At-a-Glance Summary
- Dialysis removes waste and excess fluid when the kidneys can no longer function effectively.
- The two main types are hemodialysis (HD) and peritoneal dialysis (PD). Home HD is an option for some patients after training.
- Dialysis is typically considered when symptoms and lab results indicate it’s time to begin treatment.
- Getting started includes an education visit, planning your access (an arteriovenous [AV] fistula or graft for HD, or a PD catheter), and a straightforward home setup.
- Your care team helps you choose the option that fits your medical needs and daily life through shared decision-making.
- This overview provides a high-level summary of dialysis types, treatment processes, access care, and side effects.
Introduction
At Florida Kidney Physicians, we know that learning about dialysis can feel overwhelming. Our goal is to give you a clear, simple picture of what dialysis does, when it’s considered, and how your care team helps you choose the option that fits your life.
What Dialysis Does
Dialysis is a type of renal replacement therapy (RRT). It takes over part of the kidneys’ job when they can no longer adequately filter waste products, toxins, and excess fluid. In simple terms, it helps you:
- Remove waste and toxins from your blood (such as urea and creatinine).
- Remove excess water to ease swelling and shortness of breath.
- Keep important electrolytes and minerals (like potassium and phosphorus) within a healthy range.
When these improve, many people notice more energy, less swelling, and clearer thinking.
Who Might Need Dialysis
Doctors consider starting dialysis when kidney function is very low and problems are no longer managed effectively with medication and diet. Common reasons include:
- Advanced chronic kidney disease (CKD) or end-stage renal disease (ESRD) with symptoms that affect daily life.
- Uremia — a buildup of waste products that can cause nausea, poor appetite, itching, trouble concentrating, or confusion.
- Electrolyte problems, especially high potassium (hyperkalemia) that doesn’t improve with treatment.
- Excess fluid (fluid overload) not controlled by diuretics or other medications, leading to swelling or shortness of breath.
Your nephrologist will consider your day-to-day symptoms, lab results, and blood pressure, and then discuss next steps with you.
Types of Dialysis at a Glance
There are two main ways to clean your blood with dialysis. Here’s a quick look at how each works and where it’s usually done:
- Hemodialysis (HD): Your blood flows through a filter in a machine that cleans it and returns it to your body. Many people do HD in a center several times a week; some can do it at home after training (home HD).
- Peritoneal Dialysis (PD): A sterile dialysis solution goes into your abdomen through a soft tube and later drains out. The lining of your abdomen acts as a natural filter. It can be done during the day — continuous ambulatory peritoneal dialysis (CAPD) — or overnight while you sleep with a small machine — automated peritoneal dialysis (APD).
What to Expect in Your First Steps
Education Visit: You, your nephrologist, and other team members will review your options, your home and work schedule, and what matters most to you — sleep, family time, travel, or staying active.
Planning the Right Access: For HD, many people get an arteriovenous (AV) fistula or graft in the arm so blood can flow well during treatments. Some start with a temporary catheter while a fistula heals. For PD, a soft PD catheter is placed in the abdomen. Your team will discuss timing and care.
Getting Ready at Home: You’ll learn simple hygiene steps, where to keep supplies, and how to set up a comfortable space. If you choose a home option, you’ll receive training and hands-on practice until you feel confident.
Early Follow-Ups: Expect check-ins to fine-tune your plan — adjusting treatment time, fluid removal (ultrafiltration), and medications so you feel your best.
Shared Decision-Making
There isn’t one “right” choice for everyone. The best plan is the one that matches your medical needs and your daily routine. Tell your care team what matters most — work, caregiving, sleep, or travel — and they’ll help you plan around it. Choices can change over time, and your team will revisit them with you.
Everyday Tips for Starting
- Keep a small notebook (or phone notes) for questions and how you feel after sessions.
- Bring a friend or family member to early visits to have a second person listen and help you remember details.
- Set reminders for medications and appointments.
- Wear comfortable clothes and bring a light snack if approved by your care team.
- Gentle movement and stretching can help with energy and sleep — ask what’s right for you.
FAQs
Is dialysis a cure for kidney failure? No. Dialysis replaces part of the kidneys’ work. A kidney transplant is another treatment path that some people may be eligible for in the future.
Can I work while on dialysis? Many people do. Scheduling, home options, and small adjustments at work can make it possible. Your social worker can suggest resources.
Does dialysis hurt? Needle sticks for HD can sting, but many people get used to them. PD usually doesn’t hurt. Tell your care team if you feel discomfort so they can help.
When do people start dialysis? It depends on symptoms, lab results, and overall health. Your nephrologist will review your situation and work with you to determine the best time to start.
Will my diet change once I start dialysis? Yes, your diet will likely need to change, but it will be personalized for you. A renal dietitian will help you manage fluids and minerals like potassium and phosphorus while keeping meals enjoyable.