Understanding Kidney Dialysis

What is Kidney Dialysis

Dialysis treatment filters waste and extra water from your blood, attempting to replace many important functions of your kidney.  The two types of dialysis are peritoneal dialysis and hemodialysisa procedure where a dialysis machine and a special filter called an artificial kidney, or a dialyzer, are used to clean your blood.

If you undergo peritoneal dialysisa type of dialysis which uses the peritoneum in a person's abdomen as the membrane through which fluid and dissolved substances are exchanged with the blood, fluid is put into your abdomen through a surgically placed tube. This fluid will absorb the chemicals, other waste, and extra fluid that your kidneys usually remove. After a while, this extra fluid drains out of your body.

Hemodialysis is more common than peritoneal dialysis. If you undergo hemodialysis, your blood will be sent through a tube to a filter, called a dialyzer, that cleans it by removing the waste and extra fluid that your kidneys would normally remove.

If you choose hemodialysis as your treatment choice, you will either need to visit a hospital or dialysis center several times each week for in-center hemodialysis treatmentdialysis done in a dialysis center or receive treatment at home, also known as home hemodialysishemodialysis performed at a patient's home rather than in a center. Unlike peritoneal dialysis, where you receive dialysis treatment through your abdomen, hemodialysis accessalso known as vascular access, a way to reach the blood for dialysis treatment is received through an access site in your arm, upper chest, or leg.

Hemodialysis-Graphic

Peritoneal-Dialysis-Graphic

DID YOU KNOW?

About 3 million patients globally are being treated for End Stage Kidney Disease.

In-Center Hemodialysis video
Home Hemodialysis video

Hemodialysis Access Is Important

There are several ways to gain access into your bloodstream, including AV fistulas, grafts, and hemodialysis catheters. Your access is used over and over again during hemodialysis sessions. During your sessions, two hollow needles will be inserted into your access if you have an AV fistula or graft, or tubing will be connected to a previously implanted catheter; this is necessary to clean your blood in the dialyzer before it returns to your body.

You Have Access Options

There are several types of hemodialysis access options, which you can learn about below. You can also ask your healthcare provider.

AV Fistulas

An arteriovenous (AV) fistula is a surgically-created connection between an artery and a vein. It is generally created around 6 months prior to needing hemodialysis so that the vein can open up, or dilate, under the pressure of the blood coming from the artery, which allows a good blood flow rate for hemodialysis. An AV fistula is most commonly created in the lower forearm or the upper arm above the elbow.

If you are already receiving hemodialysis using an AV graft or catheter, ask your doctor about the potential benefits of an AV fistula.

fistula diagram

Non-Surgical or Endovascular AVF (EndoAVF)

An AV fistula may be created with a non-surgical, endovascular technique. This procedure uses small device(s) to create the connection between your artery and vein. The devices are removed immediately after the connection is made. This minimally-invasive creation procedure may cause less scarring compared to open surgery.

AVF diagram

Graft

To create access with a graft, minor surgery is done using a tube made of a special plastic that joins together an artery and a vein. Your doctor places an AV graft under the skin in your arm so that blood can be drawn with a needle to be filtered and cleaned.

graft diagram

Hemodialysis Catheter

A long-term hemodialysis catheter is a soft, hollow tube that is used to take and return blood from your body during hemodialysis. It is typically used in a transitional period while patients wait for their AV fistula or graft to mature. The catheter is placed through a large blood vessel, with the tip being placed in the mid-right atrium of the heart. Along each catheter is a small cuff. Your tissue grows into this cuff to help keep the catheter in place.

The end of the catheter, or the hub, is taped to the outside of your body for comfort. Each leg of the hub is called a lumen. One lumen carries blood from your body to the hemodialysis machine (red lumen). The other lumen returns the cleansed blood from the hemodialysis machine back into your body (blue lumen).

catheter diagram