Haemodialysis (HD) is a life-saving treatment for people whose kidneys can no longer filter blood effectively. Whether you are preparing for Chronic Kidney Disease (CKD) Stage 5 or supporting a loved one, understanding the basics of renal replacement therapy is the first step toward managing your health.
Quick Facts: Key Points of Haemodialysis
Schedule: Usually performed for 4 hours, three times a week.
Access: Requires a surgical “access point” (fistula, graft, or line).
Location: Can be done in a hospital, satellite unit, or at home.
Goal: Removes toxins and excess fluid to mimic natural kidney function.
Longevity: Patients can stay on HD indefinitely or until a kidney transplant is available.
Dialysis is a medical procedure used to remove waste products and excess fluid from the blood. It becomes necessary when Chronic Kidney Disease (CKD) reaches Stage 5, also known as kidney failure or End-Stage Renal Disease (ESRD).
While dialysis is essential, it is only one part of a comprehensive treatment plan. Patients often require additional medications, such as Erythropoietin (EPO) injections for anaemia and various tablets to manage blood pressure and bone health.
There are two primary types of dialysis. Both provide approximately 5% of normal kidney function, which is enough to control symptoms and keep you alive, though they are not a “cure.”
Haemodialysis (HD): Filters blood through an external machine.
Peritoneal Dialysis (PD): Uses the lining of your abdomen to filter blood internally.
Most patients begin to feel significantly better about three months after starting treatment as toxin levels in the body stabilize.
During a session, a machine removes a small amount of blood from your body, pumps it through a dialyser (artificial kidney), and returns the cleaned blood back to you.
Time Commitment: While the treatment itself lasts 3–5 hours, the entire process—including travel, machine setup, and post-treatment monitoring—often takes 6–8 hours of your day.
Fluid Restriction: To prevent heart strain between sessions, most patients must limit fluid intake to 1.5 litres per day (or less).
Flexibility in treatment location has improved significantly in recent years:
Main Hospital Renal Unit: Best for patients with complex medical needs.
Satellite Unit: Smaller, community-based clinics closer to home.
Home Haemodialysis: Patients can be trained to perform HD at home, allowing for nighttime dialysis while they sleep.
Before starting HD, you need a way for the machine to reach your blood easily. This is called Vascular Access. There are three main types:
Arteriovenous Fistula (AVF): A surgeon joins an artery to a vein, usually in the arm. It is the “gold standard” but takes 6–8 weeks to “mature” before use.
Arteriovenous Graft (AVG): An artificial tube connects the artery and vein. It can be used sooner than a fistula.
Central Venous Catheter (Line): A plastic tube inserted into a neck vein. This is typically a temporary measure for immediate dialysis.
Pro Tip: Always protect your access arm. Never allow blood pressure readings or blood draws on your fistula/graft arm.
Preparation: Nurses prepare the machine and check your weight to calculate how much fluid needs to be removed.
Connection: Two needles are inserted into the fistula/graft, or the catheter is connected to the machine tubes.
The Session: The machine cleans the blood, removes excess water, and monitors your blood pressure.
Recovery: You may feel tired or dizzy (due to low blood pressure) immediately after a session. You will be monitored for about 30 minutes before heading home.
Like any chronic treatment, HD has risks that require careful monitoring:
Fistula and Graft Issues
Stenosis (Narrowing): Warning signs include difficulty with needles or poor blood flow. This is often fixed with a fistuloplasty (a balloon procedure).
Thrombosis (Clotting): If you can no longer feel the “buzz” (thrill) in your fistula, it is a medical emergency. Seek help at a kidney hospital immediately.
Catheter (Line) Issues
Infection: Signs include fever, chills, or discharge around the exit site. Requires urgent antibiotics.
Blockage: Can often be cleared with “clot-busting” medication.
Many patients drive themselves or are dropped off by family. However, Hospital Transport is available for those who cannot travel independently. Note that shared transport can increase the length of your day due to multiple pickups.
| Feature | Haemodialysis (HD) | Peritoneal Dialysis (PD) |
| Effort | Less work for the patient | Requires daily self-care |
| Social | Meet other patients in the unit | Done in private at home |
| Diet | Stricter fluid/food limits | Generally more flexible |
| Medical | Regular access to nurses/doctors | More independence |
Haemodialysis is a commitment, but it is a highly effective way to manage kidney failure for many years. By staying informed and protecting your vascular access, you can maintain a high quality of life.
Ready to track your health? Use PKB (Patients Know Best) to monitor your kidney blood results and dialysis data in real-time.
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