Dialysis centers - what to expect

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If you need dialysis for kidney disease, you have a few options for how to receive treatment. Many people have dialysis in a treatment center. This article focuses on hemodialysis at a treatment center.

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What to Expect

You may have treatment in a hospital or in a separate dialysis center.

You will have about 3 treatments a week.
Treatment takes about 3 to 4 hours each time.
You will have set appointments for your treatments.

It is important not to miss or skip any dialysis sessions. Be sure you arrive on time. Many centers have busy schedules. So you may not be able to make up the time if you are late.

During dialysis, your blood will flow through a special filter that removes waste and excess fluid. The filter is sometimes called an artificial kidney.

Once you arrive at the center, trained health care providers will take charge of you.

Your access area will be washed, and you will be weighed. Then you will be taken to a comfortable chair where you'll sit during treatment.
Your provider will check your blood pressure, temperature, breathing, heart rate, and pulse.
Needles will be placed in your access area to allow blood to flow in and out. This may be uncomfortable at first. If needed, your provider can apply a cream to numb the area.
The needles are attached to a tube that connects to the dialysis machine. Your blood will flow through the tube, into the filter, and back into your body.
The same site is used every time, and over time, a small tunnel will form in the skin. This is called a buttonhole, and it is like the hole that forms in a pierced ear. Once this forms, you will not notice the needles as much.
Your session will last 3 to 4 hours. During this time your provider will monitor your blood pressure and the dialysis machine.
During treatment, you can read, use a laptop, nap, watch TV, or chat with providers and other people getting dialysis.
Once your session is over, your provider will remove the needles and put a dressing on your access area.
You will probably feel tired after your sessions.

During your first sessions, you may have some nausea, cramping, dizziness, and headaches. This may go away after a few sessions, but be sure to tell your providers if you feel unwell. Your providers may be able to adjust your treatment to help you feel more comfortable.

Having too much fluid in your body that needs to be removed can cause symptoms. This is why you should follow a strict kidney dialysis diet. Your provider will go over this with you.

How long your dialysis session lasts depends on:

How well your kidneys work
How much waste needs to be removed
How much water weight you have gained
Your size
The type of dialysis machined used

Between Sessions

Getting dialysis does take a lot of time, and it will take some getting used to. Between sessions, you can still go about your daily routine.

Getting kidney dialysis does not have to keep you from traveling or working. There are many dialysis centers across the United States and in many other countries. If you plan to travel, you will need to make appointments ahead of time.

When to Call Your Doctor

Contact your provider if you notice:

Bleeding from your vascular access site
Signs of infection, such as redness, swelling, soreness, pain, warmth, or pus around the site
A fever over 100.5°F (38.0°C)
The arm where your catheter is placed swells and the hand on that side feels cold
Your hand gets cold, numb, or weak

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

Itching
Trouble sleeping
Diarrhea or constipation
Nausea and vomiting
Drowsiness, confusion, or problems concentrating

References

Cohen D, Valeri AM. Treatment of irreversible renal failure. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 117.

Kotanko P, Kuhlmann MK, Chan C, Levin NW. Hemodialysis: principles and techniques. In: Johnson RJ, Floege J, Tonelli M, eds. Comprehensive Clinical Nephrology. 7th ed. Philadelphia, PA: Elsevier; 2024:chap 98.

Misra M. Hemodialysis and hemofiltration. In: Gilbert SJ, ed. National Kidney Foundation Primer on Kidney Diseases. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 56.

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.

Review Date: 3/31/2024

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 C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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