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Starting on Dialysis

When you’re preparing for dialysis, knowing what to expect can help you get comfortable with your new treatment routine. Before starting dialysis, your doctor will help you understand your treatment options, and together you can choose the one that best fits your lifestyle. Your care team will also be here every step of the way to guide and support you on dialysis-from planning to training to learning how to thrive


What is Dialysis?

Dialysis is generally started when your kidney function drops to 15% or less or if you have severe symptoms caused by your kidney disease. Shortness of breath, fatigue, muscle cramps, nausea, or vomiting are severe symptoms that may occur. When your kidneys cannot remove extra fluid and waste from the body, then dialysis is generally recommended.

Your kidney doctor will help you decide when to start dialysis, based on the results of tests that measure how much kidney function you have left and your symptoms. Start getting ready for dialysis well in advance when your kidney disease reaches stage 4 (GFR, less than 30 mL/min). Chronic Kidney Disease (CKD) often progresses slowly. Usually, people do not even know how bad they feel until they start dialysis, which makes them feel much better. The key to feeling better is to follow the treatment plan advised by your medical professionals such as doctors, nurses, dietitians, and social workers. That can help you lead the healthiest lifestyle possible.

Choosing the dialysis option

Picking a dialysis option that fits your current lifestyle can help you keep up with the life you love and stay your healthiest. Most people can choose any type of dialysis: home peritoneal dialysis, home hemodialysis, or in-center dialysis. Making a decision early can give you more time to prepare and help you feel more in control of your health.

With in-center hemodialysis (HD), you’ll typically go to the dialysis center 3 times per week for about 3-5 hours per session to have your blood filtered, depending on the schedule your doctor prescribes. During treatment, you’ll be connected to an artificial kidney (dialyzer) via a needle in your access site. Your care team will supervise your entire dialysis treatment and make sure you have everything you need.


With home hemodialysis (HD), you are connected via a needle in your access site to an artificial kidney (dialyzer) that filters your blood. Because you’re treating at home, you can choose to time your prescribed treatments around the activities in your life. Because you won’t be traveling to the center for treatment, you’ll also save travel time and transportation costs.

With home peritoneal dialysis (PD), your blood is filtered using the lining of your abdomen, also called the peritoneum. There are no needles used during PD treatment, and your blood never leaves your body. You have the flexibility to do PD almost anywhere—in the comfort of your home, at work, or while traveling. Starting PD early may help you preserve remaining kidney function.

Frequently asked questions

Private insurance usually covers dialysis and other treatment for kidney failure. If you do not have private insurance, most people who need dialysis or a transplant qualify for Medicare even if they’re under age 65. There are also several plans that cover dialysis including HMOs, Healthcare Exchange, Medicaid, state and local programs. Talk to our admissions specialist at 844-466-3436 to help you find programs and determine coverage.

Diet is based on your personal health requirements determined by your doctor and dietitian. Although dialysis slightly reduces some diet restrictions, people on this type of therapy need to follow an eating plan regulated by their healthcare professionals. Learn more

Fluid intake is reduced when patients have chronic kidney disease and are on dialysis. Too much fluid can cause high blood pressure, shortness of breath, and heart damage. Discuss with your physician how much water you can drink each day. Learn more

Patients on dialysis can travel. If using a peritoneal dialysis cycler or home hemodialysis machine, these systems are portable. Patients arrange for supplies to be shipped ahead to their destination and the machines can easily pass through airport security. For patients on in-center dialysis, treatment coordinators at your center can help you find a clinic near your travel destination and arrange appointments for you during your trip. Learn more

Peritoneal dialysis and home hemodialysis treatments are done on your schedule at home, so you are easily able to continue working. If you are receiving dialysis in-center, you will let the center know that you work and arrange a schedule around your hours. Learn more

Yes. Patients on dialysis remain involved in their hobbies and community, see friends, and exercise. Your care team will work with you to make life as normal as possible.

Yes. Patients can remain on dialysis for a lifetime and enjoy a good quality of life.

Although you will need dialysis for the rest of your life unless you receive a transplant, the type of dialysis you choose now may be able to be changed in the future under your doctor’s supervision.

Whatever treatment option you choose, you will be guided through your care by physicians, nursing staff, social workers, dietitians, certified technicians, and an entire care team. Health care professionals will help you manage all aspects of your disease and treatment. They will be with you to answer all questions and make your experience as stress-free as possible. Learn more options Incenter peritoneal, home hemodialysis.


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