Diagram of dialyzer. Blood from body enters machine and flows past one side of membrane. Membrane is barrier that keeps blood and dialysate from mixing but lets waste through. Dialysate is special fluid that pulls waste from blood. It flows past the other side of membrane. Waste, extra fluid, and chemicals move through membrane into dialysate. Clean, filtered blood goes back to body.

Hemodialysis is a type of treatment for kidney failure (also called end-stage kidney disease or ESRD). It uses a machine that holds a filter called a dialyzer. As blood flows through the dialyzer, waste is removed and fluid and chemicals are balanced. Hemodialysis treatments are usually done at a special dialysis center. In some cases, treatments may be done at home. As the kidney failure is getting worse, your doctor may advise you to have an access placed by a surgeon into one of your arms ahead of time. This access may take several weeks to mature before it can be used for hemodialysis.

How hemodialysis is done

Two needles are inserted into a blood vessel (called an arteriovenous fistula or AV fistula) or arteriovenous graft (or AV graft), usually in your arm. Each needle is attached to a tube. One tube carries your blood into the dialyzer, where it is cleaned. Clean blood returns to your body through a second tube and needle. If this treatment has to be done as an emergency, a plastic tube (caltheter) is inserted into a large vein, typically in the neck or groin. This catheter helps carry blood to and from the dialysis machine.

Your experience

  • Hemodialysis usually takes about 3 to 5 hours. It is usually done 3 times a week.

  • You’ll have a regular schedule for your hemodialysis. Many centers have evening and weekend hours as well as weekday hours to help you continue working.

  • A trained nurse or technician connects you to the dialysis machine. He or she watches for problems and makes sure you are comfortable.

  • During treatment, only a small amount of blood (about 1 cup) is out of your body at any one time.

  • During or after your first few treatments, you may have a headache, muscle cramps, or feel nauseated. These should decrease as your body gets used to the treatments.

  • Some people are able to learn to use a dialysis at home.

Problems to watch for

Call your nurse or dialysis technician if you have any of these symptoms during or after treatment:

  • Chest pain

  • Bleeding from the needle site

  • Shortness of breath

  • Fever or chills

  • Headache or lightheadedness

  • Nausea or vomiting

  • Itching

  • Muscle cramps

  • Pain, warm or redness at your access site

  • Inability to feel yoor fistulaur blood flow and pulse at your AV graft


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