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Dialysis - hemodialysis

Artificial kidneys - hemodialysis; Dialysis; Renal replacement therapy - hemodialysis; End-stage renal disease - hemodialysis; Kidney failure - hemodialysis; Renal failure - hemodialysis; Chronic kidney disease - hemodialysis

Dialysis treats end-stage kidney failure. It removes waste from your blood when your kidneys can no longer do their job.

There are different types of kidney dialysis. This article focuses on hemodialysis.

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What is Hemodialysis?

Your kidneys' main job is to remove toxins and extra fluid from your blood. If waste products build up in your body, it can be dangerous and even cause death.

Hemodialysis (and other types of dialysis) does some of the job of the kidneys when they stop working well.

Hemodialysis can:

During hemodialysis, your blood passes through a tube into an artificial kidney or filter.

Your doctor will create an access where the tube attaches. Usually, an access will be in a blood vessel in your arm.

When to Start Dialysis

Kidney failure is the last stage of long-term (chronic) kidney disease. This is when your kidneys can no longer support your body's needs. Your doctor will discuss dialysis with you before you need it. Usually, you will go on dialysis when you have only 10% to 15% of your kidney function left.

You also may need dialysis if your kidneys suddenly stop working due to acute renal failure.

Dialysis at a Treatment Center

Hemodialysis is most often done at a special dialysis center.

At a treatment center, your health care providers will handle all your care. However, you do need to schedule your appointments and follow a strict dialysis diet.

Dialysis at Home

You may be able to have hemodialysis at home. You do not have to buy a machine. Medicare or your health insurance will pay for most or all of your treatment costs at home or in a center.

If you have dialysis at home, you can use one of two schedules:

You also may be able to do a combination of daily and nighttime treatments.

Because you have treatment more often and it happens more slowly, home hemodialysis has some benefits:

You can do the treatment yourself, or you can have someone help you. A dialysis nurse can train you and a caregiver on how to do home dialysis. Training can take a few weeks to a few months. Both you and your caregivers must learn to:

Home dialysis is not for everyone. You will have a lot to learn and need to be responsible for your care. Some people feel more comfortable having a provider handle their treatment. Plus, not all centers offer home dialysis.

Home dialysis may be a good option if you want more independence and are able to learn to treat yourself. Talk with your provider. Together, you can decide what type of hemodialysis is right for you.

When to Call Your Doctor

Call your provider if you notice:

Also, call your doctor if any of the following symptoms are severe or last more than 2 days:

References

Kotanko P, Kuhlmann MK, Chan C. Levin NW. Hemodialysis: principles and techniques. In: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Comprehensive Clinical Nephrology. 6th ed. Philadelphia, PA: Elsevier; 2019:chap 93.

Misra M. Hemodialysis and hemofiltration. In: Gilbert SJ, Weiner DE, eds. National Kidney Foundation's Primer on Kidney Disease. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 57.

Yeun JY, Young B, Depner TA, Chin AA. Hemodialysis. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner and Rector's The Kidney. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 63.

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Review Date: 1/15/2020  

Reviewed By: Walead Latif, MD, Nephrologist and Clinical Associate Professor, Rutgers Medical School, Newark, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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