Dialysis by Editorial Staff And Contributors

En Español (Spanish Version)

Definition | Reasons for Procedure | Possible Complications | What to Expect | Call Your Doctor

Definition

Dialysis is a treatment that takes over the job of your kidneys if they fail . The kidneys have many functions that help your body stay healthy. They help clear toxins out of your blood and help your body balance salt levels. Most patients begin dialysis when their kidneys have lost 85%-90% of their ability. You may be on dialysis for a short time, or you may need it for the rest of you life (or until you receive a kidney transplant), depending on the reason for your kidney failure.

If you have kidneys that are not working and the damage is not reversible, you have End Stage Renal Disease (ESRD). ESRD is caused by conditions such as diabetes, kidney cancer , drug use, high blood pressure , or other kidney problems. Dialysis is not a cure for ESRD, but it does help you feel better and live longer.

There are two types of dialysis:

• Hemodialysis
• Peritoneal dialysis

Reasons for Procedure

It may also be done to remove toxins from the bloodstream quickly. This can be used in cases of poisoning or drug overdose.

Possible Complications

Factors that may increase the risk of complications include:

What to Expect

Prior to Procedure

Hemodialysis

• Usually, before your first dialysis, you will have some sort of tubing attached to a large vein to make blood flow from your body to the machine and back more easily. If you will be on dialysis for a long time, you may have had surgery to create a shunt or a fistula, which makes access to a large vein easier. Fistulas may need as long as 2–3 months to fully heal before they can be used. They are not used if the treatment is temporary. They are typically created many months before dialysis is begun.
• Weight, blood pressure, and temperature are taken.
• Topical anesthetic (a pain-numbing medicine) is usually applied to the area of needle insertion, if needle insertion is necessary.
• Heparin is given to prevent blood clotting.

Peritoneal Dialysis

Before the first treatment, a small, soft tube (approximately 24 inches long) will be placed in the abdomen. This tube will remain there permanently. A portion of the tube remains outside the body for use in the process. It is important to keep this access clean and dry to prevent infection.

Anesthesia

For hemodialysis: topical anesthetic

Description of the Procedure

Hemodialysis

Blood is filtered through an artificial kidney machine, called a dialyzer. The blood travels from your body to the machine through tubes inserted into a large vein in your body. Once the blood is filtered in the machine, it travels back into your body through another tube.

Hemodialysis is usually done at a dialysis center or hospital. It may be done at home with assistance. It is usually done three times a week. Each treatment lasts from two to four hours.

Peritoneal Dialysis

The abdominal lining is called the peritoneal membrane. In this type of treatment, it is used to filter blood instead of using a machine. A cleansing solution, called a dialysate, is inserted into your abdominal cavity through a tube. Fluid, wastes, and chemicals pass from the tiny blood vessels in the peritoneal membrane into the dialysate. The dialysate is drained after several hours. New dialysate can be added to repeat the process. A port in the abdomen may be needed for long-term treatment.

How Long Will It Take?

The approximate time and frequency of each method:

Type	Length of procedure	Frequency of procedure
Hemodialysis	2-4 hours	3 times/week
CAPD	3-6 hours, plus 30 minutes to drain	4 times/day
CCPD	9-12 hours	Every night
IPD	12 + hours	36-42 hours/week

Will It Hurt?

In general, dialysis procedures do not cause pain. You will not feel the blood exchange. There may be some temporary discomfort with the insertion of the needle or tube.

Post-procedure Care

At the Care Center

Your blood pressure will be monitored. Once the procedure is complete and blood pressure is stable, you are free to continue daily activities.

At Home

Be sure to follow your doctor’s instructions . There are some special considerations:

Dietary Guidelines

Certain dietary guidelines should be followed. This will help to maintain overall health and optimize treatment effects. Patients who have peritoneal dialysis may have slightly fewer dietary restrictions than hemodialysis patients. This is due to the more frequent filter schedule. Talk to your doctor about your specific dietary needs.

Medications

Your doctor may give you various medicines. These include, but are not limited to

• Blood pressure medicines
• Calcium supplements or multivitamins
• Phosphorus binders—to lower phosphorus levels in the blood
• Diuretics—to remove excess fluid
• Stool softeners or laxatives—to prevent or treat constipation, which can be caused by decreased fluid intake
• Iron supplements—to increase iron intake, which is important for production of red blood cells

Call Your Doctor