There are an estimated 350,000 people across the country currently receiving dialysis treatment.  Dialysis is a treatment for people with stage 5 chronic kidney disease, or those who have suddenly and temporarily lost their kidney function .  For patients with stage 5 chronic kidney disease, kidney function declined over a period of months to years until such time that dialysis is needed for survival.  This generally occurs when your kidney function is less than 15%.

What does dialysis do?

Dialysis does the work that healthy kidneys do.  It removes waste, extra fluid and salt to keep them from building up in your body.  It helps to keep certain chemicals in your blood balances, such as sodium, potassium and bicarbonate.  It also helps to control blood pressure.

Will I Always Need Dialysis?

In some instances of acute kidney failure (sudden but temporary) your kidney function will return to normal and dialysis will only be needed until your kidneys get healthy again.  For chronic kidney disease patients in stage 5, kidneys do not get better and dialysis will be needed for the rest of your life.  You may wish to discuss transplantation with your doctor to determine if you are a candidate.

Where is dialysis done?

Dialysis is typicaly done in a dialysis unit.  This can be part of a hospital or it can also be at a facility that is not part of a hospital.  Dialysis can also be done at home.  You and your doctor will decide the best method based on your medical condition and your wishes.  It is strongly recommended that you consider all of your dialysis options and discuss them with your healthcare team and your family.  It is your right to have all information available to you and to have all of your questions answered so that you can make an informed decision.

What kinds of dialysis are there?

There are two types of dialysis --hemodialysis and peritoneal dialysis.

What is hemodialysis?

In hemodialysis, an artificial kidney is used to remove waste, extra chemicals and fluid from your blood. To get your blood into the artificial kidney, the doctor needs to make entrance (access) into your blood vessels. This is done by minor surgery to 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. This type of access may be temporary, but is sometimes used for long-term treatment.

How long do hemodialysis treatments last?

The time needed for your dialysis depends on:

• how well your kidneys work
• how much fluid weight you gain between treatments
• how much waste you have in your body
• how big you are
• the type of artificial kidney used

Usually, each hemodialysis treatment lasts about four hours and is done three times per week.
A type of hemodialysis called high-flux dialysis may take less time. You can speak to your doctor to see if this is an appropriate treatment for you.

Hemodialysis is also a treatment you might consider doing at home.  Developments in dialysis treatment have led to some very progressive home therapies that can be done at night while you are sleeping or during the day at a time you decide works best for you.  Many patients report that they feel much better with at home therapy because they are doing dialysis more frequently.  Doing dialysis at home requires a partner who is willing to assist you.  Speak with your doctor if you are interested in exploring home hemodialysis.

What is peritoneal dialysis and how does it work?

In this type of dialysis, your blood is cleaned inside your body. A catheteris placed into your abdomen (belly) to make an access. During the treatment, 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.

There are several kinds of peritoneal dialysis but two major ones are:
Continuous Ambulatory Peritoneal Dialysis (CAPD) and Continuous Cycling Peritoneal Dialysis (CCPD).
Continuous Ambulatory Peritoneal Dialysis (CAPD) is the only type of peritoneal dialysis 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. This is called an exchange. You use a new bag of dialysate each time you do an exchange. While the dialysate is in your peritoneal cavity, you can go about your usual activities at work, at school or at home.
Continuous Cycling Peritoneal Dialysis (CCPD) usually is 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 1-1/2 hours and exchanges are done throughout the night while you sleep.

Is Dialysis a Cure for Kidney Disease?

No. Dialysis does some of the work of healthy kidneys, but it does not cure your kidney disease. If you are a chronic kidney disease patient in stage 5, you will need to have dialysis treatment for the rest of your life or until you have a transplant.

Is dialysis uncomfortable?

You may have some discomfort when the needles are put into your fistula or graft, but most patients have no other problems. The treatment itself is painless. Some issues may occur during treatyment, such as a drop in 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 is Dialysis treatment paid for?

Dialysis is a very costly treatment.  The good news is that the federal government pays for 80% of all dialysis costs for most patients.  State medicaid or private health insurance can also help with the costs.

Will I feel better after I have started dialysis treatment?

Most dialysis patients feel better after they have started treatment.  Because dialysis is a change in lifestyle, you will need some time to get used to the treatment.  You should make sure you are always communicating with your healthcare team so they know how you are feeling.  You should also speak with the social worker at your dialysis facility so that the social worker can help you with adjusting to your new lifestyle.

What resources are available to help me?

There are a number of organizations dedicated to helping dialysis patients.  The National Kidney Foundation offers a number of programs for dialysis patients across the country.  You may visit the following websites for more information: