It’s a treatment that takes over your kidney functions if those organs stop doing their job. There are two types of dialysis:
- Hemodialysis: Your blood is put through a filter outside your body, cleaned, and then returned to you. This is done either at a dialysis facility or at home.
- Peritoneal dialysis: Your blood is cleaned inside your body. A special fluid is put into your abdomen to absorb waste from the blood that passes through small vessels in your abdominal cavity. The fluid is then drained away. This type of dialysis is typically done at home.
How Does Hemodialysis Work?
First, you’ll need minor surgery to create direct access to your bloodstream. This can be done in a few ways:
- Fistula (also known as arteriovenous fistula or A-V fistula): An artery and vein are joined together under the skin in your arm. Most of the time, this is done in the one you don’t write with. An A-V fistula needs 6 weeks or longer to heal before it can be used for hemodialysis. Then, it can be used for many years.
- Graft (arteriovenous graft or A-V graft): A plastic tube is used to join an artery and vein under your skin. This heals in only 2 weeks, so you can start hemodialysis faster. This won’t last as long as a fistula. You’ll likely need another graft after a few years. The risk of infection is greater with a graft. You’ll also have to see your doctor more often so they can make sure the graft stays open.
- Catheter (central venous catheter): This method is an option if you need to start hemodialysis very quickly. A flexible tube (catheter) is put into a vein in your neck, below your collarbone, or next to your groin. It’s only meant to be used for a short time.
During hemodialysis, you’ll sit or lie back in a chair. A tech will place two needles in your arm where the fistula or graft is located. A pump in the hemodialysis machine slowly draws out your blood, then sends it through another machine called a dialyzer. This works like a kidney and filters out extra salt, waste, and fluid. Your cleaned blood is sent back into your body through the second needle in your arm. Or, if there’s a catheter, blood comes out of one port and then is returned via a second port.
You can have hemodialysis in a hospital, a dialysis treatment center, or at home. If you have it in a center, the sessions last 3 to 5 hours, and you’ll likely only need them three times a week. If you have hemodialysis at home, you’ll need treatments 6 or 7 days for 2 to 3 hours each time. Some people read or watch TV during treatment. If you have hemodialysis at home, you may be able to do it at night while you sleep.