Kidney Dialysis: Care Instructions

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Your Care Instructions

Dialysis is a process that filters wastes from the blood when your kidneys can no longer do the job. It is not a cure, but it can help you live longer and feel better. It is a lifesaving treatment when you have kidney failure.

Normal kidneys work 24 hours a day to clean wastes from your blood. Your kidneys are not able to do this job, so a process called dialysis will do some of the work for your kidneys. You and your doctor will decide which type of dialysis you should have. Peritoneal dialysis uses the lining of your belly (peritoneum) to filter your blood. You can do it at home, on a daily basis. Hemodialysis uses a man-made filter called a dialyzer to clean your blood. Most people need to go to a hospital or clinic 3 days a week for several hours each time. Sometimes hemodialysis can be done at home.

It is normal to have questions about your treatment, and you have a right to know what is happening to you. Learning about dialysis can help you take an active role in your treatment. Dialysis does not cure kidney disease, but it can help you live longer and feel better. You will need to follow your diet and treatment schedule carefully.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What do you need to know about peritoneal dialysis?

Peritoneal dialysis uses the lining of your belly (or peritoneal membrane) to filter your blood. Before you can begin peritoneal dialysis, your doctor will need to place a thin tube called a catheter in your belly. This is the dialysis access.

  • Peritoneal dialysis can be done at home or in any clean place. You may be able to do it while you sleep.
  • You can do it by yourself. You do not have to rely on help from others.
  • You can do it at the times you choose as long as you do the right number of treatments.
  • It has to be done every day of the week.
  • Some people find it hard to do all the required steps.
  • It increases your chance for a serious infection of the lining of the belly (peritoneum).

What do you need to know about hemodialysis?

Hemodialysis uses a man-made membrane called a dialyzer to clean your blood. You are connected to the dialyzer by tubes attached to your blood vessels. Before you start hemodialysis, your doctor will create a site where the blood can flow in and out of your body during your dialysis sessions. This site is called the vascular access. It may be a fistula, made by connecting an artery and a vein. Or it may be a graft, which is a tube implanted under your skin.

  • Hemodialysis is done mainly by trained health workers who can watch for any problems.
  • It allows you to be in contact with other people having dialysis. This can help provide emotional support.
  • You can schedule your treatments in the evenings so you can keep working.
  • You may be able to do home hemodialysis, which gives you more control over your schedule.
  • It usually needs to be done on a set schedule 3 times a week.
  • It can cause side effects. The most common side effects are low blood pressure and muscle cramps. These can often be treated easily.
  • It requires needle sticks during every treatment, which bothers some people. Others get used to it and even do the needle sticks themselves.

How can you care for yourself at home?

  • Be sure to have all of your dialysis sessions. Do not try to shorten or skip your sessions. You have a better chance of a longer and healthier life by getting your full treatment.
  • Your doctor or health care team will show you the steps you need to go through each day before, during, and after dialysis. Be sure to follow these steps. If you do not understand a step, talk to your team.
  • Your doctor and dietitian will help you design menus that follow your diet. Be sure to follow your diet guidelines.
    • You will need to limit fluids and certain foods that contain salt (sodium), potassium, and phosphorus.
    • You may need to follow a heart-healthy diet to keep the fat (cholesterol) in your blood under control.
    • You may need higher levels of protein in your diet.
  • Your doctor may recommend certain vitamins. But do not take any other medicine, including over-the-counter medicines, and natural health products, without talking to your doctor first.
  • Do not smoke. Smoking raises your risk of many health problems, including more kidney damage. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
  • Do not take ibuprofen (Advil, Motrin), naproxen (Aleve), or similar medicines, unless your doctor tells you to. These medicines may make kidney problems worse.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have severe shortness of breath.

Call your doctor or nurse call line now or seek immediate medical care if:

  • You have swelling in your hands or feet.
  • You are dizzy or light-headed, or you feel like you may faint.
  • You have an unusual weight gain.
  • You have trembling or trouble thinking clearly.
  • You have a fever.

Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if:

  • You have any problems with dialysis or your diet.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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