HEMODIALYSIS

 

When Hemodialysis Is Used

Doctors use hemodialysis in two main situations:

• Acute kidney injury (AKI): when kidneys suddenly stop working over hours or days, often in the hospital, sometimes needing dialysis for a short time until kidneys recover.

• Kidney failure or end-stage kidney disease (ESKD): when kidney function drops to about 10–15 percent (eGFR less than 15), and the kidneys are not expected to recover.

In long-term kidney failure, most people will need ongoing dialysis or a kidney transplant to survive.

​

How Hemodialysis Works

A hemodialysis machine acts like an artificial kidney. To use it, you need a vascular access—usually created in your arm with minor surgery—that allows your blood to flow safely from your body to the machine and back.

​

During treatment:

• Your blood is pumped into a filter called a dialyzer, which has a thin membrane separating your blood from a cleansing fluid called dialysate.

• Useful parts of blood, like cells and proteins, stay in your body, while smaller waste products like urea and creatinine move through the membrane into the dialysate and are removed.

• The dialysate is specially mixed based on your prescription to help keep your potassium, sodium, calcium, and bicarbonate in safer ranges.

This process helps control swelling, blood pressure, and symptoms caused by toxin buildup.

​​

​

​

​

​

​

​

​

​

​

​

​

​

​

​

​

​

​

​

​

​

Where and How Often You Get Treatment

Hemodialysis can happen in several places:

• In a hospital

• In a dialysis center

• At home (home hemodialysis)

In a dialysis center, treatments are usually 3 times per week and last about 3–4 hours each session. Home hemodialysis can often be done more frequently—5–6 days per week—with schedules tailored to you and your care team’s plan.

​

Side Effects and How to Manage Them

Hemodialysis is powerful, but it can cause side effects. Some common issues include:

​

• Blockage or problems with the vascular access

• Muscle cramps

• Low blood pressure (hypotension)

• Weakness, dizziness, or nausea

• Blood loss during treatment or from access issues

If you feel cramps, headaches, nausea, or dizziness during treatment, your team may be able to help by slowing fluid removal, reviewing your blood pressure medicines, adjusting your “dry weight,” lowering the dialysate temperature, or switching to a different dialyzer. You can also help by staying within your fluid and sodium limits between treatments to reduce fluid buildup and make sessions easier on your body.​

​

New Options: Expanded Hemodialysis

Some people on hemodialysis may be offered different types of dialyzers (filters), including medium cut-off (MCO) dialyzers used in Expanded Hemodialysis (HDx). These can remove a broader range of waste products than traditional low-flux or high-flux dialyzers, and some patients report fewer symptoms like fatigue and itching when using them.

​

Life on Hemodialysis: Food, Money, Travel, and Work

Starting hemodialysis changes daily life, but many people continue to work, travel, and stay active with planning and support.

Key practical points:

​

• Nutrition: You’ll likely need to limit sodium to about 2,000 mg per day and may need to watch potassium and phosphorus, while still getting enough protein and calories; a kidney dietitian can help build a plan.

• Insurance: Medicare typically covers about 80 percent of dialysis costs for eligible patients, starting the first day of the fourth month of treatment (earlier if you start home training within the first 90 days). Private insurance and Medicaid can also help.

• Travel: Dialysis centers exist across the U.S. and in many other countries; with advance planning, your center can help arrange treatments at your destination.

• Work: Many people keep working, though physically demanding jobs may require adjustments in duties.​

​

​

How Kidney Konnect Can Support You

When you hear the word “hemodialysis,” it’s normal to feel overwhelmed or afraid. At Kidney Konnect, we want to help you move from fear to understanding by:

​

• Explaining how hemodialysis works in clear, everyday language.

• Helping you prepare questions for your care team about in-center versus home hemodialysis, side effects, and lifestyle.

• Connecting you with resources about diet, insurance, transportation, and emotional support so you don’t have to navigate this alone.

If you’re facing kidney failure or already on hemodialysis, Kidney Konnect is here to walk alongside you as you learn your options and advocate for the life you want beyond the dialysis chair.