Quick links this section: Treatment options:- Early management I Home Dialysis I Transplantation I Conservative Care
When your kidneys fail your body cannot get rid of extra water and waste products. Dialysis is removal of the water and waste products. Dialysis must be performed for the rest of your life or until you receive a kidney transplant. If the transplant is unsuccessful, dialysis can be restarted.
Some dialysis patients have Haemodialysis at a hospital based dialysis or satellite Dialysis Unit. This is usually in the morning or afternoon although a few hospitals offer nocturnal dialysis sessions which is dialysing while you sleep overnight.
The location and type of dialysis you have is a choice you make in consultation with your health professionals.
You may choose to have Haemodialysis or Peritoneal Dialysis at your home, if Unit-based Haemodialysis does not suit your lifestyle, or is not your personal choice.
Where and when do you have Unit-based Haemodialysis?
Unit-based Haemodialysis will usually take place in a hospital or ‘satellite’ Dialysis Unit. This type of haemodialysis is usually performed three times a week, e.g. Monday, Wednesday and Friday or Tuesday, Thursday and Saturday. Many units offer morning or afternoon appointments.
Once you have been given appointments you will usually dialyse at the same times every week. Travel to the dialysis unit is usually your responsibility, but if you prefer this modality talk to your health care team about local support with your transport options.
Quick link: Refer to our Dialysis Unit Guide online (The DUG) for locations of Dialysis and Satellite Units in your area.
How will my life be affected?
Each treatment lasts for 4-5 hours. Allow about half an hour in the unit before and after your 4-5 hour treatment for preparation and completion of the dialysis. On your three dialysis days you will need to set aside a total of 6-8 hours for the treatment and travel. On your non-dialysis days you can carry on with your usual life activities. You can work, attend social functions and carry on your usual role with your family. Exercise is encouraged to promote a healthy heart.
You will need to restrict your diet, especially potassium, and fluids and you will be referred to a renal dietician for help with understanding your diet. Unit based dialysis can only replace the work of your kidney on three days a week. It can vary how healthy you feel in-between dialysis sessions, but most people feel better than before they started dialysis.
Preparing for Haemodialysis - Access
Access to your blood stream is needed so your blood can be cleaned of the excess water and waste products. A 'vascular access' is made during surgery to allow this. The surgery is usually done as a day case. It can take up to 2 months for the access to ‘mature’ ready for dialysis.
There are three types of vascular access:
- Fistula: Joining one of your arteries to a vein. The vein enlarges and is known as the fistula. It is usually in your lower or upper arm and occasionally in your leg.
- Graft: Use of a piece of tubing attached between one of your arteries and a vein.
- Catheter: A catheter is usually a temporary tube put into a large vein until a fistula or graft is ready to use. Catheters can be used immediately.
You will need to take care of your access. Careful hygiene will help to prevent infection. You will be shown how to check your fistula or graft every day.
What happens during a haemodialysis treatment?
Before each treatment your blood pressure and weight are checked. Your health will be assessed. During each treatment you sit in a reclining chair next to the machine.
Two needles attached to soft tubing are put into your fistula or graft - one takes the blood and the other returns blood. The needles are then connected to the tubing on the machine. You are now ready to start haemodialysis.
The pump is turned on and the tubing takes the blood in a circle from you to the dialyser and back to you. Only a small amount of your blood is out of your body at any time. Haemodialysis is not painful and usually lasts for 4-5 hours.
Activities are limited during dialysis. You can read, chat, play games, watch TV, write, use a laptop or sleep, but you cannot get up and move around. At the end of the treatment all your blood is returned to you and the needles are removed.
How does haemodialysis work?
During haemodialysis your blood travels through a special filter called a 'dialyser' before being returned to your body.
The dialyser has many tiny fibres (tubes). As the blood is pumped into the dialyser it flows through the fibres. Each fibre has tiny pores in it’s walls. A special fluid called dialysate washes around the fibres. The dialysate does not come into direct contact with your blood. The extra water and waste products you don’t need travel from your blood through the fibre pores and into the dialysate. Clean blood flows back to your body. The dialysate goes down the drain.
How will I feel during and after haemodialysis?
Sometimes you can feel a little bit sick or dizzy and have muscle cramps during or after dialysis. This is usually caused by quick removal of a large amount of fluid which then causes a drop in your blood pressure. If your blood pressure drops you will need to be given some fluid back. The best way to prevent blood pressure drops is to limit how much you drink between dialysis sessions. You may also be told not to take blood pressure tablets before dialysis.
You won’t feel weak through lack of blood during dialysis as only about 300ml, about one cup, is out of your body at any time. However some people feel tired and washed out after unit based haemodialysis and need to have a sleep until they feel better.
What are the advantages of unit based dialysis?
- The dialysis is done for you by a health professional.
- You have days off between treatments when you can carry on with your usual life activities.
- You will often meet the same people every time you go in for dialysis.
What are the disadvantages of unit based dialysis?
- You can only dialyse three times a week which is not as good for your health as Home Dialysis.
- You will have to restrict your diet and fluid intake in-between dialysis sessions.
- Travel to and from dialysis can be time-consuming and expensive.
- You have fixed appointments for dialysis and unfortunately many units are unable to be flexible.
- Your care may be provided by many different health-care professionals.
View a selection of helpful videos around dialysis
from our reviewed selections from our KidneyHealthAus YouTube profile
Living with Kidney Failure KHA publication
Haemodialysis – a treatment option Renal Resource Centre NSW
Home Haemodialysis: A treatment option KHA Fact Sheets Access for dialysis
Quick links: Kidney Health Resources I Organ Donation I Recommended weblinks
UPDATED 13 MAY 2013
Disclaimer: This information is intended as a general introduction to this topic and is not meant to substitute your doctor's or health professional's advice. All care is taken to ensure information is relevant and applicable to each Australian state. It should be noted Kidney Health Australia recognises each person's experience is individual and variations do occur in treatment and management due to personal circumstances. Should you require further info always consult your doctor or health professional.