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Kidney Dialysis: How It Works, Who Needs It, What To Expect

Your kidneys are two bean-shaped organs that lie just below your rib cage, on each side of your spine. They remove waste from your body, level out your blood pressure, and keep your bones strong.

They also ensure that you have the right amount of chemicals, like potassium and sodium (salt), in your blood. Finally, they make the hormone that causes your body to create red blood cells.


What’s Dialysis? It’s a treatment that takes over your kidney functions if those organs stop doing their job. There are two types of dialysis:
Hemodialysis: Your blood is put through a filter outside your body, cleaned, and then returned to you. This is done either at a dialysis facility or at home.
Peritoneal dialysis: Your blood is cleaned inside your body. A special fluid is put into your abdomen to absorb waste from the blood that passes through small vessels in your abdominal cavity. The fluid is then drained away. This type of dialysis is typically done at home.


Who Needs Dialysis? If you have chronic kidney disease, you’ll need dialysis or a kidney transplant at some point. “Chronic” means you’ve been slowly losing kidney function over a period of time. Some people choose to start dialysis before they have symptoms of kidney failure such as nausea, fatigue, swelling, and throwing up. Even if you don’t have symptoms, you may choose to start treatment if lab tests show toxic levels of waste in your blood.


How Does Hemodialysis Work? First, you’ll need minor surgery to create direct access to your bloodstream. This can be done in a few ways:
Fistula (also known as arteriovenous fistula or A-V fistula): An artery and vein are joined together under the skin in your arm. Most of the time, this is done in the one you don’t write with.
Graft (arteriovenous graft or A-V graft): A plastic tube is used to join an artery and vein under your skin. This heals in only 2 weeks, so you can start hemodialysis faster. This won’t last as long as a fistula. You’ll likely need another graft after a few years.
Catheter (central venous catheter): This method is an option if you need to start hemodialysis very quickly. A flexible tube (catheter) is put into a vein in your neck, below your collarbone, or next to your groin. It’s only meant to be used for a short time.


What Can I Expect When I Go Through Dialysis? It shouldn’t hurt. If you have pain during or after treatment, tell your doctor right away. You may have side effects, though. Low blood pressure is common. You could also have nausea, vomiting, dry or itchy skin, muscle cramps, or feel very tired. You can lessen side effects by being careful about what you eat and drink. Your doctor can advise how much fluid, protein, and salt you should have. Try to stay away from things that can harm your kidneys, like alcohol, smoking, or illegal drugs.

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