The role of the kidneys is to remove waste products and extra water from the body. They also maintain balanced levels of minerals in the body, called electrolytes. The kidneys are essential for the health of the body. Persons with severe kidney disease are not able to perform these functions any longer. This may be due to a temporary or a permanent kidney condition. Hemodialysis is a treatment that takes over the essential functions of the kidney until you recover from the kidney disease, or obtain a kidney transplant. If you have chronic renal failure and are not eligible for a transplant, you will need to have hemodialysis for the rest of your life. 

Hemodialysis requires access to a strong blood flow. There are three ways to do this. 

  • A dialysis catheter. This is a plastic tube inserted into a large blood vessel, usually for temporary access.

  • An AV fistula. Through a minor surgical procedure, an artery in your arm is joined directly to a vein creating an arteriovenous fistula. It takes 2-4 months for the fistula to enlarge enough to be ready for dialysis.

  • An AV graft. This is an artificial implant that joins an artery and vein in persons with small veins. It can also be used when an AV fistula did not work. It can be used for dialysis a few weeks after the surgery.

A connecting tube carries blood from the access point in the body to the dialysis machine where special filters process the blood. Then the blood is returned to the body. This takes 3 to 4 hours and is usually done 3 times a week.

Hemodialysis is lifesaving for people with kidney disease, but there are possible side effects. These include infection, low blood pressure, bleeding, electrolyte imbalance, anemia, and heart disease.

Home Care

  1. Take any medicines as directed by your doctor.

  2. Follow your special renal diet as provided by your doctor.

  3. Don’t wear any clothing that could put pressure on the access site.

  4. When sleeping, don’t lie on the access site.

  5. If the access is in your arm, have blood pressure readings and blood samples taken from the other arm.

  6. Check the access site after dialysis for swelling, bleeding, or signs of infection.

  7. If you have an AV fistula or graft, check the site regularly to be sure you can always feel the vibration (called the “thrill”) of blood flowing from artery to vein. Don’t put lotions or other products on the access site.

  8. If you have an external dialysis catheter, avoid physical activities that could pull on the catheter.

Follow Up

with your doctor or as advised by our staff.

Return Promptly

or contact your doctor if any of the following occur:

  • External catheter starts bleeding or opens to air

  • Color of the blood in the external tubing changes from bright red to dark red

  • You don’t feel the “thrill” in an AV fistula or graft

  • Nausea or vomiting

  • Severe weakness, dizziness, fainting, drowsiness, or confusion

  • Chest pain or shortness of breath

  • Unexpected weight gain or swelling in the legs, ankles, or around the eyes

  • Decreased or absent urine output if you previously made urine

  • Fever of 100.4ºF (38ºC) or higher, or as directed by your healthcare provider