Day of dialysis session

Overview

A day of dialysis session is when a person with kidney failure goes to a clinic or hospital to have their blood cleaned by a machine (hemodialysis) or uses a special fluid inside their belly (peritoneal dialysis) to remove waste and extra fluid from their body.

Dialysis is a common treatment for people with advanced kidney failure. Millions of people around the world rely on it to stay alive.

It affects people of all ages whose kidneys can no longer filter their blood properly, often due to conditions like diabetes, high blood pressure, or kidney disease.

Symptoms

Common symptoms

• Feeling tired or weak after the session
• Muscle cramps, especially in the legs
• Low blood pressure, which can cause dizziness or nausea

Symptoms in children

• Children may feel anxious or fussy before or during the session
• They might complain of headaches or stomach aches
• Growth and energy levels may be affected

Symptoms in older adults

• Older adults are more likely to feel dizzy or faint from blood pressure changes
• They may have trouble keeping still for long periods
• Skin itching or dryness can be more bothersome

Causes

Main causes

• Kidney failure – the kidneys can no longer clean the blood on their own
• Damage to the kidneys from long-term conditions such as diabetes or high blood pressure

Risk factors

• Having chronic kidney disease that gets worse over time
• Not following your dialysis schedule or missing sessions
• Having other health problems like heart disease or infection

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency symptoms listed above
• If your access site is bleeding heavily or looks infected

Book a routine appointment if:

• If you feel unwell before or after your session, talk to your dialysis nurse or doctor during your next visit
• If you have questions about your diet, fluids, or medicines

Diagnosis

The need for dialysis is diagnosed through blood tests that measure waste products like creatinine and urea, and by checking how well your kidneys are working (glomerular filtration rate, or GFR).

Tests that may be done

• Blood tests to measure kidney function
• Urine tests to check for protein or blood
• Imaging tests like ultrasound to see the size and structure of the kidneys

What to expect at your appointment

If you need dialysis, your healthcare team will explain the process, help you choose the type that best fits your life, and prepare an access site (a special point in your blood vessels or belly) so treatments can start safely.

Treatment

On your dialysis day, you will come to the clinic or do the treatment at home. For hemodialysis, two needles are placed in your access site, and your blood flows through a machine that cleans it and returns it to your body. For peritoneal dialysis, a special fluid is put into your belly through a tube; it sits there for a few hours, then drains out, taking waste with it.

Self-care at home

• Arrive on time for your session and bring something to do, like a book or music
• Tell your nurse how you are feeling before and during the session
• After dialysis, rest if you feel tired and follow your fluid and diet plan

Medical treatments

Your healthcare team will adjust your dialysis prescription – the speed of the blood flow, the length of session, and the fluid balance – to match your needs. They may also give you medicines to control blood pressure, prevent anemia (low red blood cells), or manage mineral levels, but no specific drug names or doses are listed here.

When is surgery considered?

Surgery may be needed to create or repair an access site for hemodialysis (like a fistula or graft) or to place a catheter for peritoneal dialysis. This is usually done before you start regular dialysis.

Living with this condition

Living with dialysis means planning your days around your treatment schedule. You will need to make time for sessions, check your weight and blood pressure daily, and watch what you eat and drink. Many people adjust well and continue working, travelling, and enjoying time with family.

Lifestyle tips

• Follow the fluid limits and dietary advice from your care team
• Keep your access site clean and dry to prevent infection
• Stay active as much as you can – gentle exercise like walking is good

Diet and exercise

Your diet will likely be lower in salt, potassium, and phosphorus, and you may need to limit how much fluid you drink. Your dialysis team or a dietitian can give you a personal plan. Light exercise, like walking or stretching, can help you feel stronger and improve your mood.

Mental health and emotional wellbeing

It is normal to feel frustrated, scared, or sad about needing dialysis. The treatment can be tiring and time-consuming. Talk to your care team, a counsellor, or a trusted person. You are not alone.

Prevention

You cannot always prevent the need for dialysis, but you can slow the progression of kidney disease by managing blood pressure, blood sugar, and salt intake. Once you are on dialysis, following your treatment plan helps prevent complications.

Vaccines

Talk to your doctor about vaccines that are recommended for people on dialysis, such as the flu shot, pneumonia vaccine, and hepatitis B vaccine.

Screening programmes

Regular blood tests and check-ups with your kidney doctor help make sure your dialysis is working well and that you stay as healthy as possible.

Complications

If left untreated

• Fluid buildup in the lungs or body (swelling, shortness of breath)
• High levels of potassium or other minerals that can affect the heart
• Infection at the access site or in the blood

Long-term outlook

With regular dialysis and good self-care, many people live full, active lives for many years. A kidney transplant may also be an option for some, which can reduce or eliminate the need for dialysis. Your healthcare team will guide you each step of the way.

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