Hemodialysis

Dialysis is a treatment for kidney failure. It helps to replace the job of the kidneys when they stop working. Hemodialysis is a type of dialysis.

What is hemodialysis?
Who needs hemodialysis?
What is an access?
How should I care for my access?
Where can I have hemodialysis?
How long does hemodialysis take?
What can I do during hemodialysis?
How will I need to change my diet?
More Information

What is hemodialysis?

Hemodialysis is a way of cleaning wastes and extra fluids from the blood using a machine.

In hemodialysis, blood goes through a tube from the body to a dialyzer. The dialyzer is the machine’s filter. Inside the dialyzer, wastes and extra fluids are cleaned from the blood. Then, the clean blood travels through another tube and back into the body.

Who needs hemodialysis?

If your kidneys fail, you will need dialysis or a kidney transplant to live. Hemodialysis is the most common kind of dialysis. Another kind of dialysis is peritoneal dialysis. Click here for more information about peritoneal dialysis. Your doctor can help you decide which treatment is best for you.

What is an access?

For hemodialysis, blood must be taken from your body, cleaned, and returned to your body. An access (also called vascular access) is the place on your body where this happens. An access is usually in the arm that you don’t write with. This means that if you are right-handed, the access would be in your left arm.

There are three types of access:

1. Fistula

This is also called an AV (arteriovenous) fistula. To make a fistula, your doctor will do minor surgery. The surgery connects an artery and a vein in your arm. This lets you have dialysis.

A fistula is the best kind of access. It is least likely to get clots or infections. Fistulas often last longer than other kinds of access. For dialysis, needles will be put into the fistula to remove the “dirty” blood and return the “clean” blood.

It can take 1 to 4 months for the fistula to be ready for dialysis. That is why it is important to plan ahead. Talk to your doctor about your options.

2. Graft

A graft is a special tube that connects an artery and a vein in your arm. Grafts are not as safe as fistulas. They are more likely to be infected or get clots. During dialysis, needles will be put into the graft to remove the “dirty” blood and return the “clean” blood.

3. Catheter

A catheter is a tube that goes directly into a vein in your neck or leg. For dialysis, the machine is attached directly to this tube. There are no needle sticks, but catheters are more likely to have infections and problems with clotting. Catheters are only recommended for emergencies or short-term use.

How should I care for my access?

Your access lets you have the treatment you need to live. It is very important to take good care of your access, no matter which kind you have.

To care for fistulas and grafts:
▪ Keep the area clean
▪ Use your access only for dialysis
▪ Do not have blood tests or check blood pressure in your access arm
▪ Avoid wearing tight clothing or jewelry over your access area
▪ Protect your access from bumps and cuts
▪ Avoid lifting heavy objects
▪ Try not to lay or sleep on your access
▪ Learn how your needles will be placed for dialysis (The staff at your dialysis center can help you with this.)
▪ Make sure that your dialysis technician or nurse checks your access at each treatment
▪ Tell your doctor right away if you notice any swelling, redness or other changes in your access

To care for a catheter:
▪ Make sure that all clamps are closed and caps are on tight
▪ Protect the area from water and dirt as much as possible
▪ Keep the area clean, dry and bandaged
▪ Clean and re-bandage the area at each treatment (Make sure that you know how to do this at home in case the bandage becomes wet or dirty between treatments.)
▪ Tell your doctor right away if you have a fever or notice any swelling, redness or other changes around the access

Where can I have hemodialysis?

Hemodialysis can be done at a dialysis center (sometimes called “in-center hemodialysis”) or at home. A few things to know about in-center hemodialysis are:

▪ You may need to have help getting to and from the dialysis center.
▪ Most patients will need treatment at the center three times a week.
▪ Some dialysis centers have more flexible treatment hours than others.
▪ Your doctor might only use a few dialysis centers in your area.

In some cases, hemodialysis can be done at home. This means that you and a partner must be trained for it. Many dialysis centers have staff who can train patients for dialysis at home. For more information about home dialysis, visit Home Dialysis Central at www.homedialysis.org.

Both home hemodialysis and in-center hemodialysis have their pros and cons. Your doctor and the staff at your dialysis center can help you decide which is best for you.

How long does hemodialysis take?

Hemodialysis usually takes three to five hours each time. Most patients need to have hemodialysis three times a week. Your doctor will decide how long and how often you need dialysis.

Once you have started your treatment schedule, staff at the dialysis center will check your weight and blood to make sure that you are getting enough dialysis. Your doctor can make changes to your dialysis if needed.

What can I do during hemodialysis?

During hemodialysis, you will sit in a special chair. Many dialysis centers have TVs for patients to watch. Other options might be to:

Talk to other patients
Read a book
Listen to music or a book on tape
Play hand-held video games
Do crossword puzzles
Write letters
Take a nap
Exercise. Some centers have special exercise equipment for dialysis patients.

You can also talk to the staff at your dialysis center for other ideas of things to do during your treatments.

How will I need to change my diet?

Dialysis is not a cure. Dialysis does not work as well as healthy kidneys. Chemicals and fluid from the foods you eat can build up between treatments. Too much of this can be dangerous. A kidney friendly diet can help you feel better and avoid other problems.

Order our brochure “Healthy Eating for Hemodialysis” or visit our new Recipes for Living Well website for more information about a kidney friendly diet.