Dialysis is a procedure that removes metabolic end-products and excess fluid from the blood, often involving blood filtration and cleanse through a machine. Since it substitutes the natural kidney function, it is often referred to as renal replacement therapy (RRT).

When is dialysis essential?

When patients are diagnosed with stage 5 kidney disease (CKD) they have reached the stage of kidney failure, i.e. the failure to sustain the human body homeostasis (balance). This means that the kidney function has gone below 10% to 15% the kidneys are no longer able to filter the blood and make urine. That causes toxins and excess fluid to build up in the body. In case the patient does not directly proceed to pre-emptive kidney transplantation (transplantation before dialysis), one way to mimic the job of the kidneys is by hemodialysis.

The following symptoms signify that you need to start with hemodialysis:

  • a GFR of 5 to 9 ml/min (for 1,73 m² height)
  • uremia-related pericarditis (inflammation of the pericardium, the tissue surrounding your heart due to accumulated metabolic toxins)
  • coagulopathy (impaired blood’s clotting ability)
  • gastroenteropathy with nausea (with or without vomiting)
  • anorexia or unexplained weight loss
  • encephalopathy with increasing confusion
  • volume overload/hypertension unresponsive to diuretic therapy
  • resistant hyperkalemia (high potassium)

How often do I have to dialyze?

In order to successfully replace the kidney function and keep your body operating, it is vital that dialysis becomes part of your weekly routine. Dialyzing on certain days and for a specific amount of time is important for the blood to be adequately cleaned and excess fluid removed from the body.

According to current data, the usual in-center hemodialysis schedule includes dialyzing 3 times a week, for about 4 hours each time.

The frequency varies from patient to patient and it is your doctor who will assess your needs and prescribe the duration and frequency of your dialysis treatment sessions. Studies have shown that getting the right amount of dialysis improves your overall health, keeping you out of the hospital and enabling you to live longer. To ensure you are getting the right treatment amount, your healthcare team will closely monitor your well-being through monthly lab tests.

Where do dialysis treatments take place?

When it comes to the location, you can choose to do your dialysis treatments in a dialysis clinic or at home. Based on your medical condition and your wishes, you and your doctor will decide on the best course of action.

Home dialysis has gained a lot of interest lately, as it can be done from the comfort of your home with the combination of the patient’s medical monitoring by a specialized center.

However, because of all the logistic hurdles (the separate space, special plumbing, and presence of a dialysis partner), it is most common for hemodialysis to take place in a dialysis centers.

These centers should be fully equipped with the necessary technology, state of the art dialysis machines, and expert medical and nursing staff specialized in hemodialysis, in order for the process to be carried out smoothly and safely.