Treatment for Kidney Failure
Introduction to hemodialysis
Hemodialysis is the most common method used to treat advanced and permanent
kidney failure. Since the 1960s, when hemodialysis first became a practical
treatment for kidney failure, we've learned much about how to make hemodialysis
treatments more effective and minimize side effects. In recent years, more
compact and simpler dialysis machines have made home dialysis increasingly
attractive. But even with better procedures and equipment, hemodialysis is still
a complicated and inconvenient therapy that requires a coordinated effort from
your whole health care team, including your nephrologist, dialysis nurse,
dialysis technician, dietitian, and social worker. The most important members of
your health care team are you and your family. By learning about your treatment,
you can work with your health care team to give yourself the best possible
results, and you can lead a full, active life.
When Your Kidneys Fail
Healthy kidneys clean your blood by removing excess fluid, minerals, and
wastes. They also make hormones that keep your bones strong and your blood
healthy. When your kidneys fail, harmful wastes build up in your body, your
blood pressure may rise, and your body may retain excess fluid and not make
enough red blood cells. When this happens, you need treatment to replace the
work of your failed kidneys.
How Hemodialysis Works
In hemodialysis, your blood is allowed to flow, a few ounces at a time,
through a special filter that removes wastes and extra fluids. The clean blood
is then returned to your body. Removing the harmful wastes and extra salt and
fluids helps control your blood pressure and keep the proper balance of
chemicals like potassium and sodium in your body.
One of the biggest adjustments you must make when you start hemodialysis
treatments is following a strict schedule. Most patients go to a clinic-a
dialysis center-three times a week for 3 to 5 or more hours each visit. For
example, you may be on a Monday-Wednesday-Friday schedule or a
Tuesday-Thursday-Saturday schedule. You may be asked to choose a morning,
afternoon, or evening shift, depending on availability and capacity at the
dialysis unit. Your dialysis center will explain your options for scheduling
Researchers are exploring whether shorter daily sessions, or longer sessions
performed overnight while the patient sleeps, are more effective in removing
wastes. Newer dialysis machines make these alternatives more practical with home
dialysis. But the Federal Government has not yet established a policy to pay for
more than three hemodialysis sessions a week.
Picture of Hemodialysis
Several centers around the country teach people how to perform their own
hemodialysis treatments at home. A family member or friend who will be your
helper must also take the training, which usually takes at least 4 to 6 weeks.
Home dialysis gives you more flexibility in your dialysis schedule. With home
hemodialysis, the time for each session and the number of sessions per week may
vary, but you must maintain a regular schedule by giving yourself dialysis
treatments as often as you would receive them in a dialysis unit.