Finding out that your kidneys are not working well can feel scary and overwhelming. Your doctor might mention that you need a treatment called dialysis. Hearing these words for the first time makes many people feel worried and unsure about what comes next. However, once you understand how this treatment works, you will see that it is a safe and vital way to protect your health.
Let us break down everything you need to know about blood filtration, commonly known as hemodialysis, in simple terms. Learning about the process helps you feel more confident and prepared for your health journey ahead.
Key Takeaways
- Hemodialysis is a life-saving treatment that cleans your blood when your kidneys cannot do the job anymore.
- There are two main ways to get treatment: at a special center or right in your own home.
- Protecting your blood access site on your arm is one of the most important daily habits.
- Eating the right foods with less salt, potassium, and phosphorus keeps you feeling strong and healthy.
- You are the most important member of your healthcare team, and asking questions helps you stay in control.
Renal function (eGFR)
Measure kidney function based on creatinine value
What Is Hemodialysis in Simple Terms?
Think of your two kidneys as super filters inside your body. Their main job is to take extra fluid, waste products, and toxins out of your blood and turn them into urine. When kidney disease stops these organs from working well, waste builds up inside your body.
Hemodialysis is a medical process that uses a special machine to clean your blood when your kidneys cannot do it. The machine removes waste products like urea and creatinine, extra water, and harmful acids from your blood, and then returns the clean blood safely back to your body.
How Does the Machine Clean Your Blood?
Inside the hemodialysis machine, there is a special filter called a dialyzer. Some people call this filter an artificial kidney. Blood flows from your body into this dialyzer.
As your blood moves through tiny hollow fibers inside the filter, extra water and waste pass out through the walls. These waste products mix with a special cleaning liquid called dialysate. This liquid contains water and helpful minerals. After the machine cleans your blood, it sends the clean blood back to you. Think of it like a tea strainer that lets the liquid pass through while keeping the leaves behind.
Two Main Ways to Get Hemodialysis
You and your doctor can talk about which treatment choice fits your daily life best. Here are the main options available for you:
| Treatment Type | Description |
|---|---|
| In-Center Hemodialysis | This is the most common choice. You visit a hospital or a dialysis center three times a week. Trained nurses and technicians take care of you during each session, which usually lasts about three to four hours. |
| Home Hemodialysis | You can do this treatment in your own home. First, your care team spends a few weeks or months teaching you and a helper how to run the machine safely. After that, you can do treatments on your own schedule. |
Types of Home Hemodialysis Schedules
If you choose to do treatment at home, you have a few different scheduling options to choose from:
- Conventional home hemodialysis: You do treatments three days a week, with each session lasting three to four hours.
- Short daily home hemodialysis: New technology lets you do shorter treatments five to seven days a week, lasting about two hours each time.
- Nocturnal home hemodialysis: You run the machine while you sleep at night. This runs four to six nights a week for six to eight hours. Cleaning the blood slowly over a longer time removes waste very well.
Who Needs This Treatment?
You need hemodialysis if you have a severe kidney condition known as End-Stage Kidney Disease (ESKD). This treatment is also essential to keep you healthy while you wait for a kidney transplant.
Important to know: Hemodialysis does not cure kidney disease. Instead, it takes over the job of your kidneys so you can stay alive and active.
What Happens If You Refuse Treatment?
This is a serious topic, but it is important to discuss. If someone decides not to start hemodialysis, or stops treatment midway, toxins build up in the blood. Doctors call this condition uremia. Sadly, this condition is life-threatening. Without treatment, a person can usually only live for a few days or weeks.
Choosing your care path is a deeply personal decision. Before making any choices, talk openly about your fears and feelings with your doctor and your family members.
How to Prepare Before Treatment
Before you start hemodialysis, your doctor will plan a small procedure a few weeks or months ahead of time. This creates a strong access route in your body so blood can flow out to the machine and return smoothly.
There are two main types of permanent access routes:
- AV fistula: A surgeon connects an artery and a vein right under your skin in your arm.
- AV graft: If your own blood vessels are too small to connect directly, a surgeon uses a soft, small tube to join the artery and vein together.
Both methods give you a strong blood vessel that makes it easy to place small needles during your sessions. They also let your blood flow quickly.
If you need to start hemodialysis right away due to an emergency, your doctor may place a temporary soft tube called a catheter into a large vein in your neck, chest, or leg.
Protecting Your Access Site Is Very Important
You must care for your arm access site just like you would care for something precious. If it gets infected or damaged, you cannot have your treatments safely. Signs of an infection include:
- Pain or tenderness when you touch the area.
- Swelling around the site.
- Changes in skin color such as red, grey, pink, brown, or black.
- Fever or chills.
Follow these simple rules to keep your access safe:
- Never sleep on the arm that has your access site.
- Do not wear tight clothes or jewelry on that arm.
- Keep handbag straps away from your access arm.
- Never let anyone check your blood pressure or draw blood from your access arm.
Do You Need to Change Your Diet?
Yes, absolutely. What you eat and drink directly affects how well your hemodialysis works. Some foods make waste build up fast, add extra water to your body, raise your blood pressure, or make your heart beat too fast. A renal dietitian can help you build a meal plan that fits your body's needs.
In general, you will need to limit foods that contain certain minerals and substances.
| Foods to Limit | Why and Examples |
|---|---|
| Potassium | High potassium can make your heart beat in an unsafe rhythm. Examples: Bananas, avocados, oranges, tender coconut water, dried fruits like dates and raisins, potatoes. |
| Phosphorus | High phosphorus can weaken your bones and make your skin itch. Examples: Milk and dairy items like yogurt and cheese, chicken, sausages, canned foods, lentils, nuts. |
| Sodium (Salt) | Eating too much salt makes you very thirsty and causes your body to hold onto extra water. Examples: Table salt, soy sauce, ketchup, packaged soups, instant noodles, restaurant fast food. |
What Happens During the Treatment?
Your nurse or technician places two needles into your access site. One needle takes blood out of your body and sends it into the machine. After the dialyzer cleans your blood, the second needle sends the clean blood back into your arm.
The machine checks your blood pressure the entire time you get treatment. It can also speed up or slow down blood flow as needed.
Does Treatment Hurt?
You may feel a small pinch when the nurse puts the needles into your access site. After that, you will not feel any pain during the hours your treatment takes. Many people read a book, watch television, or take a nap while the machine runs.
Why Does It Take So Long?
Healthy kidneys clean your blood 24 hours a day, even while you sleep. A hemodialysis machine cannot match that natural speed. Healthy kidneys clean about 140 liters of blood every single day. This dialysis works much slower. Because of this, you need to spend three to four hours at a time getting treatment.
After Treatment and Possible Side Effects
When your treatment finishes, the staff takes out the needles, cleans the spots, and puts on a plaster. After that, you can safely go home.
Most people feel a bit tired and worn out after treatment ends. This tiredness can last for a few hours, which is completely normal. However, if you feel very sick or uncomfortable, let your doctor know right away.
Hemodialysis can sometimes cause side effects. Not everyone gets them, but knowing what to look for helps you stay safe.
| Common Side Effects |
|---|
| Low blood pressure (Hypotension): Can cause dizziness or lightheadedness. |
| Muscle cramps: Often happens in your legs. |
| Nausea and vomiting: Some people feel sick to their stomachs. |
| Itchy skin (Pruritus): Managing your phosphorus levels helps keep this under control. |
| Headaches, chest pain, or back pain can also happen sometimes. |
When to Call Your Doctor or Emergency Services
If you experience any of the following warning signs, contact your doctor right away or call 911 (US/Canada) or 999 (UK) for emergency help:
- Signs of low blood pressure that do not go away, such as severe dizziness or fainting (syncope).
- Nausea and vomiting that make it hard to keep fluids down.
- Signs of infection at your access site like swelling, redness, pain, or fever.
- Severe pain in your belly.
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