Dialysis: Types, How It Works & Living With Dialysis
Dialysis is a life-sustaining treatment for people whose kidneys can no longer adequately remove waste products and excess fluid from the blood.
Healthy kidneys continuously filter the blood and maintain the body’s balance of fluids, electrolytes and acids. Dialysis replaces some of these functions when kidney function becomes severely reduced.
How Does Dialysis Work?
Dialysis removes waste products, excess fluid and certain toxins from the blood.
There are two main ways this is done:
Hemodialysis: Blood passes through a special filter called a dialyzer, where waste and excess fluid are removed before the blood is returned to the body.
Peritoneal Dialysis: The lining of the abdomen, called the peritoneum, acts as a natural filter. Dialysis fluid is introduced into the abdomen through a catheter and later drained along with the waste and excess fluid.
Dialysis does not cure kidney failure, but it can replace some kidney functions and help maintain health and quality of life.
Types of Dialysis
Hemodialysis
Hemodialysis uses a dialysis machine to clean the blood. It is most commonly performed at a hospital or dialysis centre under medical supervision. Home hemodialysis may also be available through selected programmes.
A vascular access, usually an AV fistula or graft, provides access to the bloodstream for treatment.
Peritoneal Dialysis
Peritoneal dialysis can generally be performed at home after appropriate training.
It may be performed manually during the day (CAPD) or automatically using a cycler machine, usually overnight (APD/CCPD).
Home & Nocturnal Dialysis
Some patients may be suitable for home hemodialysis or longer, nocturnal dialysis sessions. These options can provide greater flexibility and may be available through selected dialysis programmes.
Choosing the Right Type of Dialysis
There is no single dialysis option that is best for everyone. The choice depends on:
Medical condition
Lifestyle and daily routine
Home environment
Support available at home
Personal preferences
Availability of the treatment programme
Your nephrologist can help you understand the options and choose the treatment most appropriate for you.
Dialysis Access & Care
People receiving hemodialysis need reliable vascular access, usually an AV fistula or graft.
To protect the access:
Avoid unnecessary pressure or injury to the access area.
Do not have blood pressure measured on the access arm unless advised by your healthcare team.
Keep the area clean and watch for swelling, redness, bleeding or signs of infection.
Report any unusual changes in the access to your dialysis team promptly.
Patients receiving peritoneal dialysis need to maintain strict hygiene and catheter care to reduce the risk of infection.
Possible Complications of Dialysis
Dialysis is generally safe when performed appropriately, but some patients may experience:
Low blood pressure
Muscle cramps
Nausea or vomiting
Infection
Bleeding
Electrolyte changes
Irregular heart rhythm
People on peritoneal dialysis may also develop peritonitis, an infection inside the abdomen. Cloudy dialysis fluid, abdominal pain or fever should be reported to the healthcare team immediately.
Diet & Fluid Management
Dietary and fluid requirements vary depending on kidney function, dialysis type and individual blood test results.
Patients may need to manage their intake of salt, fluids, potassium, phosphorus and protein. A nephrologist or renal dietitian can provide an individualised diet plan.
Living With Dialysis
Dialysis becomes part of everyday life, but many people continue to work, travel and participate in family and social activities.
Travel is often possible with advance planning, including arranging dialysis at the destination when required. Emotional well-being is also important, and support from family, healthcare professionals and patient support groups can help people adjust to life on dialysis.
Frequently Asked Questions
Is dialysis a cure for kidney failure?
No. Dialysis replaces some functions of the kidneys but does not restore normal kidney function. For eligible patients, a kidney transplant may provide an alternative to long-term dialysis.
Can dialysis be done at home?
Yes. Peritoneal dialysis is generally performed at home, and home hemodialysis may also be available for appropriately trained patients.
Can I travel while on dialysis?
Yes. Many patients can travel with advance planning and arrangements for dialysis or dialysis supplies.
Which is better: hemodialysis or peritoneal dialysis?
Neither is universally better. The most suitable option depends on your medical condition, lifestyle and personal circumstances. Your nephrologist can help you make the decision.
Talk to Your Healthcare Team
Starting dialysis is a major change, but understanding your treatment options can make the transition easier.
Talk to your nephrologist and dialysis team about the treatment best suited to your medical needs and lifestyle.
With the right treatment, care and support, people on dialysis can continue to live active and fulfilling lives.
Read our blog on issues faced on dialysis and management of PTH
https://kwfngo.org/news/bone-pain-in-dialysis-causes-treatment
https://kwfngo.org/news/dialysis-patient-education-guide
Watch our videos on YouTube
https://www.youtube.com/watch?v=eXfQpotZM6c
https://www.youtube.com/watch?v=u9EjbQCgBfA,
https://www.youtube.com/watch?v=ZuFfNX4hHUQ