Kidney Dialysis

What is kidney dialysis?

Kidney dialysis is a mechanical way to do the work your kidneys normally do. It:

• Cleans your blood by removing wastes.
• Removes extra water and helps control blood pressure.
• Helps your body keep the proper balance of chemicals such as potassium, sodium, and calcium.

When is it used?

Dialysis is used when you have kidney (renal) failure. If kidney failure is not treated, you will have too much water and chemical waste in your blood, which can kill you. Dialysis does not cure the disease, but it is used to do the work of your kidneys and is lifesaving. Untreated kidney failure leads to too much chemical waste and water in the blood, which can cause death.

Dialysis is generally started when your kidneys are working at less than 10% of their normal function. If you have acute kidney failure (sudden shutdown of your kidneys), you may need dialysis until the cause of the kidney failure is corrected. If you have chronic (long-lasting) kidney failure, you may need dialysis for the rest of your life.

Whether dialysis is used depends on:

• why your kidneys stopped working
• your other health conditions
• your overall health.

For many people, dialysis can extend life, and improve quality of life. For others whose condition is extreme, dialysis may seem a burden that only prolongs suffering. Discuss this with your health care provider.

How is it done?

The two types of dialysis are hemodialysis and peritoneal dialysis. Both types are not painful.

Hemodialysis is the most common method of dialysis. Your blood is filtered through a machine. The machine takes out wastes and extra water. Before your first treatment, an access to your bloodstream must be made. It provides a way for blood to be carried from your body to the dialysis machine and then back into your body. The access can be created in different ways:

• A plastic tube (catheter) is inserted into a large vein in your neck, chest, or leg near the groin.
• You have minor surgery to create a connection between an artery and a vein, usually in the forearm. A connection called a fistula can be made using your own blood vessels. Or a graft can be made using a synthetic tube.

You will be given an anesthetic before the access is created so the procedure will not be painful.

When you have hemodialysis, the dialysis machine is attached to the access with a needle.

Hemodialysis is usually done about 3 times a week in special clinics by trained staff. In some cases it can be done at home with a helper. Each treatment takes about 3 to 5 hours. During treatment, you can read, write, sleep, talk, or watch TV.

In peritoneal dialysis, the lining of your abdomen (the peritoneal membrane) is used to filter your blood. Before your first treatment a surgeon places a small, soft tube (catheter) into your abdomen. Then during each treatment, a mixture of minerals and sugar dissolved in water, called dialysis solution, travels through a small, soft tube into your abdomen. The sugar draws wastes, chemicals, and extra water from the tiny blood vessels in your peritoneal membrane into the dialysis solution. After several hours, the used solution is drained from your abdomen through the tube, taking the wastes from your blood with it. Then you fill your abdomen with fresh dialysate and repeat the cleaning process. This cycle, called an exchange, is repeated several times a day. If this type of dialysis is a possible treatment for you, ask your health care provider about the different ways to do it.

Peritoneal dialysis can be done in the home after you or a family member has had special training. You may not need a helper.

What are the benefits of dialysis?

Dialysis does the work your failed kidneys would normally do. It keeps your blood clean and healthy.

What are the risks of dialysis?

Possible problems with hemodialysis are:

• problems with the access to your blood vessels, such as infection, blockage from clotting, and poor blood flow
• muscle cramps
• a sudden drop in blood pressure, which can make you feel weak, dizzy, or sick to your stomach.

The most common problem with peritoneal dialysis is a serious abdominal infection called peritonitis. Tell your health care provider right away if:

• You have fever.
• The used dialysis solution has an unusual color or cloudiness.
• The area around the catheter is red or painful.

The infection can be treated with antibiotics.

How can I take care of myself?

• Carefully follow the diet prescribed by your health care provider.
• Do not drink more liquids than your provider recommends.
• Take medicines exactly as prescribed by your health care provider.
• If you are having hemodialysis, tell your health care provider if you have muscle cramps or feel weak, dizzy, or sick to your stomach.
• If you are having peritoneal dialysis, tell your provider if you have signs of abdominal infection.

For more information, contact:

• The National Kidney Foundation
  Phone: 1-800-622-9010
  Web site: http://www.kidney.org.
• National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
  31 Center Drive
  MSC 2560 Building 31, Room 9A-04
  Bethesda, MD 20892-2560
  Phone: 1-301-496-3583
  Web site: http://www.niddk.nih.gov.