Discover the Type of Dialysis that is Right for your Lifestyle

Up until the day he learned his kidneys were failing, Joe Grande thought he felt pretty good. The 85-year-old New Yorker had never been seriously ill. Aside from prostate surgery, he had never been hospitalized. But the numbers on his blood test, his doctor said, didn’t lie. “You’ve got to start dialysis,” he told Joe.

“It shocked me,” says Joe. “I couldn’t relate to it. To me, this was just a problem on paper.”

Now, three times a week, a machine cleans Joe’s blood of the wastes his kidneys can no longer remove — a process called hemodialysis (HD). He didn’t like the idea at first. But now, three months into his new routine, Joe has adjusted. “I had no choice but to accept it,” he says. “If I didn’t do dialysis, I knew my disease could lead to heart failure.” 

Not just lifesaving, but life-restoring

Getting diagnosed with Stage 4 or Stage 5 chronic kidney disease (CKD) isn’t easy to process. “It’s an emotional blow,” says Dori Schatell, executive director of Medical Education Institute (MEI), a nonprofit that educates and supports kidney patients and clinicians. “And when you’re emotional, you just cannot take in facts.” That’s why she begins patient education with the good news: dialysis can help most people reclaim their sense of well-being and the lifestyle they enjoyed before their diagnosis. Dialysis also makes it possible for people who qualify for a kidney transplant to wait until a healthy kidney becomes available from a living or deceased donor. 

Dialysis options

There are two types of dialysis: hemodialysis, where blood is cleaned outside the body; and peritoneal dialysis, where blood is cleaned inside the body.  

View the dialysis infographic

Peritoneal dialysis is done at home, either manually, using gravity, or by machine. You simply attach a bag of dialysis solution to a soft tube that’s been surgically placed in the belly. Several times a day, the solution flows into your body and remains there for several hours before you drain it. Or a machine does this for you while you sleep. 

Hemodialysis, which always involves a machine, can be done in a clinic or at home, during the day or overnight. For hemodialysis, you first need to get an access placed in your arm by a surgeon. The access is where you will connect to the machine. Once connected, you need to sit or recline. Some people do it as they sleep, as treatments generally take four hours. 

Talk to your doctor about which dialysis makes the most sense for your medical needs and lifestyle.

How in-center and at-home dialysis differ

People who get hemodialysis at home feel that it offers them significant advantages over getting in-clinic care. Colleen Kurpinski is one of them. After being diagnosed with chronic kidney disease, the Michigan native tried to manage her condition with diet and medication because she still had some kidney function. But over the next two years, her disease progressed. She wound up in the emergency room with kidney failure. Soon after, she began receiving dialysis at a clinic. Each visit left her exhausted. 

On the recommendation of her nurse, she began dialyzing at home. Colleen has since regained the lifestyle she thought was gone forever. Five days a week, her husband helps her connect to a hemodialysis machine to clean her blood. “I can put it off ’til I’ve had my second cup of coffee,” she says. Because it removes water from her body much more gradually than the machines at the clinic, Colleen no longer feels tired and weak. Now she dialyzes more often but spends less time per treatment. She’s making meals, baking and getting outside regularly. “I feel like I did before I found out I had kidney disease,” she says.

Choosing where to do your dialysis infographic

Is home hemodialysis (HDD) right for you?

At-home hemodialysis was ideal for Colleen, but it isn’t for every late-stage kidney patient. Some people may simply not be candidates for home hemodialysis. Others, like Joe Grande, choose in-center care because they don’t want to burden their spouse or a family member with their care, because they don’t want to dedicate space to dialysis equipment or because they are worried they cannot keep the area sterile. 

But fear is by far the biggest barrier, says Schatell. “Patients new to dialysis go into the clinic and see people sitting next to machines the size of a Ford Falcon, with things turning and blood going in and out of tubes and nurses hovering, and think, ‘There’s no way I can do this myself.’ They absolutely can! They just need training and support.” Some people, like Colleen, rely on a partner to connect and disconnect from the machine. Others do it themselves. Room is needed for equipment and supplies, but no more than a closet-sized space. And while the room where patients treat themselves should be clean, it doesn’t have to be sterile. “Some patients dialyze with a pet sitting on their lap,” says Schatell. 

Staying eligible for a transplant — or no longer needing one

Clinical studies show that at-home hemodialysis is safe and effective. In fact, people who get their blood cleaned at home while they sleep can live as long as someone who has received a kidney from a deceased donor. That’s because gentler, more frequent dialysis spares people the sudden drop in blood pressure that deprives organs of oxygen, a phenomenon known as organ stunning. Repeated stunning, says Schatell, can damage the heart. It’s one of the primary reasons why late-stage kidney patients become no longer eligible for a kidney transplant.

For Colleen, treating herself at home is the right choice: “Now that I feel like the old me, all other options, from here on out, are off the table.” Talk to your health care team to see if at-home dialysis can help you feel more like your old self, too.