The kidneys are a pair of organs, each about the size of a fist,
located on either side of your spine. They’re responsible for purifying your
blood by removing waste and excess fluid from your body. When the kidneys don’t
work properly, dialysis is used to perform the function of the kidneys.
Dialysis is a treatment that filters and purifies the blood using
a machine. This helps keep your body in balance when the kidneys can’t do their
job. Dialysis has been used since the 1940s to treat people with kidney
Is Dialysis Used?
Properly functioning kidneys prevent extra water, waste, and
other impurities from accumulating in your body. They also help control blood
pressure and regulate the levels of chemicals in the blood, such as sodium, or
salt, and potassium. They even activate a form of vitamin D that improves the
absorption of calcium.
When your kidneys can't perform these functions due to disease or
injury, dialysis can help keep the body running as normally as possible.
Without dialysis, salts and other waste products will accumulate in the blood
and poison the body. However, dialysis isn’t a cure for kidney disease or other
problems affecting the kidneys. Different treatments may be needed to address
Does Dialysis Work?
Dialysis is an artificial way of cleaning your blood. There are
two different types of dialysis:
the most common type of dialysis. It uses an artificial kidney, known as a hemodialyzer, to remove waste and
chemicals from your blood. To get the blood to flow to the artificial kidney,
your doctor will surgically create a vascular access, or an entrance point, into
your blood vessels. This vascular access will allow a larger amount of blood to
flow through your body during hemodialysis treatment. This means more blood can
be filtered and purified.
The two type of vascular access designed for long-term dialysis
treatments are an arteriovenous (AV) fistula, which connects an artery and a
vein and an AV graft, which is a looped tube. For short-term use, a catheter
may be inserted into the large vein in your neck.
Hemodialysis treatments usually last three to five hours. The
treatment is typically needed three times per week. However, hemodialysis
treatment can also be done in shorter, more frequent sessions.
Most hemodialysis treatments are done at a hospital, doctor's
office, or dialysis center. The length of treatment depends on your body size
and the amount of waste in your body.
After you’ve been on hemodialysis for an extended amount of time,
your doctor may feel that you're ready to give yourself dialysis treatments at
home. This option is more common for people who will need long-term treatment.
Peritoneal dialysis involves surgery to implant a
catheter into your belly area. During treatment, a special fluid called dialysate flows into your
abdomen. Once the dialysate draws waste out of the bloodstream, it’s drained
from your abdomen.
There are numerous different types of peritoneal dialysis, but
the main ones are continuous ambulatory
peritoneal dialysis and continuous
cycler-assisted peritoneal dialysis. In continuous ambulatory peritoneal dialysis, your abdomen is filled
and drained multiple times each day. Continuous
cycler-assisted peritoneal dialysis, however, uses a machine to cycle
the fluid in and out of your abdomen. It’s usually done at night while you
Peritoneal dialysis can be done at home. You’ll receive training on
how to perform the steps of the treatment.
There Any Risks Associated with Dialysis?
While both peritoneal dialysis and hemodialysis are treatments
that can save your life, they can have certain risks.
Peritoneal dialysis is associated with an increased risk for
infections in or around the catheter site in the abdominal cavity. For example,
a person can experience peritonitis,
an infection of the membrane lining the abdominal wall, after catheter
implantation. Other risks include:
- abdominal muscle weakening
- high blood sugar due to the dextrose in the
- weight gain
Hemodialysis also has unique risks, including:
- low blood pressure
- anemia, or not having
enough red blood cells
- muscle cramping
- difficulty sleeping
- high blood potassium levels
- pericarditis, which is an inflammation of the
membrane around the heart
If you continue to have these symptoms while on peritoneal dialysis
or hemodialysis, tell the healthcare provider performing the treatment.
Those who undergo long-term dialysis treatments are also at risk
of developing other medical conditions, including amyloidosis. This disease can
occur when amyloid proteins produced in bone marrow build up in the kidneys,
liver, heart, and other organs. This usually causes joint pain, stiffness, and
swelling. Some people may also develop depression after being diagnosed with
long-term kidney failure. Call 911 immediately if you’re having thoughts
associated with depression, such as thoughts of harming yourself or committing
suicide. The National
Alliance on Mental Illness can also provide you with resources if you
struggle with depression.
Do I Prepare for Dialysis?
Before your first dialysis treatment, your doctor will surgically
implant a tube or device to gain access to your bloodstream. This is typically
a quick operation. You should be able to return home the same day.
It's best to wear comfortable clothing during your dialysis
treatments. You should also follow your doctor's instructions, which may
include fasting for a certain amount of time before the treatment.
Is the Long-Term Outlook for Someone Who Needs Dialysis?
Not all kidney disorders are permanent. Dialysis can temporarily serve
the same function as kidneys until your own kidneys repair themselves and begin
to work on their own again. However, in chronic kidney
disease, the kidneys rarely get better. You must go on dialysis permanently
or until a kidney transplant becomes an option if you have this condition.