What to Expect During Dialysis

A diagnosis of kidney failure can be frightening and raise questions in your mind about your treatment. Depending on the stage of your kidney disease, your doctor may have you begin dialysis, which must be done consistently until your condition improves, or you receive a kidney transplant. You must commit hours to this process every week, but many people are able to make it a part of their routine, and continue to lead fulfilling lives. 

Dialysis Basics

When your kidneys are only performing at 15–10% and you have a glomerular filtration rate (GFR) of less than 15, your doctor will probably prescribe dialysis. Dialysis uses a specialized machine, or process to clean your blood, something healthy kidneys do on their own. Dialysis removes waste and fluid and works to maintain the correct levels of potassium, sodium and bicarbonate in your body. 

Types of Dialysis 

Chronic kidney disease, or CKD treatment, comes in two forms: hemodialysis and peritoneal dialysis. 

Hemodialysis

If you undergo hemodialysis, you will go to a hospital or other medical facility, usually three times a week, where medical personnel will hook you up to a machine that functions as an external artificial kidney. They will connect your blood vessels to this machine in one of several ways. 

Your doctor may create a fistula under your skin by joining a vein and an artery. This method allows easier access to your circulatory system. Sometimes, the doctor creates a graft instead by using a plastic tube to join the vein and artery. Less often, you will need a catheter placed in your neck. These procedures are all minor and are usually done as an outpatient procedure. 

Hemodialysis treatments last about four hours, but this time period may vary according to your fluid and waste levels, body size and degree of kidney failure. 

Peritoneal Dialysis

Peritoneal dialysis works by allowing your own body to cleanse your blood. Your doctor creates an access point in your abdominal area with a catheter. Then you introduce a dialysate into this cavity which draws the waste and fluid out of your blood. There are two peritoneal dialysis methods:

• Continuous Ambulatory Peritoneal Dialysis (CAPD): This method requires no machines. Instead, you introduce about two quarts of the dialysate into your peritoneal cavity, let it stay there for about five hours and then drain it back into the bag, which you then dispose of. You perform this process approximately four or five times a day.
• Automated Peritoneal Dialysis (APD): This process requires a machine called a cycler that completes the necessary exchanges at home while you sleep—one about every 90 minutes. 

Final Notes

Many people successfully undergo dialysis for years. You will require some minor surgery to create access points to your blood. Hooking up to the machine may cause slight discomfort, but the actual cleansing process is usually painless.

Your doctor will help you decide which type of dialysis is best for your situation and work with you to create a livable and successful treatment schedule.