1. Castner, Debra RN, APNC, CNN, MS

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What is dialysis?

Dialysis is a filtering process that removes toxins and fluids from your blood when your kidneys can no longer do it. The purpose is to keep the right levels of chemicals, fluids, and salts in your bloodstream; control your blood pressure; and remove waste products.


Why do I need dialysis?

If you lose 85% to 90% of your kidney function, and your health care provider doesn't expect your kidney function to return to normal, you'll need dialysis to keep harmful waste products from building up in your bloodstream. If this waste isn't removed, the results can be deadly. Ideally, a kidney specialist (nephrologist) will prepare you for starting dialysis even before your kidneys get to that point.


Chronic kidney disease (CKD) can be caused by diabetes, high blood pressure, or chronic kidney inflammation. Sometimes people with CKD have it for a long time before they notice symptoms such as fatigue, swollen feet and ankles, itching, nausea, or a poor appetite. Dialysis can help you manage CKD.


Dialysis also may help you if your kidneys suddenly stop working for a short period of time (a condition called acute kidney failure). Acute kidney failure can occur after major surgery, serious infections, severe dehydration, prolonged periods of low blood pressure, drug reactions, direct injury to the kidneys, or autoimmune diseases such as lupus.


What types of dialysis are there?

Two types of dialysis are available.


* Hemodialysis is the most common type of dialysis. It uses a filter called a hemodialyzer to remove waste products, and the cleaned blood is returned to your body. Treatments take 3 to 4 hours and are done three times a week. For this treatment, you'll need a simple surgical procedure that will create a connection between your blood vessels (called a fistula or graft). Two needles will be placed in your arm during the treatment. Sometimes a narrow plastic tube called a catheter will be placed in your neck or chest for the short term so you can receive the treatment until a fistula or graft can be done. You and your nephrologist can decide which is better for you.Usually, hemodialysis is done at a dialysis center. When you go to a dialysis center, you'll need to follow a special diet so waste doesn't build up too quickly in your blood.


* Peritoneal dialysis uses your abdominal cavity as the filter. It can be used for acute or chronic kidney failure and can be done at home.



During surgery, a catheter is inserted into your abdomen just below your navel. A fluid called dialysate is placed into your abdomen through the catheter, and it stays in your abdomen for 4 to 6 hours. The dialysate attracts waste products and excess fluid so that when you drain the dialysate out, the waste products are removed as well.


The two main types of peritoneal dialysis are continuous ambulatory peritoneal dialysis (CAPD) and continuous cycling peritoneal dialysis (CCPD). CAPD uses gravity to move fluid in and out of your abdomen. CCPD uses a machine called a cycler to exchange fluids while you sleep. Your nephrologist can teach you how to do either type of dialysis in your home.


Which type of dialysis is for me?

You and your nephrologist should talk about the best type of dialysis for you, based on your health and lifestyle. Ask for information and talk with your family and close friends for support. Playing an active role in your care will help you make a choice that will best suit your needs.


Where can I learn more?

Organizations such as the National Kidney Foundation ( can help you learn more about dialysis and kidney disease. Many dialysis centers often have free classes about dialysis choices and will provide a tour of the center before you make your choice. Ask your nephrologist about classes or support groups in your area.