Dialysis is a procedure to remove waste products and excess fluid from the blood when the kidneys stop working properly. It often involves diverting blood to a machine to be cleaned.
Normally, the kidneys filter the blood, removing harmful waste products and excess fluid and turning these into urine to be passed out of the body.
What happens during dialysis
There are 2 main types of dialysis: haemodialysis and peritoneal dialysis.
Haemodialysis
Haemodialysis is the most common type of dialysis and the one most people are aware of.
During the procedure, a tube is attached to a needle in your arm.
Blood passes along the tube and into an external machine that filters it, before it’s passed back into the arm along another tube.
At dialysis centres, this is usually carried out 3 days a week, with each session lasting around 4 hours.
It can also be done at home. Some examples of a home dialysis schedule include:
- 4 times a week for 4 hours
- 5 times a week for 3 hours
- 6 days a week for 8 hours overnight
Peritoneal dialysis
Peritoneal dialysis uses the inside lining of your abdomen (the peritoneum) as the filter, rather than a machine.
Like the kidneys, the peritoneum contains thousands of tiny blood vessels, making it a useful filtering device.
Before treatment starts, a cut (incision) is made near your belly button and a thin tube called a catheter is inserted through the incision and into the space inside your abdomen (the peritoneal cavity). This is left in place permanently.
Fluid is pumped into the peritoneal cavity through the catheter. As blood passes through the blood vessels lining the peritoneal cavity, waste products and excess fluid are drawn out of the blood and into the dialysis fluid.
The used fluid is drained into a bag a few hours later and replaced with fresh fluid.
Changing the fluid usually takes about 30 to 40 minutes and normally needs to be repeated around 4 times a day.
If you prefer, this can be done by a machine overnight while you sleep.
Side effects of dialysis
Haemodialysis can cause itchy skin and muscle cramps. Peritoneal dialysis can put you at risk of developing peritonitis, an infection of the thin membrane that surrounds your abdomen.
Both types of dialysis can make you feel exhausted.
Life on dialysis
Many people on dialysis have a good quality of life.
If you’re otherwise well, you should be able to:
- continue working or studying
- drive
- exercise
- go swimming
- go on holiday
Most people can remain on dialysis for many years, although the treatment can only partially compensate for the loss of kidney function.