Dialysis

About This Treatment

Healthy kidneys filter wastes and toxins from your blood. They're also important for blood cell production and bone health. When your kidneys aren’t working properly, due to conditions like advanced chronic kidney disease (renal failure) or hypercalcemia, your doctor may recommend dialysis to help filter the waste and toxins from the blood. Dialysis may be done on a temporary or more permanent basis until a kidney transplant donor can be found.

Types of dialysis

At Franciscan Health, there are two main types of dialysis hemodialysis and peritoneal dialysis. The physicians at Franciscan Health will monitor your dialysis access with diagnostic imaging of the fistulas and grafts. If blood clots form, interventional radiology can be used for mechanical and pharmacologic thrombolysis.

• Hemodialysis: Blood is taken out of the body, filtered by a machine and then returned to the body. Hemodialysis usually takes place three times a week, for about four hours each time, at a dialysis center, hospital or sometimes in your home.
• Peritoneal dialysis: By placing a fluid inside the abdominal cavity through a catheter, the blood passes through the vessels in the peritoneum (lining of the abdomen). Waste products are drawn out of the blood and into the fluid. The used fluid is drained a few hours later and replaced with clean fluid. Peritoneal dialysis needs to be done every day but can be done at home and sometimes while you're asleep.

Hemodialysis access

With hemodialysis, a vascular surgeon needs to create an access portal under the skin. There are two types of portals:

• Fistula, which the surgeon constructs by joining an artery to a vein
• Graft, or a plastic tube inserted under the skin to connect an artery to a vein

These access ports cause more blood to flow through the vein and allow it to be strengthened and stretched for a more efficient dialysis treatment.

Fistulas can take three to six months to fully develop and are more resistant to infection. However, they may not be a viable option in someone who has reduced circulation due to  hardening of the arteries (atherosclerosis). Grafts can be used within two to six weeks when the vein has sufficiently healed.

The physicians at Franciscan Health will monitor your dialysis access to check for blood clots or infection. If a blood clot forms, your doctor might recommend a medication to dissolve the clot, or you might need a minimally invasive procedure to remove a clot. If your fistula or graft becomes infected, your doctor will likely prescribe an antibiotic.

What are the side effects of dialysis?

Both hemodialysis and peritoneal dialysis can cause side effects. One common side effect from dialysis is fatigue. Some note feeling like their energy is drained and they are very tired. 

Hemodialysis may cause:

• Itchy skin
• Clotting
• Narrowing
• Aneurysm in the access
• Infection and bleeding

Peritoneal dialysis can cause infection of the abdominal membrane (peritonitis).

Many people on dialysis have a good quality of life and can remain on dialysis for years. People who are otherwise healthy should be able to continue driving, swimming, maintaining light exercise or even working.