-stage kidney failure, your physician will likely work to slow, or control, the cause of your kidney disease. Treatment options vary, depending on the cause. But kidney damage can continue to worsen even when an underlying condition, such as high blood pressure, has been controlled. Your doctor will likely also work to treat any complications that arise from kidney disease. Treatments may include: High blood pressure medications Medications to lower cholesterol levels Medications to treat anemia Medications to relieve swelling Medications to protect your bones A lower protein diet to minimize waste products in your blood
Fast Facts

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.

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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