Healthy kidneys clean your blood and remove extra fluid in the form of urine. They also make hormones your body needs for some important functions. When kidney failure occurs, treatment is needed to replace some of the important jobs your kidneys do. The treatments for kidney failure are hemodialysis, peritoneal dialysis and kidney transplant.
When will I need to start treatment?
Treatment is needed when someone has stage 5 chronic kidney disease (CKD), or kidney failure. Your doctor can tell your stage of CKD by checking your glomerular filtration rate (GFR). Your GFR can be estimated from the results of a blood test for creatinine, a waste product from muscle activity. If your GFR falls below 15, you are said to have kidney failure (CKD stage 5), and you will need to have some form of treatment to replace the function of your kidneys. If your GFR is less than 30, your doctor should talk to you about the different treatments for kidney failure. Learn all you can to make the best treatment choices for yourself and your family.
What does dialysis do to keep me healthy?
Both hemodialysis and peritoneal dialysis do the following:
- Remove waste, salt and extra water to prevent them from building up in your blood
- Keep a safe level of certain chemicals in your blood
- Help to regulate blood pressure
How does hemodialysis work?
A hemodialysis machine has a special filter called a dialyzer, or artificial kidney, to clean your blood. To get your blood into the dialyzer, the doctor needs to make an access, or entrance, into your blood vessels. This is done with minor surgery, usually to your arm. Three different types of access can be made—a fistula, a graft or a catheter.
How does the dialyzer clean my blood?
The dialyzer, or filter, has two parts—one part for your blood and the other part for a washing fluid called dialysate. A thin membrane separates these two sides. Blood cells, protein and other important things remain in your blood because they are too big to pass through the membrane. Smaller waste products such as urea, creatinine and extra fluid pass through the membrane and are removed. Changes in the dialysate or cleansing fluid can be made for your special needs.
How long will each hemodialysis treatment last?
Hemodialysis treatments are usually done three times a week. Each treatment lasts about four hours, but you may need more time to ensure that enough wastes and fluid are removed. The amount of dialysis you need depends on:
- How much your own kidneys are working
- How much fluid weight you gain between treatments
- How much you weigh
- How much waste you have in your blood
- The type of artificial kidney used by your dialysis center
Your doctor will give you a dialysis prescription that tells how much treatment you need. Studies have shown that getting the right amount of dialysis improves your overall health, makes you feel better, keeps you out of the hospital and enables you to live longer.
Will I need to follow a special diet?
Yes. Your diet will be different from the one you followed before starting dialysis. Although certain foods may be limited, it’s important to get the right amount of protein and calories to maintain good health. The registered dietitian at your center will help you develop a meal plan that meets your needs.