Hemodialysis is a treatment that filters waste products, excess salt and extra fluid from the blood when the kidneys can no longer do this adequately. Dr. Satarupa Deb, Consultant Nephrologist at Bombay Hospital, South Mumbai, helps patients and families understand when dialysis is needed, prepare for it, and stay well on long-term treatment.
What Is Hemodialysis?
During hemodialysis, blood is drawn from your body through a dialysis access, passed through a special filter called a dialyser, and returned to you. The dialyser removes waste and excess fluid, while the dialysis machine carefully controls the process. A typical session lasts about four hours and is usually done two to three times a week in a dialysis unit, depending on your individual needs.
Hemodialysis does not cure kidney disease, but it takes over some of the important work of the kidneys. It may be used for a short period in acute kidney injury, or long term for kidney failure, sometimes as a bridge to a kidney transplant.
When May Dialysis Be Needed?
The decision to start dialysis is based on symptoms and overall clinical condition, not on a single blood test value. Your nephrologist will consider your kidney function trend along with how you are feeling.
- Persistent nausea, vomiting, loss of appetite or weight loss
- Severe tiredness, itching or difficulty concentrating
- Fluid overload causing breathlessness or swelling that does not respond to medicines
- High potassium or severe acid build-up in the blood
- Advanced kidney failure with worsening symptoms
Dialysis Access: Fistula, Graft or Catheter
Hemodialysis requires a reliable way to reach the bloodstream. An arteriovenous (AV) fistula, created by joining an artery and a vein, usually in the arm, is generally the preferred long-term access because it tends to have fewer infections and complications. A fistula needs several weeks to mature, so it is ideally planned well before dialysis is required.
An AV graft may be used when veins are not suitable for a fistula. A dialysis catheter placed in a large neck vein may be used for urgent dialysis or while a fistula matures. Planning access early is one of the most useful steps in preparing for dialysis.
Living Well on Hemodialysis
Many people on hemodialysis continue to work, travel and enjoy family life with some planning. Staying well depends on regular sessions, taking medicines as advised, and following diet and fluid guidance.
- Limit fluid intake as advised to avoid excess weight gain between sessions
- Reduce salt to help control thirst and blood pressure
- Follow guidance on potassium and phosphorus in foods
- Take phosphate binders, anaemia treatment and other medicines as prescribed
- Protect your fistula arm: avoid blood pressure cuffs, injections or tight bands on it
- Do not skip or shorten sessions without discussing with your doctor
What to Expect From Your Nephrologist
Dr. Deb will explain the options for kidney replacement therapy, including hemodialysis, peritoneal dialysis, kidney transplantation and conservative care, so you can make an informed choice. For patients on dialysis, ongoing review includes checking dialysis adequacy, blood tests, fluid status, blood pressure, anaemia and bone health, and adjusting the treatment plan as needed.
Dr. Satarupa Deb holds a DM in Nephrology from KEM Hospital, Mumbai, and has treated more than 1000 patients over the last decade across government and private hospitals.
Frequently Asked Questions
Is hemodialysis painful?
The dialysis itself is not painful. Some people feel a brief pinch when needles are inserted into a fistula. A few may experience cramps, tiredness or low blood pressure during or after a session, which the team can often manage by adjusting the treatment.
Once I start dialysis, is it for life?
Not always. In acute kidney injury, kidney function may recover and dialysis can sometimes be stopped. In established kidney failure, dialysis is usually long term unless a kidney transplant is performed.
Can I travel while on hemodialysis?
Yes, in many cases. With advance planning, sessions can often be arranged at a dialysis centre in the city you are visiting. Discuss your plans with your nephrologist and dialysis team well ahead of time.
How long before dialysis should a fistula be made?
A fistula usually needs several weeks to a few months to mature. For this reason, nephrologists generally recommend planning it in advance for patients with advanced chronic kidney disease who are likely to need hemodialysis.
Consult Dr. Satarupa Deb
If you or a family member may need dialysis, or would like a second opinion on dialysis care, book a consultation with Dr. Satarupa Deb at Bombay Hospital, Marine Lines, South Mumbai. Call +91 9326786023 or +91 9833990040.
This page is for general information only and is not a substitute for a medical consultation. Please consult a qualified doctor for diagnosis and treatment.