Dialysis: Purpose, Types, Risks, and More (2024)

If your kidneys cannot keep your blood filtered and purified, dialysis performs the function of your kidneys using a machine.

The kidneys filter your blood by removing waste and excess fluid from your body. This waste is sent to the bladder to be eliminated when you urinate.

When your kidneys can’t perform well due to disease or injury, dialysis can help keep the body running. Kidney failure occurs when the kidneys perform only 10% to 15% of their typical function. Without dialysis, salts and other waste products accumulate in the blood and can damage other organs.

Learn more about dialysis, including the different types and possible risks.

Types of dialysis can include hemodialysis, peritoneal dialysis, and continuous renal replacement therapy (CRRT).

What is hemodialysis?

Hemodialysis is a form of dialysis that uses a filter called a hemodialyzer to remove waste and extra fluid from the blood.

Before hemodialysis

A doctor performs minor surgery to create an entry point into your blood vessels. This is done in advance, as it may take several months to heal.

The three types of entrance points include:

  • Arteriovenous (AV) fistula
  • AV graft
  • Vascular access catheter

Both the AV fistula and AV graft are designed for long-term dialysis treatments. Catheters are designed for short-term or temporary use.

During hemodialysis

During treatment, your blood is removed from the body and filtered through the hemodialyzer. The filtered blood is then returned to the body with the help of a dialysis machine.

Hemodialysis treatments last about 4 hours each, up to 3 times per week. You may also have hemodialysis treatment in shorter, more frequent sessions.

At first, most hemodialysis treatments are performed at a hospital, doctor’s office, or dialysis center. The length of treatment depends on your body size, the amount of waste in your body, and your current health.

After hemodialysis

After you’ve been on hemodialysis for an extended period, you may be ready to give yourself dialysis treatments at home. This option is common for people who need long-term treatment.

What is peritoneal dialysis?

Peritoneal dialysis uses a peritoneal dialysis (PD) catheter in your abdomen to filter your blood. The catheter filters blood through the peritoneum, a membrane in your abdomen.

Before peritoneal dialysis

A doctor performs surgery to implant the catheter. This typically happens about 3 weeks in advance.

You typically receive training from a dialysis nurse for a couple of weeks before dialysis to learn to care for the catheter site and perform the exchanges.

During peritoneal dialysis

During treatment, a special fluid called dialysate flows into the peritoneum. The dialysate absorbs waste. Once the dialysate draws waste out of the bloodstream, it’s drained from your abdomen.

This process can take a few hours and needs to be repeated 3 to 5 times daily. But this fluid exchange can happen while you’re sleeping or awake—and even during daily activities.

Types of peritoneal dialysis include:

  • Continuous ambulatory peritoneal dialysis (CAPD): Your abdomen is filled and drained multiple times daily. This method doesn’t require a machine and must be performed while awake.
  • Continuous cycling peritoneal dialysis (CCPD): CCPD uses a machine to cycle the fluid in and out of your abdomen. It’s usually done at night while you sleep.
  • Intermittent peritoneal dialysis (IPD): This treatment is usually performed in the hospital, though you may perform it at home. It uses the same machine as CCPD, but the process takes longer.

After peritoneal dialysis

After treatment, you’ll need to take care of your exit site, catheter, and other supplies to prevent infection.

What is CRRT (continuous renal replacement therapy)?

CRRT is used primarily in the intensive care unit for people with acute kidney failure. It’s also known as hemofiltration.

A machine passes the blood through the tubing. A filter then removes waste products and water. A machine returns the blood to the body, along with replacement fluid. This procedure is performed 24 hours or more at a time.

All three forms of dialysis can carry certain risks.

Risks associated with hemodialysis

Hemodialysis risks include:

  • low blood pressure (hypotension)
  • anemia
  • muscle cramps
  • difficulty sleeping
  • itching
  • high blood potassium levels (hyperkalemia)
  • pericarditis, an inflammation of the membrane around the heart
  • sepsis
  • bacteremia, or a bloodstream infection
  • irregular heartbeat
  • sudden cardiac arrest

Risks associated with peritoneal dialysis

Peritoneal dialysis may increase your risk of infections in or around the catheter site, such as peritonitis.

Other risks include:

  • abdominal muscle weakening
  • high blood sugar due to the dextrose in the dialysate
  • weight gain from dextrose and excess fluids
  • nausea or vomiting
  • hernia
  • fever
  • stomach pain

Risks associated with CRRT

The risks associated with CRRT include:

  • infection
  • hypothermia
  • low blood pressure (hypotension)
  • electrolyte disturbances
  • bleeding
  • delayed renal recovery
  • weakening of bones
  • anaphylaxis

Those who undergo long-term dialysis are also at risk of developing other medical conditions, including amyloidosis.

Some people develop depression or anxiety after receiving a diagnosis of long-term kidney failure. If you’re having thoughts associated with depression, talk with a member of your care team or a mental health professional. The National Alliance on Mental Illness also has resources for dealing with depression and chronic conditions.

Other treatment options may help manage your symptoms if you decide not to pursue dialysis.

One option is anemia management. When the kidneys work correctly, the hormone erythropoietin (EPO) is produced naturally. To help with an under-functioning kidney, you can get an injection of EPO every week.

Maintaining healthy blood pressure can help slow the deterioration of your kidney. Drink fluids to avoid dehydration. Talk with a doctor before using any anti-inflammatory drugs, including ibuprofen (Advil) and diclofenac (Solaraze, Voltaren).

A kidney transplant may be an option. Talk with a doctor to see if a transplant is right for you. You may not be a good candidate for a kidney transplant if you:

  • smoke
  • heavily use alcohol
  • have obesity
  • have an untreated mental health condition

A medical professional may provide specific directions. You may need to fast for a certain amount of time before treatment.

You may want to wear comfortable clothing during treatment.

You can perform both hemodialysis and peritoneal dialysis at home. Peritoneal dialysis can be performed alone, while hemodialysis often requires a partner. This can be a friend, family member, or dialysis nurse.

With either type, you’ll receive thorough training from a medical professional beforehand.

Dialysis can temporarily serve the same function as kidneys until your kidneys repair themselves and begin to work on their own again.

But if you have chronic kidney disease, you typically go on dialysis permanently or until a kidney transplant becomes an option.

While on hemodialysis, you’ll need to limit your potassium, phosphorus, and sodium intake. You may need to keep a record of how much liquid you consume. Having too much fluid in the body can cause problems.

A nephrologist (kidney doctor) typically has a dietician on the team to help guide dietary choices.

Being consistent with your dialysis will also decrease your chances of needing a kidney transplant.

Stopping dialysis

If you’re considering stopping dialysis, mention any concerns to a doctor.

While it’s in your right to stop any treatment at any time, they may suggest you talk with a mental health professional before ending this life-saving treatment. If the condition causing kidney failure hasn’t been corrected, stopping dialysis will eventually lead to death.

Dialysis is a life-saving therapy that can replace the work of non-functioning kidneys. This may be due to acute kidney failure, chronic kidney disease, or other kidney issues. It works by filtering your blood to help restore both fluid and electrolyte balances.

There are also risks and complications to consider, as well as problems with treatment access. Talk with a doctor about the pros and cons of dialysis, and ask them which type may be best for your situation.

Dialysis: Purpose, Types, Risks, and More (2024)

FAQs

Dialysis: Purpose, Types, Risks, and More? ›

Dialysis is a treatment for individuals whose kidneys are failing. There are two types of dialysis, hemodialysis and peritoneal dialysis, that both perform normal kidney functions, filtering waste and excess fluid from the blood.

What are the different types of dialysis? ›

What happens during dialysis. There are 2 main types of dialysis: haemodialysis and peritoneal dialysis.

What are the different types of dialysis facilities? ›

There are 3 main types of dialysis: in-center hemodialysis, home hemodialysis, and peritoneal dialysis. Each type has pros and cons. It's important to remember that even once you choose a type of dialysis, you always have the option to change, so you don't have to feel "locked in" to any one type of dialysis.

Which type of dialysis is safer? ›

Peritoneal dialysis offers continuous filtration and does not require as much disruption to your daily activities. However, hemodialysis is ideal for patients with less kidney function. Peritoneal dialysis is not a good option for obese patients or people who have abdominal scarring.

What are dialysis patients at risk for? ›

People receiving haemodialysis are at increased risk of developing sepsis (blood poisoning). This is where bacteria enter the body and spread through the blood, potentially leading to multiple organ failure. Warning symptoms include dizziness and a high temperature.

What type of dialysis is most gentle? ›

Peritoneal Dialysis (PD)

This needle-free dialysis treatment uses the inner lining of the abdomen to clean your blood. You can do the flexible treatments at home, work or while on vacation.

Which type of dialysis is less painful? ›

PD does not require any blood, so there are no needle sticks involved. Fluid simply enters your abdomen through the catheter, dwells inside for awhile, and then drains back out. This process is usually completely painless.

Which dialysis is more effective? ›

If dialysis is recommended for you, you'll often be able to choose whether to have haemodialysis or peritoneal dialysis. Both methods of dialysis are equally effective for most people, so it's usually a case of personal preference. But there may be some situations where a particular type of dialysis is best.

What are the 3 types of dialysis access? ›

As a hemodialysis patient, your access is one of the following:
  • Fistula: an access made by joining an artery and vein in your arm.
  • Graft: an access made by using a piece of soft tube to join an artery and vein in your arm.
  • Catheter: a soft tube that is placed in a large vein, usually in your neck.

Why is peritoneal dialysis not popular? ›

In this brief review, we discuss some of the factors underlying the low prevalence of PD. These include inadequate patient education, a shortage of sufficiently well-trained medical and nursing personnel, absence of infrastructure to support urgent start PD, and lack of support for assisted PD, among other factors.

What is the new alternative to dialysis? ›

The two newest innovations in renal replacement technology—implantable BAK and cellular kidney regeneration—create a fully functioning alternative to long-term dialysis or a donor organ.

Can kidneys start working again after dialysis? ›

Dialysis for Chronic Kidney Disease

There is currently no way to reverse chronic kidney damage, so people with kidney failure need regular dialysis to replace kidney function. The only way to safely stop dialysis is through a successful kidney transplant.

What is the life expectancy of a person on dialysis? ›

The average life expectancy for patients on dialysis is 5 to 10 years but many patients have lived well on dialysis for 20 or even 30 years.

Who should not get dialysis? ›

Dialysis can help with symptoms caused by kidney failure, but if you have other medical conditions, eg stroke, Parkinson's disease, peripheral vascular disease, frailty, or dementia, dialysis won't help with the symptoms that they cause, and could even make them worse.

What are the first signs you need dialysis? ›

Guidelines for doctors about when to start dialysis include kidney failure symptoms, problems controlling blood pressure, problems controlling fluid, and problems with nutrition. The guidelines suggest that if you are not having these problems, you can wait to have dialysis until your eGFR is 6 mL/min.

Is dialysis 3 times a week bad? ›

When your kidneys aren't working properly, dialysis is used to try to achieve balance by imitating the fluid and toxin removal functions of healthy kidneys. But for many kidney patients, treating three times per week may not be enough dialysis, and this can hurt their heart.

Which is more effective, hemodialysis or peritoneal dialysis? ›

If dialysis is recommended for you, you'll often be able to choose whether to have haemodialysis or peritoneal dialysis. Both methods of dialysis are equally effective for most people, so it's usually a case of personal preference.

What type of dialysis does not use a machine? ›

Continuous ambulatory peritoneal dialysis (CAPD): Does not require a machine. Exchanges, often referred to as "passes," can be done three to five times a day, during waking hours.

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