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Overview

What Is Hemodialysis?

Hemodialysis is a treatment that helps replace some filtering functions of the kidneys when they cannot remove enough waste and extra fluid from the blood. During treatment, blood travels from the body through a vascular access point and into a dialyzer, sometimes called an artificial kidney. The dialyzer removes waste products, extra salt, and fluid, then returns the cleaned blood to the body while helping keep blood chemistry in balance.

Which Conditions It Treats

Which Conditions Does Hemodialysis Treat?

Hemodialysis is most often used for end-stage kidney failure, when the kidneys can no longer adequately remove waste and fluid. It may also be used temporarily for severe acute kidney injury or for dangerous chemical, electrolyte, acid-base, or fluid imbalances that need urgent correction. The care team decides whether treatment is needed based on kidney function, symptoms, laboratory results, and the person’s overall condition.

  • Remove waste products that have built up in the blood.
  • Control fluid overload when the kidneys cannot remove enough water.
  • Correct dangerous electrolyte or acid-base problems.
  • Support the body while kidney function is assessed or a transplant is considered.

Regimen / Schedule Used

Hemodialysis Schedule and Treatment Options

Many people receive hemodialysis at a dialysis center several times per week according to a prescribed schedule. Home hemodialysis may involve more frequent or longer sessions, depending on the treatment plan, available equipment, training, and support from the dialysis team. The best setting and schedule depend on medical needs, daily life, safety, and personal preferences.

ApproachWhat to explain
In-center hemodialysisClinic-based treatment with staff support and a preset schedule
Home hemodialysisTreatment at home after training, with a schedule tailored by the care team
Peritoneal dialysisA different dialysis method that uses the lining of the abdomen rather than a blood-filtering machine

During the Procedure / What to Expect

What to Expect During Hemodialysis

Vascular access and connection

Before treatment, staff examine the vascular access used to connect the blood circuit, such as an arteriovenous fistula, graft, or catheter. They check for signs of infection or other problems and may assess the access vibration or pulse before connecting the machine. During the session, blood moves through the dialyzer and back to the body while the team monitors blood pressure, symptoms, fluid removal, and the machine settings.

Side Effects & Risks

Side Effects and Risks of Hemodialysis

  • Fatigue or feeling washed out may occur during or after treatment.
  • Muscle cramps can happen, particularly when fluid is removed.
  • Headache may occur during or after a session.
  • Nausea is a possible treatment-related effect.
  • Dizziness may result from changes in fluid balance or blood pressure.
  • Blood-pressure changes can occur during or after treatment.
  • The vascular access can become infected or blocked by a clot.
  • Bleeding can occur from the access or from problems with blood clotting.
  • Anemia may develop or continue because of kidney disease and treatment-related factors.
  • Electrolyte levels can become abnormal and require monitoring or adjustment.
  • Rapid fluid removal can cause low blood pressure, cramps, dizziness, or other complications.

Individual risk

Risks vary from person to person

Individual risk depends on kidney function, other medical conditions, the type and condition of the vascular access, fluid status, and adherence to the prescribed dialysis plan. Regular monitoring helps the care team adjust treatment and respond to complications.

Recovery

Recovery and Life Between Hemodialysis Sessions

Some people feel tired or washed out after a hemodialysis session, while others can resume their usual activities soon afterward. Recovery can change over time as the care team adjusts the treatment prescription, fluid removal, medicines, and other aspects of care. Tell the dialysis team about symptoms that are new, severe, or becoming more frequent.

  • Follow the fluid and dietary guidance provided by the dialysis team.
  • Take prescribed medicines as directed and discuss side effects before making changes.
  • Protect and inspect the vascular access as instructed.
  • Attend all scheduled dialysis sessions.
  • Keep laboratory tests and follow-up appointments.

When to Call a Doctor

When to Call a Doctor

  • Fever or chills may indicate an infection and should be reported.
  • Redness or drainage at the vascular access needs prompt medical advice.
  • Increasing pain or swelling around the access should be assessed.
  • Unusual bleeding from the access should be reported promptly.
  • Loss of the access vibration or pulse may indicate a blockage.
  • Worsening shortness of breath can be a sign of fluid or another urgent problem.
  • Chest pain requires immediate medical attention.
  • Fainting should be evaluated urgently.
  • Rapid unexplained weight gain may indicate excess fluid.

Get medical help

Know when symptoms are urgent

Seek emergency help for severe breathing difficulty, chest pain, uncontrolled bleeding, confusion, or loss of consciousness. Contact the dialysis team promptly for less urgent concerns, including access changes, fever, swelling, or symptoms that persist after treatment.

Diseases & Conditions

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