Dialysis is a treatment for kidney disease that does some of the things done by healthy kidneys. It is necessary when your own kidneys no longer function well enough to remove the wastes and toxins from your blood. Click LEARN MORE in the boxes below for more information.
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, a doctor will create an access point (entrance) into your blood vessels through minor surgery on your arm or leg. Sometimes, an access is made by joining an artery to a vein under your skin to make a bigger blood vessel called a fistula.
However, if your blood vessels are not adequate for a fistula, the doctor may use a soft plastic tube to join an artery and a vein under your skin. This is called a graft. 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. Although this type of access may be temporary, it is sometimes used for long-term treatment. When the blood leaves your body, it is cleansed by the kidney “machine” and returned to your blood vessels.
Hemodialysis: At home or in-center?
Dialysis center hemodialysis:
- A nurse or technician handles the treatment.
- Usually done three times a week for about three to four hours or longer each time
- Treatments are done on a pre-scheduled day, time, and at a specific center
- You and a loved one/caregiver are doing your treatment.
- You will be trained at the hospital or at a dialysis center before doing it at home
- You will have support people to contact with any problems.
- Studies show that the more you know about your treatment and the more you do on your own, the better you are likely to do on dialysis.
- More information on Hemodialysis at Home, the Hemodialysis at Home page.
In peritoneal dialysis, your blood is cleaned while it stays inside your body. The doctor will do surgery to place a plastic tube called a catheter into your abdomen (belly) to create an access point (entrance). During the treatment, the inside of 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.
Peritoneal Dialysis: CAPD or CCPD?
Continuous Ambulatory Peritoneal Dialysis (CAPD):
- Only type of peritoneal dialysis that is done without machines
- You do it yourself, usually four to five times a day
- Through the catheter, you pour a new bag (about 2 quarts) of dialysate into the catheter
- The dialysate stays in your peritoneal cavity for four to five hours, while you go about your usual activities at work, school or home.
- Afterward, you drain your catheter back into the bag and throw it away
- Each input and output of dialysate is called an “exchange”
Continuous Cycling Peritoneal Dialysis (CCPD):
- Done at home using a special machine called a cycler
- Like CAPD except that more cycles (exchanges) occur, each lasting 1 to 1.5 hours
- It works through the night while you sleep.
Dee stays positive while living on dialysis.
If not for her positive outlook and personal strength, Dyneshia “Dee” Daniels from Pontiac does not know where she would be today. Dee struggles with both lupus and chronic kidney disease, two conditions that alone would make it difficult to go to school full-time and stay employed. Although these frustrations might deter some, Dee stays in good spirits and fights to reach her goals while living on dialysis.
What does dialysis do?
Like healthy kidneys, dialysis keeps your body in balance by doing the following:
- Removes waste, salt (sodium), 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
- Helps to control blood pressure
Is kidney failure permanent?
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. Check with your doctor about being placed on a waiting list for a new kidney.
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. You and your doctor will decide which place is best, based on your medical condition and your wishes.
Will dialysis cure my kidney disease?
No. Dialysis does some of the work of healthy kidneys, but it does not cure your kidney disease. You will need to have dialysis treatments for your whole life unless you are able to get a kidney transplant.
Does dialysis 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.
How long has dialysis been available?
Hemodialysis and peritoneal dialysis have been done since the mid-1940s. In 1960, dialysis became a regular treatment for kidney failure. It is now a standard treatment all over the world. CAPD began in 1976. Thousands of people with kidney disease have been helped by these treatments.
Is dialysis expensive?
Yes. Dialysis costs a lot of money. However, the federal government pays 80 percent of all dialysis costs for most patients. Private health insurance or state medical aid also help with the costs.
Do dialysis patients have to eat special diets?
Yes. You may not be able to eat everything you like, and you may need to limit how much you drink. Your diet may vary according to your type of dialysis.
Can dialysis patients travel?
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 can help you make the appointment.
Can dialysis patients continue to work?
Each person responds to dialysis differently. The physical nature of your job, how well you feel on dialysis, and your time are all factors in whether or not you can work while on dialysis. You should do what feels best for you.
For dialysis questions or support, please contact the National Kidney Foundation of Michigan’s Patient Services department.
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