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Dialysis centers - what to expect

If you need dialysis for kidney disease, you have a few options for how to receive treatment. Many people have dialysis in a treatment center. This article focuses on hemodialysis at a treatment center.

Alternate names

Artificial kidneys - dialysis centers - what to expect; Dialysis - what to expect; Renal replacement therapy - dialysis centers - what to expect

What to expect

You may have treatment in a hospital or in a separate dialysis center.

  • You will have about 3 treatments a week.
  • Treatment takes about 3 to 4 hours each time.
  • You have to make appointments for your treatments.

It's important not to miss or skip any dialysis sessions. Be sure you arrive on time. Many centers have busy schedules. So you may not be able to make up the time if you are late.

During dialysis, your blood will flow through a special filter that removes waste and excess fluid. The filter is sometimes called an artificial kidney.

Once you arrive at the center, trained health care providers will take charge of you.

  • Your access area will be washed, and you'll be weighed. Then you'll be taken to a comfortable chair where you'll sit during treatment.
  • Your provider will check your blood pressure, temperature, breathing and heart rate, and pulse.
  • Needles will be placed in your access area to allow blood to flow in and out. This may be uncomfortable at first. If needed, your provider can apply a cream to numb the area.
  • The needles are attached to a tube that connects to the dialysis machine. Your blood will flow through the tube, into the filter, and back into your body.
  • The same site is used every time, and over time, a small tunnel will form in the skin. This is called a buttonhole, and it's like the hole that forms in a pierced ear. Once this forms, you won't notice the needles as much.
  • Your session will last 3 to 4 hours. During this time your provider will monitor your blood pressure and the dialysis machine.
  • During treatment, you can read, use a laptop, nap, watch TV, or chat with providers and other dialysis patients.
  • Once your session is over, your provider will remove the needles and put a dressing on your access area.
  • You will probably feel tired after your sessions.

During your first sessions, you may have some nausea, cramping, dizziness, and headaches. This may go away after a few sessions, but be sure to tell your providers if you feel unwell. Your providers may be able to adjust your treatment to help you feel more comfortable.

Having too much fluid in your body that needs to be removed can cause symptoms. This is why you should follow a strict kidney dialysis diet. Your provider will go over this with you.

How long your dialysis session lasts depends on:

  • How well your kidneys work
  • How much waste needs to be removed
  • How much water weight you've gained
  • Your size
  • The type of dialysis machined used

Between sessions

Getting dialysis does take a lot of time, and it will take some getting used to. However, between sessions, you can go about your daily routine.

Getting kidney dialysis does not have to keep you from traveling or working. There are many dialysis centers across the U.S. and in many foreign countries. If you plan to travel, you’ll need to make appointments ahead of time during your time away from home.

When to call your doctor

Call your doctor if you notice:

  • Bleeding from your vascular access site
  • Signs of infection, such as redness, swelling, soreness, pain, warmth, or pus around the site
  • A fever over 100.5 °F (38.0 °C)
  • The arm where your catheter is placed swells and the hand on that side feels cold
  • Your hand gets cold, numb, or weak

Also call your doctor if you severely suffer from any of the following symptoms or they last more than 2 days:

  • Itching
  • Trouble sleeping
  • Diarrhea or constipation
  • Nausea or vomiting
  • Drowsiness, confusion, or problems concentrating

References

Tolkoff-Rubin N. Treatment of Irreversible Renal Failure In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 133.

Yeun JY, Ornt DB, Depner TA. Hemodialysis. In: Brenner and Rector's The Kidney?. 9th ed. Philadelphia, PA: Elsevier Saunders; 2001: chap. 64.

Update Date: 3/3/2014

Updated by: Charles Silberberg, DO, Private Practice specializing in Nephrology, Affiliated with New York Medical College, Division of Nephrology, Valhalla, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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