Demystifying Dialysis: Understanding Treatment Options and Life Changes

Facing kidney failure can be a daunting challenge, but with dialysis, individuals with kidney failure can continue living fulfilling lives. Read on to learn about different dialysis modalities, hear how people have adjusted to life on dialysis, and find helpful resources.

What is dialysis?

The kidneys have incredibly important jobs, including;

• Removing waste 
• Removing extra fluid
• Controlling the production of red blood cells
• Helping regulate blood pressure
• Controlling the amount of nutrients, like calcium and potassium, in the blood.

Learn more about how the kidneys work.

With end-stage kidney disease, the kidneys no longer work properly, resulting in symptoms like nausea, swelling, and fatigue. When this happens, people need dialysis and a regimen of medications to do the jobs their kidneys can no longer do. The average life expectancy for patients on dialysis is 5 to 10 years but many patients have lived well on dialysis for 20 or even 30 years.

"Dialysis is a process that removes toxins and fluid from your body when the kidney can't do it anymore. The machine acts like a kidney," said Renal Care Vice President William Henderson. "It can take three and a half to four hours to remove the toxins and fluids. People normally go three days a week; Monday, Wednesday, and Friday or Tuesday, Thursday, and Saturday."

There are two types of dialysis:

1. Hemodialysis: Hemodialysis uses a machine and filter, called an artificial kidney or dialyzer, to clean the blood and remove extra fluids. Blood goes into the machine and returns to the body via tubes. Hemodialysis is done in-center or at home.
2. Peritoneal dialysis: A cleaning fluid, dialysate, is pushed into and out of the stomach lining, which acts as a filter. Peritoneal dialysis is done daily by the patient wherever they feel comfortable doing it.

"Dialysis machines can be alarming. There are a lot of tubes and patients don't like having needles in their arms. It's up to the staff to get them comfortable and build rapport so they open up and better understand what dialysis is," Belina Bimbo, a dialysis facility manager, said. "They are in an end stage renal disease so they need dialysis to live. We explain the different parts of the machine and the procedures in layman's terms to help them understand exactly what is happening. The more education they have, the more likely they are to stick with their treatment." 

Learn more about dialysis.

How has life changed since starting dialysis?

Life on dialysis is undeniably different, but it doesn't have to be the end. 

"Starting dialysis does not mean the end of life. I encourage patients not to let dialysis stop them from doing normal activities. I have a patient who was depressed when he first started dialysis because he didn’t think he could work full-time anymore even though he felt great.," said social worker Ebony McKinley. "I asked why would he stop working if he felt fine? He was surprised, and his entire attitude changed. He's still working to this day. We encourage patients not to let this be the end."

This couldn't be more true for Reginald Gramling, a sixty-three-year-old dialysis patient who made his dialysis appointments work for and not against him.

"Life is still good, even though I'm on dialysis! People are amazed that I still referee high school basketball,” said Reginald. “I used to start dialysis at 11:00 a.m. but I didn't like that because it was smack in the middle of the day and I didn't get out until close to four–that was too close to the start of the games. I switched to six a.m. and I’m fine now.”

That isn't to say dialysis isn't tricky or requires adjustment. 

"A dialysis diet can be hard for patients, but the two main reasons why people are on dialysis are uncontrolled high blood pressure and diabetes," said Girly Banzuela, RN. "We want to make sure patients follow the low salt and low sugar diet. If they are on hemodialysis, they'll also want to watch fluid intake."

"Dialysis is overwhelming at times but I've grown to know the staff and the patients. We've become a new family. Being on the machine is difficult, but it's saving my life," Cassandra Watkins, a dialysis patient, said. "I'm one of the lucky ones. I'm still driving, but there are some days when I'm a little more tired than others. I'm blessed because a lot of patients are not as strong as I am."

Looking for ways to pass the time on dialysis? Here are eight activities to try during your dialysis sessions.

Resources for people on dialysis

Living well while on dialysis can be challenging, but you don't have to do it alone. 

Five helpful resources for living well on dialysis: 

1. NKF Peers: Connect with a mentor who has lived well while on dialysis. 
2. Dialysis Community: Join this safe and supportive space where you can share your experiences, ask questions, and get answers from other people doing dialysis. 
3. Medicare Guide: Get a breakdown of Medicare programs for dialysis patients. 
4. Dialysis-friendly recipes: Struggling to stick to your dialysis diet? Try these tasty dialysis-friendly meals and snacks. 
5. Kidney Learning Center: Find free online courses about kidney transplants and living kidney donations.

If you need services not listed here or transportation to dialysis treatments, speak with your dialysis care team. They are there to help. You can also contact NKF Cares to receive help from trained professionals.