ABOUT DIALYSIS
Here are answers to some of our patients most frequently asked questions regarding their hemodialysis. If you can't find the answer you're looking for, please don't hesitate to Contact Us.
Questions and Answers:
The PRE ESRD Orientation
Once your kidney failure progresses to the end stage - called Chronic
Kidney Failure (CKD) or End Stage Renal Disease (ESRD) - you will need
dialysis. As part of our Mission, your Nephrologist will ask you to
attend a PRE ESRD Orientation session which is designed to inform you
about kidney disease and its treatment. Being informed about your
options will help you to make the best choice when the time comes for
dialysis.
The Orientation gives you an overview of Hemodialysis, Home
Hemodialysis, Peritoneal Dialysis and Transplantation giving you the
advantages and disadvantages of each option. Although dialysis may not
be in your immediate future, it is always a good idea to be well
informed about the course of your health care.
The main focus of the health care team is to make your transition to
dialysis as smooth as possible. We encourage you, even after the PRE
ESRD Orientation session, to call us at any time with questions,
concerns or even a more private meeting with the dialysis staff. Our
goal is to help you make the treatment choice that will best fit your
lifestyle.
What Happens during Hemodialysis?
Hemodialysis - The process of filtering waste and fluid from the blood. During Hemodialysis, blood travels outside of the body through tubing and passes through a filter known as a dialyzer or an artificial kidney. The dialyzer cleans the blood and then the blood is returned back to your body. Two needles are inserted into a permanent access at each treatment. One needle withdraws the blood and the other returns the filtered blood to the body.
There are Two Types of Permanent Accesses:
Fistula: A surgical linking of an artery to a vein.
(VIEW IMAGE)
Graft: A synthetic (man made) tubing that is surgically placed under the skin, linking an artery and a vein.
(VIEW IMAGE)
What is a CVC (Central Venous Line)?
In-Center Hemodialysis: Advantages and Disadvantages
Advantages: Nurses and technicians perform the treatment for you - Maintain contact with other hemodialysis patients and staff - Usually three treatments per week with 4 days off - No equipment or supplies at home - Medical help is available quickly in case of an emergency 
Disadvantages: Travel to the center 3 times per week - Insertion of 2 needles each treatment - Restricted diet/ fluid intake - Possible discomfort including a headache, nausea, cramps and fatigue
What is My In-Center Schedule?
Monday, Wednesday and Friday or
Tuesday, Thursday and Saturday
6:00 am, 11:00 am or 4:00 pm (4 hours)
PERITONEAL DIALYSIS
In Peritoneal Dialysis, the blood is cleaned inside of the body using one of the body's own filters, the peritoneal membrane or the lining of your abdomen.
How does Peritoneal Dialysis work? A solution is placed in the abdomen, through a catheter, for several hours. Waste and fluids pass through the peritoneal membrane or filter, then the solution and waste are drained from your abdomen. This is done 7 days a week.
The Catheter
During a one-day surgery, a tube called a catheter is placed through the wall of your abdomen as a permanent access for PD. It is usually placed about an inch below and to the side of the navel. About 4-6 inches of the catheter extends out of the body.
TWO TYPES of PERITONEAL DIALYSIS:
Continuous Ambulatory Peritoneal Dialysis or CAPD
CAPD is done manually and does not require a machine. Gravity allows the solution to enter and leave your body. The solution is exchanged 4 times each day when you wake up, at lunch, at dinner and before bed.
Exchanges can be performed in any clean area at home, work, school or even on vacation. Each exchange requires 30 minutes.
Automated Peritoneal Dialysis or APD
Requires a 'cycler' machine which does the exchanges for you and is done overnight, while you sleep. However, there is enough tubing from the machine to allow you to walk about your home (33 feet).
Advantages and Disadvantages of PD
Advantages: Allows for a flexible lifestyle and independence - Doesn't require needles - Is a continuous therapy which is more like your natural kidneys - Don't have to travel to a dialysis unit for treatment - Portable - 24 hour technical and clinical support - Less restricted diet
Disadvantages: Is performed seven days a week - Have a permanent external catheter - Requires storage space - Increased risk for infection.
KIDNEY TRANSPLANT
A kidney transplant is an operation during which a healthy kidney from another person is placed into your body. Dialysis may be required while you are waiting for a kidney transplant.
Sources of Healthy Kidneys
How do I know if I am a Candidate for a transplant?
DIET - What does a Renal Dietitian do?
Nutrition is very important for each person with kidney disease. A Registered Dietitian meets with each new dialysis patient to review how they have been eating and what changes will help them feel better. The Dietitians help with recipe ideas, menus, and grocery shopping lists planned for your special needs. Your Dietitian will help you understand how drinking and eating are related to your dialysis treatments.
As you continue on dialysis, your Dietitian will meet with you monthly, to review your progress. What you eat will affect your monthly lab values and help to keep you healthy.
If you have diabetes, heart disease or high blood pressure in addition to your kidney disease, your Dietitian will help you make sense of the many diet recommendations associated with those conditions.
DIET - General Guidlines
SOCIAL WORK - What Does a Renal Social Worker Do?
Emotional well being of an individual also plays a critical role in the treatment of kidney disease. Every renal patient will acquire their own Licensed Masters Social Worker who will provide assistance through supportive counseling during the adjustment period. 
Your social worker will assess for any needs making appropriate referrals to home care services, durable medical equipment, transportation, insurance, and travel.
Your social worker will meet with you regularly to ensure that you and your family are coping well and that you are maintaining your maximum independence while advocating for the highest quality of life. Your renal Social Worker C.A.R.E.S. - Counsel, Advocacy, Resources, Education.
Transportation:
Insurance:
Travel:
EMPOWERMENT - What You Should Know...