Dialysis process

There is no way to prevent kidney failure, but you can slow down disease progression and help delay it by managing blood glucose levels and blood pressure, making dietary changes and working with a medical nutritionist, staying active, and monitoring your kidney functioning regularly. If you have any comorbid diseases, talk with your healthcare provider about the best way to manage them to minimize their effects on your kidney disease.

When you are told you have kidney failure and need treatment to stay alive, it can be a difficult time in your life. If your kidney diagnosis is new, you may feel overwhelmed, confused and angry. But there are some important things you can do to help yourself. Learn all you can about your different treatment options and take an active role in decisions about your care. Hemodialysis is a treatment that replaces the work of your own kidneys to clear wastes and extra fluid from your blood. This is done using a special filter called a dialyzer or artificial kidney. Your blood travels through plastic tubing to the dialyzer, where it is cleaned and then returned to you. At the beginning of each treatment, two needles are placed into your access. These needles are connected to the plastic tubing that carries your blood to the dialyzer. Only a small amount of blood is out of your body at any one time. The dialysis machine pumps your blood through the dialysis system and controls the treatment time, temperature, fluid removal and pressure. This basic process is the same for home hemodialysis, except that you and a care partner are trained to do your treatment at home. You can do hemodialysis at a dialysis center where a nurse or technician performs the tasks required during treatment. In-center hemodialysis is usually done three times a week for about three to four hours or longer each session. In-center treatments are done at a pre-scheduled time. You can also do hemodialysis at h...

• • A procedure that connects an artery to a vein in preparation for dialysis • • For patients with failing kidneys, this procedure creates an access point for the dialysis machine • • An AV fistula is a good long-term solution for dialysis, but some alternatives exist • • Involves Vascular & Endovascular Surgery, Chronic Kidney Disease Program, and nephrology Dialysis is a common treatment for people whose kidneys are functioning poorly. Taking over the work of the failing kidneys, a dialysis machine filters out toxins from the blood in people who have end-stage renal or kidney disease. To undergo dialysis, a patient must first have a surgical procedure to create an access point for the machine. This is typically done in the arm or the wrist, most often by connecting an artery and a vein. The procedure is performed by a vascular surgeon who specializes in treating the circulatory (vascular) system. “Once the diagnosis of end-stage renal disease is reached, the option of dialysis should be discussed,” says Kristine Clodfelter Orion, MD, a Yale Medicine vascular surgeon and assistant professor of surgery at Yale School of Medicine. “The longest-lasting and best type of dialysis access is an arteriovenous fistula, or AV fistula.” At Yale Medicine, our vascular surgeons use the newest vascular surgery approaches for patients who need an access point for dialysis. They are also widely known for being at the forefront of researching the best surgical techniques for this procedu...