Dialysis

Kidney disease can get worse over time, and may lead to kidney failure.

The treatment options for kidney failure include dialysis or kidney transplant.  Dialysis and kidney transplant are treatments—not cures—for kidney failure.

A nephrologist will discuss what options are available. Neither dialysis nor transplant will cure kidney failure.

What does dialysis do?

Dialysis cleans waste products from the blood, removes extra fluid, and controls the body’s chemistry in place of the kidneys.

Dialysis helps your body because it:

  • Removes waste, salt and extra water from the body.
  • Keeps certain chemicals in the blood, such as potassium, sodium and bicarbonate at safe levels.
  • Helps to control blood pressure.

A dialysis treatment time is different for each person on dialysis. The amount of dialysis that a particular person needs depends on:

  • Functioning of native kidneys
  • Size of person
  • Amount of waste or fluid built up in the body
  • Type of artificial kidney being used

There are two types of dialysis:  hemodialysis and peritoneal.

Hemodialysis

Hemodialysis is a treatment process that removes extra fluid and wastes from the body by constantly moving blood through an external filter. This filter is called an  artificial kidney or dialyzer, which is located inside a dialysis machine.

In order to get blood into the artificial kidney, a person needs an access.  An access is an entrance that allows blood to go in and out of the body so that it can be cleaned.  A surgeon will place the access (entrance) into the body in either the arm or leg.

There are two types of accesses.

One type of access is called a fistula.  A surgeon joins an artery to a vein under the skin to make a larger blood vessel.

A doctor may choose instead to use a soft plastic tube to join an artery and a vein under the skin. This type of dialysis access is called a graft.

Occasionally, an access must be made by means of a narrow plastic tube, called a catheter, which is inserted into a large vein in the neck. This type of access may be temporary, but is sometimes used for long-term treatment.

Hemodialysis is a procedure that is usually done at a dialysis facility.  This dialysis is called in-center hemodialysis.  Most patients go to hemodialysis treatments three times a week.  These appointments last between three to five hours.

In some parts of Wisconsin, a dialysis provider may also offer a night-time schedule for patients.  This type of dialysis is called “nocturnal.”

Peritoneal Dialysis

Peritoneal dialysis (PD) also filters the blood. But, instead of using an artificial kidney, PD uses the thin membrane (called the peritoneum) that lines the abdominal cavity. A large number of blood vessels exist just beneath the peritoneum. When a fluid called dialysate is put into the abdominal cavity, the chemical properties of the fluid draw toxins out of the blood vessels through the membrane, thus filtering the blood. When the filtering process is complete, the dialysate (along with the toxins) is pumped out of the abdominal cavity. To gain access to the cavity, a catheter (a flexible hollow tube) is surgically placed in the lower abdomen. There are two types of PD:

  • Continuous Cycling Peritoneal Dialysis (CCPD). During CCPD, a machine automatically fills and drains the dialysate from the abdomen.  This process takes about 10 to 12 hours and is usually performed at night, while a person sleeps.
  • Continuous Ambulatory Peritoneal Dialysis (CAPD), which gives patients total mobility and can be used at home, on the job or while traveling. It usually involves four short (half-hour) exchanges each day.

Support

Dialysis patients, family members and caregivers can meet other families living with chronic illness in their local community by attending a “Living Well With Chronic Conditions” program.

Questions About Dialysis

Will dialysis help cure the kidney disease?
No. Dialysis does some of the work of healthy kidneys, but it does not cure kidney disease. A person will need to have dialysis treatments for his/her whole life unless he/she receives a kidney transplant.

How long has dialysis been available?
Hemodialysis and peritoneal dialysis have been done since the mid 1940’s. Dialysis, as a regular treatment, was begun in 1960 and is now a standard treatment all around the world. CAPD began in 1976. Thousands of patients have been helped by these treatments.

Can dialysis patients travel?
Yes. Dialysis centers are located in every part of the United States. The treatment is standardized. A person must make an appointment for dialysis treatments.

Last worked on: November 25, 2016