For more information on understanding your lab values click here. In some cases of sudden or acute kidney failure, dialysis may only be needed for a short time until the kidneys get better. However, when chronic kidney disease progresses to kidney failure over time, your kidneys do not get better and you will need dialysis for the rest of your life unless you are able to receive a kidney transplant.
When you begin hemodialysis, the needles put in your fistula or graft may be uncomfortable. Most patients get used to this in time. Your dialysis care team will make sure you are as comfortable as possible during your treatment. Symptoms like cramps, headaches, nausea or dizziness are not common, but if you do have any of them, ask your dialysis care team if any of the following steps could help you:.
You can help yourself by following your diet and fluid allowances. The need to remove too much fluid during dialysis is one of the things that may make you feel uncomfortable during your treatment. Dialysis is expensive. However, the federal government's Medicare program pays 80 percent of all dialysis costs for most patients. Private health insurance or state medical aid may also help with the costs. For more information on insurance click here. Before you reuse your dialyzer, your dialysis center cleans it according to careful guidelines.
If done properly, reuse is generally safe. Before each treatment, your dialyzer must be tested to make sure it is still working well. If your dialyzer no longer works well, it should be discarded and you should be given a new one. Ask your dialysis care team if they have tested your dialyzer and if it still works well. If you do not wish to reuse your dialyzer, your center may be willing to provide you with a new dialyzer for each treatment.
Ask about the center's policy on reuse. Dialysis centers are located in every part of the United States and in many foreign countries. Before you travel, you must make an appointment for dialysis treatments at another center. The staff at your center may be able to help you arrange this appointment.
For more information on traveling on dialysis click here. Many dialysis patients continue to work or return to work after they have gotten used to dialysis. If your job has a lot of physical labor heavy lifting, digging, etc. A good access needs good blood flow. Doppler ultrasound or venography tests may be done to check blood flow at a possible access site. Vascular access is often done as a day procedure. You can go home afterwards.
Ask your doctor if you will need someone to drive you home. Talk to your surgeon and anesthesiologist about anesthesia for the access procedure. There are two choices:. Taking care of your access will help you keep it as long as possible. A graft does not last as long as a fistula. It can last 1 to 3 years with proper care.
Holes from the needle insertions develop in the graft. A graft has more risk for infection or clotting than a fistula. Kidney failure - chronic - dialysis access; Renal failure - chronic - dialysis access; Chronic renal insufficiency - dialysis access; Chronic kidney failure - dialysis access; Chronic renal failure - dialysis access.
Updated January Accessed August 5, Brenner and Rector's The Kidney. Philadelphia, PA: Elsevier; chap Review provided by VeriMed Healthcare Network. Editorial team. Hemodialysis access procedures. They also may report a better quality of life. Training for home hemodialysis Most dialysis centers require that you have a trained partner in your home during hemodialysis treatments, so you must ask a family member or friend to go through the training with you.
If you already know how to place the needles into your access, training may take less time. The home-training nurse will make sure that you and your partner feel confident and may visit your home to help with your first at-home treatment.
In addition to providing training and a hemodialysis machine that stays in your home, the dialysis center also provides hour support if you have a question or problem. Some programs also monitor treatments over the internet. Dialysis is a complex treatment that takes time to understand. No one wants to start you on dialysis before you need it, but it takes time to prepare for dialysis.
Watch this video to learn why your nephrologist may refer you to a surgeon while you still feel well. If you have kidney disease, remind health care providers to draw blood and insert IV lines only in veins below your wrist; for example, ask them to use a vein in the back of your hand. If an arm vein is damaged by an IV line or by repeated blood draws, that vein may not be able to be used for dialysis.
Watch this video describing how to take care of the blood vessels in your arms in case you need dialysis. One important step before starting hemodialysis treatment is having minor surgery to create a vascular access.
Dialysis moves blood through the filter at a high rate. Blood flow is very strong. The machine withdraws and returns almost a pint of blood to your body every minute.
The access will be the place on your body where you insert needles to allow your blood to flow from and return to your body at a high rate during dialysis. Work closely with your nephrologist and vascular surgeon—a surgeon who works with blood vessels—to make sure the access is in place in plenty of time. Healing may take several months. The goal is for your access to be ready for use when you are ready for dialysis.
Watch a video of a doctor explaining vascular access. AV fistula The best type of long-term access is an AV fistula. A surgeon connects an artery to a vein , usually in your arm, to create an AV fistula.
An artery is a blood vessel that carries blood away from your heart. A vein is a blood vessel that carries blood back toward your heart. When the surgeon connects an artery to a vein, the vein grows wider and thicker, making it easier to place the needles for dialysis.
The AV fistula also has a large diameter that allows your blood to flow out and back into your body quickly. The goal is to allow high blood flow so that the largest amount of blood can pass through the dialyzer. Most people can go home after outpatient surgery. You will get local anesthesia to numb the area where the vascular surgeon creates the AV fistula. Depending on your situation, you may get general anesthesia and not be awake during the procedure. Watch a video about why the fistula is the best access option.
To create an AV graft, your surgeon uses a man-made tube to connect an artery to a vein. You can use an AV graft for dialysis soon after surgery.
Repeated blood clots can block the flow of blood through the graft and make it hard or impossible to have dialysis. Catheter for temporary access If your kidney disease has progressed quickly, or you have not had a vascular access placed before you need dialysis, you may need a venous catheter—a small, soft tube inserted into a vein in your neck, chest, or leg near the groin—as a temporary access.
Watch a video about problems with catheters. You have to adjust your life to build your dialysis treatment sessions into your routine. If you have in-center dialysis, you may need to rest after each treatment. Adjusting to the effects of kidney failure and the time you spend on dialysis can be hard.
You may need to make changes in your work or home life, giving up some activities and responsibilities. Accepting these changes can be hard on you and your family. A mental health counselor or social worker can answer your questions and help you cope. You will have to change what you eat and drink. Your health care team may adjust the medicines that you take.
Your access is your lifeline. You will need to protect your access. Wash the area around your access with soap and warm water every day. Check the area for signs of infection, such as warmth or redness. When blood is flowing through your access and your access is working well, you can feel a vibration over the area. Your energy level may increase and you may have a better appetite.
Hemodialysis reduces salt and fluid buildup, so you should have less shortness of breath and swelling as well. This video explains how most people with kidney failure feel better after starting dialysis. When hemodialysis treatments are working and you keep to your ideal dry weight, your blood pressure should be well controlled.
In addition, blood tests can show how well your hemodialysis treatments are working. Read more about hemodialysis dose and adequacy.
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