What is hemodialysis?

Hemodialysis uses a man-made membrane (dialyzer) to clean your blood. You're connected to the dialyzer by tubes attached to your blood vessels. Before you start dialysis, your doctor will create a site where the blood can flow in and out of your body during your sessions.

• Hemodialysis is done mainly by trained health workers. They can watch for problems.
• You can do it at a center where other people are doing dialysis. This can help provide emotional support.
• You can schedule your treatments in the evenings and maybe at home. This gives you more control over your schedule.
• It usually needs to be done on a set schedule 3 times a week.
• It can cause side effects, like low blood pressure and muscle cramps. These can often be treated easily.
• It requires being poked by a needle at each treatment. This bothers some people. Others get used to it and can do it themselves.

Hemodialysis is often started after symptoms or complications of kidney failure develop. These may include:

• Symptoms of uremic syndrome, such as nausea, vomiting, loss of appetite, and fatigue.
• Mild confusion.
• Signs of the kidneys' inability to rid the body of daily excess fluid intake, such as swelling.
• High levels of potassium in the blood (hyperkalemia).
• High levels of acid in the blood (acidosis).

Hemodialysis is sometimes used when acute kidney injury develops. Dialysis is always used with extra caution in people who have acute kidney injury, because dialysis can sometimes cause low blood pressure, irregular heart rhythms (arrhythmias), and other problems that can make acute kidney injury worse.

Hemodialysis uses a man-made membrane called a dialyzer to clean your blood. You are connected to the dialyzer by tubes. They are attached to your blood vessels through your vascular access.

• Blood flows from your body into the dialysis machine through one of the tubes.
• In the machine, your blood is filtered. When your blood is in the filter, dialysate solution also goes through the filter. This solution takes waste out of your blood.
• The used solution is pumped out of the machine. Your clean blood returns to your body through the other tube.

There are different types of hemodialysis. Talk about these with your doctor to decide which one might be best for you.

In-center hemodialysis.

You go to a hospital or a dialysis center. Dialysis usually is done 3 days a week and takes 3 to 5 hours a day.

Home hemodialysis.

After you are trained, you do your dialysis treatments at home. Dialysis is usually done 3 days a week (or every other day). Discuss with your doctor how long each session needs to be. A session could be as long as 6 hours, which may help you feel better.

Daily home hemodialysis.

After you are trained, you do your dialysis treatments at home. Dialysis is done 5 to 7 days a week. Each session takes about 3 hours.

Nocturnal home hemodialysis.

After you are trained, you do your dialysis treatments at home. You do them 3 to 7 nights a week. Each session is done overnight (about 6 to 8 hours).

Hemodialysis does not fully replace normal kidney function. It doesn't reverse chronic kidney disease or kidney failure. Hemodialysis only provides up to 10% of normal kidney function. For this reason, it's important to take your medicines as instructed and follow your eating plan.

Dialysis is sometimes used to treat an acute kidney injury. It may be used when fluid and electrolyte problems are causing severe symptoms or other problems. Some people who develop acute kidney injury stay dependent on hemodialysis and will go on to develop kidney failure.