Dialysis is a treatment that does some of the work healthy kidneys do: it removes waste products and extra fluid from the blood and helps keep the body's salts in balance. It is used when kidney function has declined to the point where the kidneys can no longer clean the blood well enough on their own.

It is important to know that dialysis does not cure kidney disease. It replaces part of the kidneys' work and helps the body carry on. The type of treatment, and how many sessions you need and for how long, are decided by your treating medical team according to your own situation — there is no single schedule that suits everyone.

Why is dialysis needed?

The kidneys act as the body's natural filter. When that filter weakens, waste and fluid begin to build up, and symptoms may appear such as tiredness, swelling in the feet or face, shortness of breath, loss of appetite, nausea and difficulty sleeping.

Your doctor decides when to start dialysis based on several factors together — blood test results, fluid build-up, the symptoms you feel and your general health — not on any single number.

Types of dialysis

1. Hemodialysis

Blood is passed through a machine containing a special filter that acts like a kidney, and returns to the body once cleaned. This is usually done in a specialised center under the supervision of medical staff.

2. Peritoneal dialysis

The peritoneal membrane inside the abdomen is used as a natural filter: a sterile fluid is placed into the abdominal cavity and drained after a period set by the doctor. It can be done at home after the patient or their carer has been trained.

Choosing the right type is a medical decision that balances your health, your daily life and what is available at your center.

Vascular access

Hemodialysis needs a way to reach the bloodstream. This may be:

An arteriovenous fistula: created surgically by joining an artery to a vein; it needs time to mature before it can be used.
A graft: a medical tube connecting an artery to a vein.
A catheter: often used as a temporary solution or when treatment is needed urgently.

Caring for the access site is a daily responsibility. Keep it clean and dry, avoid pressure on it, do not sleep on it or carry heavy objects with that arm, and do not allow blood pressure measurement or blood sampling from it. Contact your team immediately if you notice redness, warmth, pain, discharge, or any change in the usual thrill of the fistula.

What happens during a session?

Your weight is measured before and after the session to work out how much fluid should be removed.
Vital signs such as blood pressure, pulse and temperature are checked.
You are connected to the machine and monitored by staff throughout.
During the session you can rest, read, listen to something or sleep.

Some patients feel a drop in blood pressure, dizziness, muscle cramps, nausea or tiredness during or after a session. Tell the nurse or doctor as soon as you feel any of these — many can be managed during the session itself.

Between sessions: your part

Keep your appointments: missing or shortening sessions lets waste and fluid build up.
Fluids and salt: stick to the amount your team sets for you; too much fluid puts extra strain on the heart and lungs.
Food: kidney patients have specific considerations around potassium, phosphorus and protein. Follow the plan from the dietitian at your center rather than general advice or recipes shared informally.
Medicines: take them exactly as prescribed, and never add any medicine, supplement or herbal remedy without asking your doctor.
Self-monitoring: record your weight, blood pressure and symptoms between sessions; this information helps your team adjust your treatment plan.

When to contact your team immediately

Go to your center or the nearest medical facility without delay if you have:

Shortness of breath or difficulty breathing.
Chest pain or a clearly irregular heartbeat.
Bleeding from the access site that does not stop with pressure.
Signs of infection: fever, or redness, warmth and pain at the access site, or discharge.
Rapid swelling or a sudden increase in weight.
Repeated vomiting, confusion or severe weakness.

Living with dialysis

Dialysis becomes part of a routine, and many patients continue to work, study, travel and take part in family life in coordination with their medical team. It is normal for this journey to bring worry or frustration at times; talking with your team, your family, or others going through the same experience helps a great deal.

The DayLAZa app helps you follow your session times, record your measurements and symptoms, and read educational content approved by your center.

> Note: This content is for general health education only and does not replace medical advice. Decisions about treatment type, session schedule, medicines and diet are made by your treating medical team according to your condition.

What is dialysis?