Dialysis

Dialysis is a type of renal replacement therapy that cleans the blood via artificial means, removing waste and extra fluid buildup that result from lost kidney function. Dialysis can be helpful for people who have either acute renal failure (sudden loss of function, with possible recovery) or end stage renal failure (those who will not recover kidney function in the future). There are options for dialysis treatments which can be administered in-center or by the patient at home.

 

In-Center Considerations:

• Set schedule for treatment
• Professional administration of treatment

 

At Home Considerations:

• Patient can choose the time of day to perform dialysis
• Extra responsibility is placed on the patient for equipment, supplies, setting up, preparing, cleaning and disposing of supplies used during treatment.
• Presence of another adult at home is necessary in case of emergency

 

Types of Dialysis:

• In-Center Hemodialysis (HD)
  HD involves placing two needles into and arteriovenous fistula then connecting tubes to each needle through which the patient’s blood is continuously filtered by a dialysis machine. The process removes excess water and waste before returning the blood back to the patient’s body. Treatments generally last 3 to 5 hours.

• Conventional Home Hemodialysis
  After several weeks of in-center training with a dialysis technician, a patient can begin at home treatments which are administered 3 times a week for 3 to 4 hours each session.

• Daily Home Hemodialysis (DHHD)
  After several weeks of in-center training with a dialysis technician, a patient can begin at home treatments which are administered 5 to 7 days a week for 2 to 3 hours each session. The daily treatments more closely mimic normal kidney function, require fewer dietary and fluid restrictions and less medication. Cleansing the blood more frequently may reduce frequency of symptoms associated with poor kidney function such as headaches, nausea, cramping and exhaustion.Talk to your doctor regarding special circumstances such as travel. While away from home a patient may need to temporarily switch to conventional in-center hemodialysis. Upon returning home, the patient can resume a normal at home schedule for dialysis.

• Nocturnal Home Hemodialysis
  After several weeks of in-center training with a dialysis technician, a patient can begin nocturnal home hemodialysis treatments which are administered while the patient is sleeping 3 to 7 nights per week for 6 to 10 hours each session. The additional dialysis time does a better job of cleaning the blood and most closely resembles normal kidney function.  Cleansing the blood overnight for longer periods of time may reduce frequency of symptoms associated with poor kidney function such as headaches, nausea, vomiting, cramping, difficulty breathing, itching, dry skin and exhaustion. Appetite and taste also improve.

• Peritoneal Dialysis (PD)
  A surgical procedure is required to implant a small catheter into the peritoneum, a membrane that lines the abdominal cavity and protects the intestines, bowel and organs. The peritoneum has small holes in it through which waste and other chemicals can be strained from the blood. Once the permanent access is implanted, PD treatment can begin. During treatment, a dextrose based solution flows into the peritoneal cavity through the catheter with the solution remaining in the cavity for several hours. While the solution is in the cavity, waste and excess fluid pass from the blood and are eliminated when the fluid is drained from the cavity. Each treatment is referred to as an exchange. The number of exchanges per day can vary from patient to patient.

 

Because there is not one superior dialysis treatment, a patient/doctor conversation is in order to determine the appropriate dialysis treatment based on the patient’s individual health concerns and preferences.