Dialysis is a life-saving medical treatment for people whose kidneys are no longer able to efficiently filter waste, toxins and excess fluids from the blood.
The term dialysis means to separate. In this health context, it’s more similar to cleansing the blood of toxins. When someone develops kidney failure, their kidneys can’t properly remove toxins or regulate key substances like sodium, potassium and water. Kidney failure leads to kidney toxin buildup in the body, creating health problems.
A dialysis machine functions like an “artificial kidney,” which takes over the function of failing kidneys to maintain the necessary balance. Dialysis helps wash away toxins in the blood and excess fluid buildup to allow the body to function better.
Common causes of kidney failure include diabetes, high blood pressure, glomerulonephritis (an inflammation of tiny filters in the organ called glomeruli) and genetic disorders. For some, dialysis may be temporary, resulting from an emergency situation. For others, it becomes a permanent treatment until they receive a kidney transplant. The National Kidney Foundation reports that many patients lead long, active and fulfilling lives while undergoing dialysis for years.
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There are three types of dialysis. One is done at a dialysis center, called in-center hemodialysis. The other two are done at home and are called home hemodialysis and home peritoneal dialysis. Each has its advantages.
In-center hemodialysis is performed by trained medical staff at a dialysis center, offering professional oversight. Traveling to and from the dialysis center at a set schedule is needed. These treatments are done three times a week.
Home hemodialysis provides greater independence and is done in the comfort of one’s home. In some states, patients are required to have a partner in case of an emergency. Relatively simple equipment installation and periodic center visits are required.
Peritoneal dialysis is another at-home method. It is done daily at home, using the lining of the abdomen as a natural filter, and requires no equipment installation. It also does not require a partner to be present at home. Both home dialysis options offer better scheduling flexibility and fewer dietary restrictions.
Selection of the appropriate dialysis options for a particular person should be made in close discussion with their kidney doctor. Each option depends on a patient’s personal health, lifestyle and preferences. Dialysis patients and their care team work closely together to choose the best option for that individual and make adjustments as needed.
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The prospect of dialysis can feel overwhelming, but many patients can maintain fulfilling lives with important adjustments. The frequency and duration of dialysis treatments may impact your schedule. Some patients find that undergoing dialysis at home or doing overnight sessions can help with their quality of life and ability to do day-to-day tasks.
Kidney failure affects the body’s ability to process certain foods and nutrients, so patients on dialysis may follow specific dietary guidelines.
Common recommendations include limiting salt, potassium, phosphorus and fluid intake while maintaining adequate protein levels to support overall health. Plant-based diets with appropriate lean protein intake — as guided by your doctor and nutritionist to your unique situation — can help improve overall health. Fresh vegetables, fruits and lean meats are great options that nourish the body.
Patients should avoid processed and factory-made foods and snacks to protect the heart and the body in general. Dialysis patients often have a dietitian on their care team to create a balanced diet tailored to their needs.
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Although people can have a good quality of life while undergoing dialysis, there are risks and side effects that patients experience.
Some symptoms, according to NYU Langone Health, include cramping and feeling drained, especially with in-center hemodialysis. The side-effect symptoms tend to be fewer with either of the at-home methods. Fluid management is easier with the both home hemodialysis and home peritoneal dialysis, because they are done more often. Typically, in-center treatment is three times per week, while peritoneal dialysis is daily and home hemodialysis is four to five times per week. This increased frequency allows steadier fluid management and less fluctuations so patients typically feel less fatigued or swollen.
Your doctor monitors your health during dialysis and recommends any necessary treatment to minimize side effects. To ease patients’ adjustment to dialysis, additional resources and care team members are available, such as an ongoing social worker and registered dietitian support. To offer comprehensive, holistic care, dialysis teams — led by the doctors —go over each patient’s global needs and situations with the social workers, dietitians and nurses on an ongoing basis.
People receiving dialysis should live their life to the fullest, including traveling with friends and family! With some planning, patients can arrange for treatment at local dialysis centers while away, or plan trips around their typical treatments. There are even ocean cruise ships with dialysis machines on board.
Kidney transplantation should be seen as the preferred long-term solution for kidney failure. In eligible patients, dialysis often can serve as a bridge from diagnosis with kidney failure until they can get a kidney transplant. Transplant surgery involves receiving a healthy kidney from a living or deceased donor to restore normal kidney function.
Because many patients receiving dialysis treatment go to a center multiple times a week, a transplant can significantly improve their quality of life. Depending on the scope, patients who undergo a kidney transplant may take daily medication like immunosuppressants to prevent organ rejection.
The time it takes to find a match can vary. NYU Langone has the highest transplant rate ratio and shortest time to transplant in New York State, according to the Scientific Registry of Transplant Recipients (SRTR).
For more information about living kidney donation, visit the National Kidney Foundation. For information on deceased organ donations or to register to become an organ donor, visit organdonor.gov/sign-up and select your home state.
Many insurance plans cover a significant portion of dialysis treatment costs. Medicare covers certain dialysis services and supplies for eligible patients. Financial aid programs and nonprofit organizations are available to assist patients who might struggle to afford the costs.
Additionally, emotional support is vital for patients adjusting to the challenges of dialysis. Many support groups, both in-person and online, connect individuals with others facing similar experiences. Dialysis social workers can help connect patients and their families to resources and groups according to their unique situations.
Dialysis is a remarkable medical advancement that allows people with kidney failure to lead fulfilling lives. While it requires adjustments to daily routines, dietary habits and emotional well-being, dialysis saves lives and provides hope for those with end-stage renal disease. Whether you’re newly diagnosed, undergoing treatment or helping support a loved one, asking questions, working with healthcare providers to manage symptoms and quality of life, and using available support and resources will help you navigate life with dialysis.
Nobuyuki Miyawaki, MD is the chief of nephrology at NYU Langone Hospital — Long Island; an assistant dean of preclinical education at NYU Grossman Long Island School of Medicine; and an associate professor in the Department of Medicine, Division of Nephrology at NYU Grossman Long Island School of Medicine. He treats all aspects of kidney disease, from high blood pressure and kidney stones to kidney failure. He works closely with patients and their families to determine the best treatment plan for each individual.
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