All You Need to Know About Preparation for Dialysis Treatment

By now you have grown to accept the fact that your kidney function is deteriorating and that at some stage, in the not too distant future, you are going to have to undergo dialysis. You have gone through the various stages of denial and grief, and are now coming to terms with the changes you will need to make in your life in preparation.

Step One – Vascular Access Placement

In preparation for dialysis, you will need a form of vascular access placed so as to allow for the blood to be drawn and filtered without harming the veins. There are 3 types of accesses: The much preferred method is an Arteriovenous Fistula (AVF) connecting an artery to a vein. Other methods include an Arteriovenous Graft (AVG), connecting the artery to the vein using synthetic tubing and a Central Venous Catheter, used as a temporary access option. The AVF is the golden standard, with a higher success rate, lower percentage of complications and infections, superior longevity and less need for additional surgical intervention. In recent years the AVF has become even safer. The use of VasQ™, a device designed to improve maturation of AV fistulas, was found as an efficient device for AVF.

The access will be placed several weeks to months prior to the start of dialysis, in order to allow sufficient time for healing and for maturation. Caring and monitoring of access site is crucial in reducing the chance of complications and infection.

Step Two – Taking Care of Your Health Before and During Dialysis

While caring for your general health is always important, it is even more so in preparation for dialysis treatments.

  • Keep healthy, and remember that infections and illnesses are potentially dangerous. Make sure your vaccinations are up to date and inquire whether other vaccinations are recommended. Avoid crowded places, stay away from sick people and wash your hands frequently.
  • If you haven’t quit smoking yet, now is the time. The nicotine and tobacco harm your immune system, your lungs and your general health, and make you even more susceptible to disease.
  • Control all underlying conditions such as high blood pressure or diabetes by medication, diet and exercise.
  • Maintain a healthy lifestyle, with strict adherence to the recommended diet (including the allowed amount of liquids), daily exercise and enough sleep.
  • Find emotional support. Support groups, friends, family, therapists or spiritual guides are excellent choices for offering emotional support. Be honest with them and let them know what you need from them at any given period in time.

Step Three – Know About Your Dialysis Options

Dialysis can be done in a dialysis center, at home or in a hospital. Most people undergo dialysis 3 times a week, 3-5 hour sessions at a time. The frequency and duration may change, depending on your health and needs. Dialysis can also be done daily at home, each session lasting approximately 2-3 hours. Peritoneal dialysis is also an option that should be considered. Discuss the options with your medical team, deciding which is the better for your needs.

Step Four – What to Expect During Your Dialysis Session

In preparation for your dialysis session you will have your weight, blood pressure, temperature and pulse checked and recorded. Your blood pressure and pulse will be monitored periodically though out your session. At the end of your session your weight will be checked once again.

The needles will then be inserted through the access site, one needle removing the blood for filtering, the other – returning the clean blood to the body. As the blood is being filtered and cleaned, you will be free to sit in the reclining chair and relax. Some people choose to work, others to read, watch TV, relax or talk to other patients.

Possible side effects include discomfort, nausea and tiredness. Inform the staff if you would like medication to relieve the symptoms. Other side effects can include low blood pressure, high blood pressure, cramping, pain, shortness of breath, itchy skin, fatigue, anemia and insomnia. Report all symptoms to your medical teams, both during, and after, your sessions. Mood changes are also common, and it is important to inform your doctor of any signs of depression or mood changes. Relaying all symptoms and side effects is crucial, as they may be signs of deteriorating kidney function, illness or even a need for medication adjustment.

While the thought of undergoing dialysis treatments may be daunting, most people find that they are able to lead a relatively normal life and continue doing the things they love.