Frequently Asked Questions About Dialysis
What can I expect at my first appointment?
Your doctor makes plans for your first dialysis treatment. It is possible that you may have your first few hemodialysis treatments in the hospital. Northwest Kidney Centers facilities provide dialysis after you go home from the hospital. If you have hepatitis B, you dialyze in a special treatment room in our Special Care Unit at Haviland Kidney Center.
If you choose peritoneal dialysis, you might have your first dialysis treatments in the hospital or at the Northwest Kidney Centers Peritoneal Unit in the Haviland Kidney Center. Once the catheter site heals, our staff train patients to dialyze at home.
For both forms of dialysis, staff will contact you about the date and time of your first treatment.
For your first dialysis at Northwest Kidney Centers, you need an extra 30 minutes to 1 hour before and about 30 minutes after dialysis for such things as signing forms. For example, if your treatment lasts four hours, plan for about five to six hours. For future treatments, you usually need an extra half-hour before and after dialysis.
When you arrive for your first treatment you need to sign a medical "consent for treatment" form. This gives Northwest Kidney Centers legal permission to treat you. A staff member reviews this form with you.
Staff will then take you to the treatment area where your nurse gives you a tour of the unit and starts dialysis.
Blood is drawn for several tests as part of your first treatment. One of these, an HIV test, is discussed carefully with you. Staff will ask you to sign a consent form stating that you understand the purpose of this test and agree to it.
Staff will discuss reuse of your personal dialyzer with hemodialysis patients. They give you detailed information about dialyzer reuse and the reasons for it. Then our staff will ask you to sign an agreement to reuse your personal dialyzer during future treatments.
How long does dialysis take?
The length of each person's dialyses varies and depends on how many hours of treatment your doctor ordered. Hemodialysis treatments usually last three to five hours. Continuous cycling peritoneal dialysis (CCPD) takes longer and continuous ambulatory peritoneal dialysis (CAPD) involves shorter but more frequent treatments.
What does dialysis feel like?
It is normal for you to feel nervous and uneasy about your treatment the first time. The nurses and technicians caring for you can help ease these feelings by explaining what they are doing and what they expect from you. Not everyone feels the same way during treatment. This section lists the most common symptoms. You may not have all these symptoms or any of them, and most can be prevented or treated. Let staff know if you feel different than usual at any time during your treatment.
Hemodialysis patients with a fistula or graft may feel a sting or pressure as staff insert the needles. Once in place you should not feel the needles. Some patients have other symptoms during dialysis that include upset stomach, vomiting, dizziness, sweating, chills, shortness of breath, muscle cramps, headache, restlessness, or itching.
If you are on peritoneal dialysis, you may feel pressure or coolness as the dialysis fluid enters your body. Other feelings may include a fullness in your abdomen, restlessness, or cramping.
How will I feel after my first treatment?
Each person reacts differently to their first dialysis treatment. Those who feel good after dialysis can go about their normal activities. Some people feel physically drained or "washed out" and need to rest after dialysis. After several dialysis treatments most people feel better than they have for a long time. If your symptoms continue or seem to get worse, tell your doctor and the dialysis staff right away.
What will my dialysis schedule be? What if I work or I’m in school?
Most hemodialysis patients dialyze three times a week, either on Monday, Wednesday, and Friday, or on Tuesday, Thursday, and Saturday or Sunday. The Broadway centers close on Saturdays; and the other centers close on Sundays.
Patients do peritoneal dialysis several times every day when using CAPD or eight to 10 hours every night for CCPD.
Usually your first treatment takes place during the day, but staff may ask you to dialyze at different times in the future. Please understand that a number of people may want to dialyze at the same time. Staff will talk to you about what times are open in your unit. Then they will work out the best schedule possible based on your wishes. Northwest Kidney Centers makes a special effort to meet the schedule needs of patients who work or go to school.
You can ask to have your dialysis time changed but this is not always possible. Ask staff to put you on a waiting list for the times that you might prefer. Remember that if your dialysis needs change, your schedule may also need to change.
Northwest Kidney Centers operates on a regular schedule for most holidays. Check with your dialysis unit about the schedule. You may ask ahead of time about changing your dialysis time if you have conflicting holiday plans.
How will I known when to come for dialysis?
Sometimes plans are made for your first dialysis while you are still in the hospital. If so, a hospital nurse may tell you your treatment time at Northwest Kidney Centers, or the dialysis unit will call you at home. You can also call us at (206) 292-3090 to check the time for yourself. If you know your unit or center, please call after 2 p.m. on the day before you come for treatment.
Once you start dialysis at Northwest Kidney Centers, you are responsible for knowing your next treatment time. Patients who dialyze in Patient Education Unit - North or the Peritoneal Unit have a set dialysis schedule. Special Care Unit patients have set dialysis days but need to phone for the scheduled time after 2 p.m. the day before their next treatment.
Do I need to bring my medicine with me?
Please bring all the medicines you are currently taking to your first dialysis treatment. There are two reasons for this:
• You may need to take some medicines while on dialysis. Check with your doctor about taking any medicine once you start dialysis treatments (such as blood pressure medicine or insulin).
• Northwest Kidney Centers keeps an accurate medication list for each patient. A nurse will talk with you about this and review the list with you each month.
Can I eat before dialysis?
Eating a large meal before dialysis may make you feel ill or even vomit. More blood will flow to your stomach at the same time it needs to be going through the dialysis machine. You may want to eat a snack or light meal at least two to three hours before you dialyze. Plan a meal that is easy to fix after you get home. Make sure it is high enough in calories to make up for what you missed during the day.
If you cycle on a peritoneal dialysis machine in the center, you get a sack lunch. Because these treatments last eight to 10 hours, you may also want to bring a snack. Check with your dietitian if you have questions about what to bring.
If you have diabetes, ask your doctor about eating during dialysis and insulin coverage. The Northwest Kidney Centers has a nutrition department that can answer questions you might have.
All of our centers have ice available for patients. You can bring a snack to eat during dialysis that does not require help or refrigeration.
How can I get help if my center is closed?
Whether you dialyze at home or in a center, call your doctor if you have a medical problem. If you dialyze in a center and have a problem related to your dialysis treatment, call your doctor or your dialysis unit with your concerns.
If you dialyze at home and have a problem related to dialysis, call one of the two numbers listed below. When the home training units are closed, the answering service responds to your call. Tell the operator that you are a Northwest Kidney Centers patient and need to talk to the:
• Hemodialysis Nurse - Call 206-292 -2558 if you are on home hemodialysis.
• Peritoneal Dialysis Nurse -- Call 206-292-2285 if you are on home peritoneal dialysis.
How will the dialysis center staff know what kind of dialysis I need?
Your doctor prescribes your care provided by Northwest Kidney Centers. Our staff will "fill" this prescription by providing treatment as directed by your doctor. Plan to continue to see your doctor regularly at his or her office after starting dialysis treatment. Contact the doctor's office to schedule your appointments.
What activities can I do during dialysis?
The most popular activities are watching TV, reading, or sleeping. We provide television sets. You may bring your own radio or tape player if it is battery operated and used with an earpiece or headphones. Some patients do other quiet activities such as needlework or writing. You can check out books on tape from the patient library at Haviland Kidney Center (call our receptionist at 206-292-2771), research what you might like to borrow on this website or check with your center staff. When you are receiving new patient education, you also spend time learning more about kidney disease and its treatment.
What should I wear to my dialysis appointment?
Wear comfortable, washable clothes without buckles, and avoid tops with buttons down the back. Loose or short sleeves are best because staff take your blood pressure many times. Many people feel cool while on dialysis so you may want to bring a blanket or wear long underwear (cut the sleeves shorter). You can also bring a pillow. Talk to staff about any other things you think you may need to bring.
What happens after my first treatment?
Within a few weeks after starting dialysis, you and your social worker develop a long term care plan. At this time you:
• Review the different treatment choices offered by Northwest Kidney Centers.
• Review the many services available to you.
• Discuss plans for the type and place of your ongoing dialysis care.
Your social worker reviews your care plan with you every six months. This is a good chance to see how you are doing on dialysis. You can talk about any needed changes. Keep in mind that your care plan can be changed at any other time as your needs and wishes change.
What will I do about my job and having to get dialysis?
You may need to take some time off work when you first start dialysis, but not all patients need to do this. Everyone needs a different amount of time, so talk with your doctor. Let your doctor know that you need advance notice before starting dialysis to arrange time off from work.
Can I drive to my appointment?
Some patients feel weak and a little unsteady after their first few treatments. It is best to have someone pick you up after dialysis, at least for the first week. After that, you may feel able to drive. Your social worker may be able to help you if you have a problem with arranging a way to travel to or from dialysis. Let your social worker know as soon as possible if you need help.