Dialysis is a treatment for kidney failure that rids your body of unwanted toxins, waste products and excess fluids by filtering the blood. When kidneys fail, the body cannot properly filter toxins and waste, and therefore cannot keep your system chemically balanced. Dialysis can take the place of some kidney function and, along with medication and proper care, help people live longer.
There are two types of dialysis: hemodialysis and peritoneal dialysis. Both use different methods to filter blood. With hemodialysis, the filtering membrane is called a dialyzer and is inside a dialysis machine. Blood is circulated through the dialysis machine and cleaned before returning to your body. With peritoneal dialysis, the filtering membrane is the natural lining of your peritoneum, or abdomen, and blood never leaves your body. Both types of dialysis also use a dialysate solution in the filtering process to remove unwanted substances from your bloodstream.
Who is a candidate?
When someone with chronic kidney disease (CKD) reaches end stage renal disease (ESRD), also known as kidney failure or stage 5 kidney disease, the kidneys no longer function to filter and clean blood the way healthy kidneys normally would. Without treatment, life-threatening waste and toxins will build up in the body. At this point, dialysis treatment, or a kidney transplant, is needed.
What to expect
Vascular surgeons perform the procedure that allows dialysis, which most commonly involves a small incision in the wrist or at the elbow to create a dialysis fistula, allowing blood to be removed from the patient, filtered and returned.
Generally, from the time of operation, it’s 6 weeks (sometimes 12 or longer) before that fistula be used for dialysis, so this procedure needs to be completed well before the patient needs dialysis.
Surgery for your dialysis access is done at the hospital, is an outpatient procedure, and typically takes 30-90 minutes to complete. It can be done with either general or local anesthesia – usually the patient and anesthesiologist make that decision together.