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A Treatment for Failing Kidneys

Dialysis is the most common treatment for severe kidney failure. You may need to go on dialysis if you have lost 85 to 90% of your kidney function. You can have dialysis in a hospital, at a dialysis center, or at home. You might need dialysis until your kidneys recover. If you have permanent kidney damage, you could need it for the rest of your life. Some people stay on dialysis only until they can get a kidney transplant. Here are eight things to know about dialysis.

Female doctor with illustration of kidneys over tablet

1. Dialysis is a filtering system.

Your kidneys filter and remove waste, water, chemicals and salt from your body. When they don’t work, your blood pressure goes up and fluid builds up in your body. Chemicals like potassium, sodium and bicarbonate can reach dangerous levels. Dialysis does not cure kidney disease. But, it is a very good way to filter your system when your kidneys can’t.

2. Dialysis removes waste from your blood.

There are two types of dialysis: hemodialysis and peritoneal dialysis. A hemodialysis machine is about the size of a dishwasher. Blood flows through the machine, and the machine filters it. Peritoneal dialysis cleans your blood inside your own body. For this method, a fluid called dialysate fills your belly. The fluid draws waste products out of your blood. You then flush the fluid out of your body.

3. You need minor surgery before dialysis.

Before you start hemodialysis, your doctor will do minor surgery in your arm or leg to create what's called vascular access. That's where your blood will be removed and then returned to your body. For peritoneal dialysis, your doctor also will do surgery. The doctor will put a catheter (a soft plastic tube) into your belly. This lets the dialysate flow into and out of your body.

adult male standing next to peritoneal dialysis equipment with catheter and saline bag hanging from IV pole

4. Dialysis takes about four hours.

Each hemodialysis treatment takes about four hours, and you will need about three treatments each week. There are two main types of peritoneal dialysis. You do continuous ambulatory peritoneal dialysis (CAPD) 4 or 5 times a day. The other type, automated peritoneal dialysis (APD), uses a machine called a cycler. It sends dialysate in and out of your belly at night while you sleep.

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5. Dialysis is more versatile than you think.

You can have hemodialysis at a kidney dialysis center or at home. You can do it at home if you and a good support person are willing to learn the process. It takes 4 to 6 weeks of training. You can do CAPD by yourself at home or even at work. Once you fill your belly with fluid, you can resume your activities for 4 or 5 hours. Then you remove the fluid. With APD, you only attach the machine at night. It works while you sleep.

6. Dialysis has risks you can manage.

One major risk of hemodialysis is developing a blood clot in your vascular access. If that happens, your doctor may need to remove the clot. This keeps the access area usable. You also could get an infection near your access. The main risk of peritoneal dialysis is an infection inside your belly that doctors call peritonitis. Your healthcare team will teach you how to check for these problems. Also, you might feel nauseous or dizzy from dialysis treatments. These side effects lessen over time.

7. Insurance covers much of your dialysis costs.

Dialysis requires a lot of equipment and a team of experts. That makes it costly. In 2011, hemodialysis cost about $88,000 a year, and peritoneal dialysis cost an average of $71,000. Most people with kidney failure can be on Medicare. It covers up to 80% of the cost. Private insurance or Medicaid may cover much of the rest.

8. You will have a team of caregivers.

Dialysis is complicated. It requires a team of caregivers. Your team may include your nephrologist (kidney specialist), a dialysis nurse, and technicians. A dietitian will help you stick to a healthy diet. A social worker can help you deal with money, work and travel issues. You and your family are the most important members of the team. If everyone works together, you can live a full and active life on dialysis.

8 Things to Know About Dialysis

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