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By Mayo Clinic staffYour doctor will help determine when you should start hemodialysis, based on several factors — your overall health, kidney function, signs and symptoms, quality of life, and personal preferences.
You might notice signs and symptoms of kidney failure (uremia), such as nausea, vomiting, swelling or fatigue. Your doctor uses your estimated glomerular filtration rate (eGFR) to measure your level of kidney function. Your eGFR is calculated using your blood creatinine test results, sex, age and other factors. A normal value varies with age. This measure of your kidney function can help to plan your treatment, including when to start hemodialysis.
Hemodialysis can help your body control blood pressure and maintain the proper balance of fluid and various minerals — such as potassium and sodium — in your body. Normally, hemodialysis begins well before your kidneys have shut down to the point of causing life-threatening complications.
Common causes of kidney failure include:
- Diabetes
- High blood pressure (hypertension)
- Kidney inflammation (glomerulonephritis)
- Blood vessel inflammation (vasculitis)
- Kidney cysts (polycystic kidney disease)
However, your kidneys may shut down suddenly (acute kidney injury) after a severe illness, complicated surgery, heart attack or other serious problem. Certain medications can also cause kidney injury.
- Hemodialysis. National Kidney Foundation. http://www.kidney.org/atoz/content/hemodialysis.cfm. Accessed April 7, 2013.
- Treatment methods for kidney failure: Hemodialysis. National Institute of Diabetes and Digestive and Kidney Diseases. http://kidney.niddk.nih.gov/kudiseases/pubs/hemodialysis/. Accessed April 7, 2013.
- Hemodialysis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/genitourinary_disorders/renal_replacement_therapy/hemodialysis.html. Accessed April 7, 2013.
- Berns JS. Patient information: Hemodialysis (Beyond the Basics). http://www.uptodate.com/home. Accessed April 7, 2013.
- Kidney disease: Causes. National Kidney Foundation. http://www.kidney.org/atoz/content/kidneydiscauses.cfm. Accessed April 9, 2013.
- Kidney disease basics. National Kidney Disease Education Program. http://www.nkdep.nih.gov/learn/kidney-disease-basics.shtml. Accessed April 9, 2013.
- The kidneys and how they work. National Kidney and Urologic Diseases Information Clearinghouse. http://kidney.niddk.nih.gov/KUDiseases/pubs/yourkidneys/index.aspx. Accessed April 9, 2013.
- Consequences of frequent hemodialysis: Comparison to conventional hemodialysis and transplantation. Transactions of the American Clinical and Climatological Association. 2011;122:124.
- Anderson CF (expert opinion). Mayo Clinic, Rochester, Minn. April 12, 2013.
- Norby SM (expert opinion). Mayo Clinic, Rochester, Minn. April 18, 2013.
- About chronic kidney disease. National Kidney Foundation. https://www.kidney.org/kidneydisease/aboutckd.cfm. Accessed April 26, 2013.
- Albright RC (expert opinion). Mayo Clinic, Rochester, Minn. May 2, 2013.
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