Kidneys are two brown-colored bean-shaped organs of our renal system responsible for a wide range of bodily functions. They play a crucial role in releasing hormones that regulate blood pressure, clean the blood, balance body fluids, remove waste in the form of urine, and control the production of red blood cells besides making substances that keep your body healthy. When kidneys begin to stop functioning and are no longer able to remove waste fluids from the body, these harmful toxins begin to build up in your bloodstream. When both kidneys cease to filter blood normally, taking waste substances out of the blood is done through an artificial process called dialysis. There are two ways to get dialysis-one is Hemodialysis and the second is Peritoneal dialysis. Hemodialysis is a procedure where a dialysis machine and a filter called a dialyzer is used to purify the blood. To get your blood into the dialyzer, the doctor needs to make access to your blood vessels. This is done by way of minor surgery, mostly to your upper limbs.

When Is Hemodialysis Required?

Kidney disease happens in five different stages. It is during the final stage that doctors consider the patient to be in end-stage renal disease or kidney failure, which is usually by the time you lose about 90 percent of your kidney function. Kidneys are believed to be failing when they carry only 10 to 15 percent of their normal function. In some cases, dialysis is done while the patient is waiting for a transplant. If the kidney transplant is successful and there are no further complications, dialysis is stopped.

Also read: Kidney Cancer: Causes, Symptoms, And Treatment

How Does Hemodialysis Work?

The hemodialysis procedure contains a pump that draws the impure blood and sends it to another machine called a dialyzer, filtering waste, salts, and toxic fluids. While removing blood through a needle, waste is moved into a dialysis solution that contains clean water and additives, thus returning filtered blood to your body through another needle in your arm. Hemodialysis can be done at home during the day or at night, in a hospital, or a dialysis center. The process is not very complicated, but the patient is given clear instructions on how to prevent infection in the fistula besides a detailed procedure on how to manage home hemodialysis. Each hemodialysis lasts about three to four hours and is done three times a week. The time needed for your dialysis depends on the patient’s height and weight, how effectively the kidneys are working, and the amount of waste that builds up in the body between treatments.

Procedure Before Hemodialysis

To make hemodialysis an easier procedure and to help blood flow in and out of your body effectively, a minor surgical procedure is done to access the bloodstream before dialysis is started and the following are the methods:

Arteriovenous Fistula:  One of the safest types of vascular access, AV fistula lasts for years and may not cause any infections or blood clots. In this procedure, a surgeon connects an artery that carries blood from your heart and a vein that carries blood to your heart under the skin of your arm. It is advised to get an AV fistula two to three months before starting Hemodialysis. 

Arteriovenous Graft: This procedure is chosen in the case of a short artery and the vein is difficult to connect. Doctors use a soft, hollow plastic tube to connect them, also called a graft. Despite a safe alternative access option, it can cause infections and blood clots after a few weeks; hence it is not very often used for the procedure.

Catheter:  It is a Y-shaped plastic tube where one end of the catheter connects to a large vein deeper inside your body, and the other end comes out through your skin. There are two types of catheters one is venous, and the other is tunneled.

The venous catheter is a slender tube inserted usually below the right collarbone and threaded into a vein, also called the superior vena. If dialysis is needed instantly, the doctor may recommend a venous catheter because it can be placed at the earliest. But it should only be used for a short period. A tunneled catheter allows long-term access to the vein and is commonly placed in the neck, the groin, chest, or back. However, catheters are not advised by doctors as the patients using them are more likely to have problems of infection as well as blood clots.

Side Effects Of Hemodialysis

Potential and serious side effects of Hemodialysis can be the following:

  • Chest or back pain
  • Infection
  • Low blood pressure
  • Throbbing headache
  • Itchiness on the skin 
  • Muscle cramps
  • Nausea
  • Blood Clots
  • Blood poisoning

Living With Hemodialysis

If the kidneys have failed to perform their functions, hemodialysis may be needed for the whole life, the other alternative being a kidney transplant. While patients live normal lives when on the procedure, life expectancy on hemodialysis can vary depending on your other medical condition and the effectiveness of the treatment plan. Average life expectancy ranges from five to twenty, even thirty years. Dialysis helps prevention of further problems caused by kidney failure.


Hemodialysis is a lifesaving treatment for people with end-stage renal disease. The patient can stay on hemodialysis indefinitely or until he or she gets a kidney transplant. Some find this procedure convenient to be done at home, while others prefer it at a hospital or a specific dialysis center. A kidney specialist can explain different approaches, review the best hemodialysis options, and help patients make the best treatment choices.