What to Expect When Beginning Dialysis

If your kidneys have stopped working, your doctor has probably recommended that you start dialysis treatments. You most likely have many questions and concerns about these treatments and about what it is like to be a dialysis patient. In the spirit of National Kidney Month, I’d like to share with you some helpful tips that I’ve learned throughout my years of experience as a dialysis professional.

Your dialysis treatments can take place in a clinic or in your home. You can discuss these options with your doctor and choose whichever is best for you, but most people decide to have dialysis in a clinic because they feel more secure having nurses perform the procedure. Whichever method you choose, dialysis will make you healthier and feel better. There are, however, a few bits of information that you need to know in order to avoid problems during and between treatments.


Your access connects you to the dialysis equipment. The preferred dialysis access is either a graft or fistula surgically placed in your forearm. The access is your life-line. Be sure to care for your access exactly as the surgeon instructs. Never let your graft or fistula get compressed in any way (like with a tight sleeve or jewelry) and never let anyone draw lab work from it. Those actions might cause the access to clot, and that would necessitate a new one.

You might be asking if it is safe to have so much of your blood outside of your body while it goes through the dialysis machine. Only about 1/2 cup of blood is out of your body at any given time during treatment. That is not much considering that adult bodies contain about 5 or 6 quarts of blood. You will not suffer any ill effects from having a little less blood circulating through your body during dialysis. Just lay back in the chair for the duration of the treatment so that you avoid feeling dizzy. Don’t worry – the staff will remind you of this if you try to stand while connected to the machine.

You will be laid back in a big chair for about 4 hours of dialysis and you will do this at least 3 times a week. Do you think that will get boring? Think about what you could do to pass the time. You might want to have a portable DVD player and headphones with you during treatments. You could bring a book or crossword puzzles. Or, like many patients, you might just want to spend that time sleeping.

Be sure to bring a blanket and pillow with you to the treatment center because dialysis centers are notoriously cold. Your clothing should be comfortable and should be something that won’t be totally ruined if it gets accidentally soiled while in the clinic.

Infection control regulations prohibit any food or drink in the treatment area. You should probably eat before you start each dialysis so that you don’t get too hungry, but don’t eat so much that you have nausea during the treatment. There are also other infection control measures that you will be asked to follow, such as:

  • Always wash your hands upon entering and leaving the treatment area.
  • Report any fever or redness, swelling, or pain around the access
  • Make sure the staff washes their hands before touching you or your machine

Your doctor will prescribe a special renal diet for you and your nurses will make sure that you understand any dietary and fluid restrictions. Your health depends on maintaining the special diet and taking your medications as prescribed.

Please do not feel overwhelmed or anxious about beginning dialysis. The doctors, nurses, social workers, and dietitians that will be working with you are ready and willing to assist with any questions or needs you may have.