Introduction to Dialysis

What is Dialysis?

Dialysis is a treatment that does the job of your kidneys when they are not working properly. Healthy kidneys filter waste, extra fluid, and toxins from the blood. If kidneys fail, dialysis helps keep the body in balance by removing waste, controlling blood pressure, and keeping the right levels of minerals such as potassium and sodium.

When is Dialysis Needed?

Dialysis is usually started when chronic kidney disease (CKD) reaches its final stage (end-stage kidney disease), and kidney function is less than 10–15%. It may also be needed sooner if symptoms of kidney failure become severe.

  • Extreme fatigue or weakness
  • Swelling in legs, ankles, or face (fluid buildup)
  • Shortness of breath
  • Confusion or difficulty concentrating
  • Nausea, vomiting, or loss of appetite
  • Uncontrolled high blood pressure

Dialysis Options: In-Center and At Home

Hemodialysis (HD)

Blood is filtered through a machine called a dialyzer. Treatment is usually done at a dialysis center, 3 times a week for 3–5 hours per session. Some people may also do home hemodialysis with special training (see Home Dialysis below).

Peritoneal Dialysis (PD)

Uses the lining of your abdomen (peritoneum) to filter blood. A cleansing fluid flows into the belly through a catheter and later drains out, carrying waste with it. Can be done at home during the day or overnight using a cycler.

Home Dialysis Options

Many people are eligible to do dialysis at home. With training and support, treatments can be done safely and comfortably in your own space.

Home Hemodialysis (HHD)

  • Training: Typically 4–6 weeks with a home dialysis nurse; most people train with a care partner.
  • Care partner: Usually recommended; some patients may qualify for solo/independent HHD if approved by their doctor and after additional training.
  • Access: Fistula (heals ~6–8 weeks), graft (~2–3 weeks), or catheter (immediate use but higher infection risk).

Peritoneal Dialysis (PD) at Home

  • Training: Up to ~2 weeks of in-center training before starting at home.
  • Catheter: PD catheter usually needs about 2 weeks to heal; may be accelerated if urgent.
  • Schedule: Exchanges during the day (CAPD) or overnight using a cycler (APD).

Home Setup Requirements (What You’ll Need)

  • A clean, closeable room or area with good lighting; keep pets out during connect/disconnect.
  • A nearby telephone for support during treatments.
  • The right kind of electrical outlet (your tech team will set this up).
  • A water source if required by your equipment.
  • A bathroom or plumbing drain for treatment fluids (as directed by your team/equipment).
  • Storage space for supplies (often a closet-sized area; many patients keep about 6 weeks of supplies at home).

Your home dialysis nurse will visit your home to help choose a treatment area, confirm safety, and organize supplies.

How Dialysis Works

Dialysis removes waste and extra fluid from the body when the kidneys can no longer do so. The way it works depends on the type of treatment:

Hemodialysis

Blood leaves the body through a tube, flows into a dialyzer (artificial kidney), where waste and fluid are filtered out. The clean blood is then returned to the body. This treatment usually takes place in a dialysis center, though some patients may do it at home.

Peritoneal Dialysis

A special cleansing fluid flows into the belly through a soft tube called a catheter. The lining of the abdomen (peritoneum) acts as a natural filter, removing waste and extra fluid. After a few hours, the fluid is drained and replaced with fresh solution. This process can be done during the day or overnight.

💡 Whether dialysis is done in a center or at home, the process of how it works is the same. The main difference is where and when treatments take place..

Living with Dialysis

Dialysis is a major lifestyle change, but many people continue to live active and fulfilling lives while on treatment. With the right support, you can still work, travel, and spend time with loved ones.

  • Diet and fluids: Your care team will guide you on healthy eating and how much fluid to drink.
  • Medications: Medicines help support blood pressure, bone health, and other needs while on dialysis.
  • Monitoring: Regular checkups track your overall health and make sure treatments are working well.
  • Daily life: Many patients continue working, exercising, and enjoying hobbies with some adjustments.
  • Support: Social workers, dietitians, and nurses are part of your care team to help you thrive.

💡Everyone’s experience with dialysis is different. Your care team will work closely with you to make treatments fit your life.

Benefits and Possible Risks

Dialysis is a life-saving treatment that helps replace some of the work of the kidneys. Like any medical treatment, it has both benefits and possible risks.

Benefits

  • Removes waste and extra fluid from the body
  • Helps control blood pressure
  • Restores better balance of minerals such as potassium and sodium
  • Improves quality of life and prolongs survival

Possible Risks

  • Infection at the access site
  • Low blood pressure, dizziness, or cramping (especially during hemodialysis)
  • Weight gain or risk of hernia (with peritoneal dialysis)
  • Feeling tired after treatments

💡Your care team will work with you to reduce risks and help you get the most benefit from your treatment.

Alternatives to Dialysis

Dialysis helps you live when your kidneys can no longer work properly, but it is not a cure for kidney disease. For many patients, the best long-term treatment option is a kidney transplant.

Kidney Transplant

A kidney transplant is a surgery that places a healthy kidney from a donor into your body. If successful, it can allow you to live without dialysis. Patients are usually placed on a waiting list for a donor kidney, or may receive one from a living relative or friend.

  • Can offer greater freedom and a better quality of life
  • Often improves energy, appetite, and overall health
  • Requires lifelong medications to prevent rejection

💡Your nephrologist can discuss whether a kidney transplant may be an option for you and help you start the evaluation process. Learn more on our Kidney Transplant page.

When to Talk to Your Doctor

It’s important to stay in close contact with your care team while on dialysis. Call your doctor or dialysis center right away if you notice:

  • Worsening swelling in your legs, ankles, or face
  • Shortness of breath or chest discomfort
  • Severe fatigue, confusion, or difficulty staying alert
  • Persistent nausea, vomiting, or loss of appetite
  • Uncontrolled or very high blood pressure
  • Fever, chills, or redness around your access site

💡If you ever feel your symptoms are severe or life-threatening, call 911 or go to the nearest emergency room.

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Need Guidance About Dialysis?

Our kidney care team is here to answer your questions and support you every step of the way. Whether you’re just learning about dialysis or already receiving treatment, we’ll help you find the best option for your life.

Talk to Our Kidney Care Team

Disclaimer: This information is educational and not a substitute for professional medical advice. Always follow your clinician’s guidance.