When is dialysis not an option

In hemodialysis, an artificial kidney hemodialyzer is used to remove waste and extra chemicals and fluid from your blood. To get your blood into the artificial kidney, the doctor needs to make an access entrance into your blood vessels. This is done by minor surgery to your arm or leg. Sometimes, an access is made by joining an artery to a vein under your skin to make a bigger blood vessel called a fistula. However, if your blood vessels are not adequate for a fistula, the doctor may use a soft plastic tube to join an artery and a vein under your skin.

This is called a graft. Occasionally, an access is made by means of a narrow plastic tube, called a catheter, which is inserted into a large vein in your neck. This type of access may be temporary, but is sometimes used for long-term treatment. A type of hemodialysis called high-flux dialysis may take less time. You can speak to your doctor to see if this is an appropriate treatment for you.

In this type of dialysis, your blood is cleaned inside your body. The doctor will do surgery to place a plastic tube called a catheter into your abdomen belly to make an access.

During the treatment, your abdominal area called the peritoneal cavity is slowly filled with dialysate through the catheter. The blood stays in the arteries and veins that line your peritoneal cavity. Extra fluid and waste products are drawn out of your blood and into the dialysate. There are two major kinds of peritoneal dialysis. You put a bag of dialysate about two quarts into your peritoneal cavity through the catheter.

The dialysate stays there for about four or five hours before it is drained back into the bag and thrown away. This is called an exchange. You use a new bag of dialysate each time you do an exchange. While the dialysate is in your peritoneal cavity, you can go about your usual activities at work, at school or at home. This is similar to CAPD except that a number of cycles exchanges occur.

Dialysis does some of the work of healthy kidneys, but it does not cure your kidney disease. You will need to have dialysis treatments for your whole life unless you are able to get a kidney transplant. You may have some discomfort when the needles are put into your fistula or graft, but most patients have no other problems. Measure content performance. Develop and improve products. List of Partners vendors. When your kidneys begin to fail , you will typically go through stages of loss of kidney function over time.

The stages are from stage 1 through 5 of chronic kidney disease CKD. Stage 5 kidney failure is when many people need either dialysis or a kidney transplant. The purpose of kidneys is to clean the blood and turn waste into urine.

Dialysis is a medical procedure that helps clean the blood when kidneys cannot. People can have mild kidney disease stage and never end up at stage 5. Kidney disease comes with a long list of complications. In the early stages of chronic kidney disease , these complications are treated with medications and dietary changes. These complications include high blood pressure, abnormal electrolytes , and swelling. Eventually, people who do get to stage 5 might have complications that are harder to treat.

This is when people need a kidney transplant or dialysis if a transplant is not possible. Kidney disease has 5 stages. If disease makes it to stage 5, this is called kidney failure, and it requires a kidney transplant.

Transplants are not always possible for every patient, so those patients go through a process called dialysis. Dialysis is an artificial way of replacing some of the kidneys' functions. The kidney does a lot of important functions in the body.

Here is a brief summary:. Dialysis attempts to replace some, but not all, of these functions. There are different kinds of dialysis. One technique is called hemodialysis. Hemo is the Greek word for blood. After the blood goes through this filter, called the dialyzer, the purified blood is returned to the patient.

Hemodialysis is usually done in a dialysis center about three times every week, for three to four hours. The exact time it takes depends on the patient's size. Both hemodialysis and peritoneal dialysis can be performed by patients themselves at home. Your nephrologist and a dialysis nurse will train you for a few weeks on how to do the procedures yourself. Once you are comfortable doing it, they will let you do it at home. Home hemodialysis may happen as often as five to seven times per week.

The time for each session is adjusted by your kidney doctor based on your needs. Another kind of dialysis that is also done at home is called peritoneal dialysis. Peritoneum refers to the abdominal cavity. In this type of dialysis, a soft plastic tube called a catheter, is permanently inserted into the patient's peritoneum through the abdomen. Dialysis fluid is then put into the peritoneum. This fluid sits there for a few hours while it cleans the blood and balances electrolytes.

Sometimes it can be very difficult to discuss health matters with loved ones, especially if your health is deteriorating. You may be concerned that you might upset them, or you may be worried about how they will react to your wishes about ongoing care and treatments. They will be able to give you advice and suggest other forms of support. It can be difficult to decide whether the potential gains of dialysis will outweigh the additional burdens.

Although your kidney team ideally would like to plan the next step of your treatment in advance you may not be able to commit to either a dialysis or a supportive care plan. In this case it is OK to wait and see how you feel and make a decision at the last minute. Dialysis can then be started in an unplanned way. Sometimes people find dialysis too difficult and wish to stop after a short or a long time. If you find this is the case, your team will respect your wish to stop.

Take a look at our Dialysis Decision Aid booklet. It has been specially developed to give clear information about the types of treatments generally available to people with kidney failure including active supportive care.

The booklet has space for your own notes and some suggested prompts to help you raise any issues that may be concerning you. You have the right to refuse any medical treatment, including dialysis, if you feel it will not benefit you. All major religions accept this.

You may wish to speak with your religious advisor if you have any concerns about this. If you have no urine output time left is likely to be shorter. It is a good idea to discuss this question with your kidney doctor. You may receive care in hospital, at home or in your local community for example, day care services at your local hospice. Your medical care will normally be managed by your kidney doctors together with your GP, whose role — like that of the district nurse — may increase if your kidney failure gets worse and you require a greater level of end of life care.

You can also find information about other forms of support, together with advice on managing your medications and taking care of your mental health in our How can I help myself? We need better understanding of some of the common symptoms of kidney failure, such as cramps, itching, nausea, and restless legs, so that better treatments can be developed for them.

Join our Kidney Voices for Research network and get involved in the latest research into the causes and treatments of kidney disease. Necessary cookies are absolutely essential for the website to function properly.