Dialysis is the process of cleaning the blood of waste products and excess fluids. It is used for patients whose own kidneys are no longer functioning well-enough on their own. Dialysis does not replace or restore the patient’s own kidneys but serves as a substitute. Generally, when patients with chronic kidney disease progress to Stage V (reflecting 15% or less of total kidney function) they require either dialysis or transplantation. Dialysis treatments may be performed either in-center or at home (home dialysis).
In-center dialysis is a form of hemodialysis in which the patient goes to an outpatient center usually thrice weekly. The dialysis is performed by removing small amounts of a patient’s blood and putting it through a filter and then returning it to the bloodstream. These treatments are usually 3-5 hours and performed at a regularly scheduled time. In order to access the blood patients usually have a vascular access placed in their arm or leg. This may be either a native fistula or a synthetic graft made of gortex. Both types of vascular access connect an artery and a vein under the skin. They require surgical placement and need to be placed weeks prior to their use. The fistula or graft is accessed by a technician or nurse who places two needles into the access for the duration of the therapy. In patients who are unable to have a fistula or graft a catheter which protrudes from the body may be placed instead. This is known as a dialysis catheter and is less desirable on a long-term basis due to increased risk of infection and poorer function. During the treatment the patients are monitored for changes in blood pressure and pulse. Laboratory values are checked at least monthly to ensure that the blood is being adequately cleaned.
Why?
Dialysis is performed in patients whose own kidneys no longer function sufficiently. It is necessary until the patient recovers kidney function (unusual in chronic kidney disease) or a transplant is performed.
Complications: The patient may have changes in blood pressure and pulse rate during the treatment. There may be bleeding after the treatment or cramping at the end. Patients may feel very tired or “washed-out” after the procedure.
Where?
- Inpatient Dialysis is provided at all 4 NorthShore hospital locations (Evanston, Glenbrook, Highland Park and Skokie).
- Outpatient Dialysis is provided at Highland Park Hospital
Outpatient dialysis treatment choices include:
• Conventional in center treatment from 1 time per week to daily depending on the needs of each individual patient
• Nocturnal dialysis long, slow, overnight therapy provided 3 times per week provided in the outpatient center
• Home dialysis, both peritoneal and hemodialysis
• For more information, please call 847.480.3700
Our nephrologists also follow patients at other outpatient and home dialysis centers in the North Shore that offer in-center dialysis and home therapies. Locations for these center based services include Evanston, Skokie, Glenview, Deerfield and Lake Bluff. Home dialysis services are provided across a wide geographical area. Please consult your nephrologist about the provider, location and therapy that would best suit your needs.