What you can expectBy Mayo Clinic staff
You can receive hemodialysis in a dialysis center, at home or in a hospital. Many people get hemodialysis three times a week in sessions of three to five hours each. This is known as conventional hemodialysis. Daily hemodialysis involves more-frequent, but shorter sessions — usually six or seven days a week for about two to three hours each time.
In recent years, smaller, simpler hemodialysis machines have made home hemodialysis less cumbersome, so that with special training and someone to help you, it's possible to do hemodialysis at home. Benefits include saving time on travel to and from the dialysis center and having more flexibility about when to do your treatments. You may even be able to do the procedure at night while you sleep.
Before the procedure
When you arrive at the dialysis center, a member of your health care team checks and records your weight, blood pressure, pulse and temperature. If you choose, you may be able to do this yourself. The skin covering your access site — the point where blood leaves and then re-enters your body during treatment — is cleansed.
During the procedure
During hemodialysis, two needles are inserted into your arm through the access and taped in place to remain secure. Each needle is attached to a flexible plastic tube that connects to a machine called a dialyzer. The dialyzer filters your blood a few ounces at a time, allowing wastes and extra fluids to pass from your blood into a cleansing fluid called dialysate. The filtered blood returns to your body through another needle.
During treatments, you sit or recline in a chair while your blood flows through the dialyzer. You can use the time to watch television, read, nap or make phone calls. If you receive hemodialysis at night, you can sleep during the procedure.
Hemodialysis itself doesn't hurt. But you may experience nausea and abdominal cramps as excess fluid is pulled from your body — especially if you undergo hemodialysis three times a week (conventional hemodialysis) rather than six or seven times a week (daily hemodialysis). If you're uncomfortable during the procedure, ask your care team about adjusting your medication or changing your diet or fluid intake to minimize side effects.
Because blood pressure and heart rate can fluctuate as excess fluid is drawn from your body, your blood pressure and heart rate will be checked several times during each treatment.
When hemodialysis is complete, the needles are removed from your access and a pressure dressing is applied to the site to prevent bleeding. Your weight may be recorded again. Then you're free to go about your usual activities until your next session.
- Hemodialysis. National Kidney Foundation. http://www.kidney.org/atoz/content/hemodialysis.cfm. Accessed Oct. 19, 2010.
- Treatment methods for kidney failure: Hemodialysis. National Institute of Diabetes and Digestive and Kidney Diseases. http://kidney.niddk.nih.gov/Kudiseases/pubs/hemodialysis. Accessed Oct. 19, 2010.
- Himmelfarb J, et al. Hemodialysis. In: Brenner BM, et al. Brenner and Rector's the Kidney. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-1-4160-3105-5..50060-8&isbn=978-1-4160-3105-5&type=bookPage§ionEid=4-u1.0-B978-1-4160-3105-5..50060-8--cesec2&uniqId=223035191-9. Accessed Oct. 19, 2010.
- Hemodialysis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec17/ch234/ch234b.html. Accessed Oct. 19, 2010.
- Crawford PW, et al. Treatment Options for End Stage Renal Disease. Primary Care: Clinics in Office Practice. 2008;35:407.
- Schmidt RJ, et al. Psychiatric illness in dialysis patients. http://www.uptodate.com/home/index.html. Accessed Oct. 19, 2010.
- Perl J, et al. Home hemodialysis, daily hemodialysis, and nocturnal hemodialysis: Core curriculum 2009. American Journal of Kidney Diseases. 2009;54:1171.
- Anderson CF (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 23, 2010.