Dialysis is a procedure that performs the functions of natural kidneys when the kidneys fail. Most patients begin dialysis when their kidneys have lost 85%-90% of their ability to function and will continue dialysis for the rest of their lives (unless a kidney transplant is available and successful). Dialysis is not a cure for ESRD, but helps you feel better and live longer.
The purpose of dialysis is to help keep the body's chemicals in balance, which the kidneys do when they are healthy. The main functions of dialysis are:
There are 2 main types of dialysis: hemodialysis and peritoneal dialysis.
For hemodialysis, an artificial kidney machine, called a dialyzer, filters the blood, and returns the cleaned blood to your body. You are connected to the dialyzer via tubes that are inserted into a vein in your arm, leg, or occasionally, neck. If hemodialysis is being done as a temporary measure, then the catheter is likely to be inserted into your natural vein. If hemodialysis is going to be done regularly, then a vascular access site called a fistula or shunt may be surgically created, usually in your arm or leg.
Hemodialysis is usually done at a dialysis center or hospital by trained technicians or nurses, or may be done at home with assistance. Hemodialysis is usually done 3 times a week and each treatment lasts from 2-4 hours.
Complications from hemodialysis include the following:
Instead of using a machine, peritoneal dialysis uses the abdominal lining, called the peritoneal membrane, to filter blood. A cleansing solution, called a dialysate, is infused through a tube inserted into your abdomen. Long-term peritoneal dialysis may require the surgical creation of a port in the abdomen through which dialysate can be infused. Fluid, wastes, and chemicals pass from the tiny blood vessels in the peritoneal membrane into the dialysate, which is then drained after several hours. New dialysate can then be added to repeat the process.
Complications from peritoneal dialysis include the following:
There are 3 main types of peritoneal dialysis:
Chronic kidney disease (CKD) in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 22, 2013. Accessed July 2, 2013.
Dialysis for end-stage renal disease. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 4,2013. Accessed July 2, 2013.
Hemodialysis. National Kidney Foundation website. Available at: https://www.kidney.org/atoz/content/hemodialysis. Accessed July 2, 2013.
Peritoneal dialysis: What you need to know. National Kidney Foundation website. Available at: https://www.kidney.org/atoz/content/peritoneal. Accessed July 2, 2013.
Rabindranath KS, Strippoli GF, Daly C, Roderick PJ, Wallace S, MacLeod AM. Haemodiafitration, haemofiltration, and haemodialysis for end-stage kidney disease. Cochrane Database Syst Rev. 2006;(4)CD006258.
Last reviewed June 2016 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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