Dialysis Life Guide: What to Expect and How to Thrive
This guide explains what dialysis is, how it works as a treatment for advanced kidney failure, and practical tips for managing daily life while on dialysis.
Dialysis is a life-saving treatment that replaces kidney function when your kidneys can no longer filter waste and excess fluid from your blood. There are two main types: hemodialysis, done at a clinic 3 times a week, and peritoneal dialysis, which you can do at home daily. With proper care and support, most people on dialysis can live active, fulfilling lives for many years.
Overview
Dialysis is a life-sustaining medical treatment for end-stage renal disease (ESRD, also called end-stage kidney disease), a condition where your kidneys have lost 85–90% of their ability to filter waste, excess fluid, and electrolytes from your blood. It does not cure kidney disease, but it replaces the key functions of healthy kidneys to keep you alive. Many people on dialysis are also eligible for a kidney transplant, which offers better long-term outcomes for most patients.
Signs & Symptoms That Indicate Dialysis May Be Needed
- Extreme, unexplained fatigue
- Swelling in the legs, ankles, feet, or face from fluid buildup
- Shortness of breath with light activity
- Persistent nausea, vomiting, or loss of appetite
- Confusion or trouble concentrating
- Reduced urine output
- Hard-to-control high blood pressure
Causes & Risk Factors for Kidney Failure Requiring Dialysis
The most common causes of kidney failure that require dialysis are diabetes (high blood sugar damages kidney blood vessels over time) and high blood pressure (hypertension, which strains the tiny filtering units in your kidneys). Other causes include glomerulonephritis (inflammation of the kidney filters), polycystic kidney disease (a genetic condition where fluid-filled cysts grow in the kidneys and damage tissue), and long-term urinary tract blockages from kidney stones, an enlarged prostate, or certain cancers. Risk factors for developing ESRD include a family history of kidney disease, heart disease, and being Black, Indigenous, or Latinx, groups that face disproportionately high rates of kidney failure due to systemic healthcare disparities and higher rates of underlying conditions like diabetes and hypertension.
Diagnosis: When Dialysis Is Recommended
Your doctor will diagnose kidney failure using blood tests that measure your creatinine level (a waste product removed by the kidneys) and your glomerular filtration rate (GFR, a measure of how well your kidneys filter blood per minute). Dialysis is typically recommended when your GFR falls below 15 mL/min/1.73m², or if you have severe, life-threatening symptoms of kidney failure even with a higher GFR. Your care team will also discuss your overall health, lifestyle, and personal preferences to help you choose the right type of dialysis for you.
Treatment & Management: Types of Dialysis
| Type of Dialysis | How It Works | Where It's Done | Frequency | Key Considerations |
|---|---|---|---|---|
| Hemodialysis | Blood is pumped out of your body through a dialyzer (artificial kidney) that filters out waste and excess fluid, then returned to your body. | At a dialysis clinic, or at home with specialized training | 3 times per week, 3–5 hours per session | Requires a vascular access (fistula, graft, or catheter) placed in your arm. Some people experience cramping or low blood pressure during sessions. |
| Peritoneal dialysis | The lining of your abdomen (peritoneum) acts as a natural filter. Sterile dialysis solution flows into your abdomen through a catheter, absorbs waste and fluid, then is drained out. | At home, or in some clinical settings | Daily: either 4–5 manual exchanges per day (CAPD) or automatic overnight exchanges with a machine (APD) | Requires strict sterile technique to avoid peritonitis (abdominal infection). You may feel mild bloating when the solution is in your abdomen. |
Living With Dialysis
Managing life on dialysis involves sticking to your treatment schedule, taking all prescribed medications (such as phosphate binders, blood pressure drugs, and erythropoietin for anemia), and following dietary guidelines to limit potassium, phosphorus, sodium, and fluid intake between sessions. Many people on dialysis continue working, traveling, and enjoying hobbies with some planning and support from their care team and loved ones. The average life expectancy on dialysis is 5–10 years for adults, though many people live much longer, especially if they are eligible for a kidney transplant.
Your vascular access (for hemodialysis) or peritoneal catheter is your lifeline. Never let anyone draw blood or take blood pressure from the arm with your fistula or graft, and report any redness, swelling, pain, drainage, or loss of the buzzing sensation in your access site immediately to avoid infection or clotting.
Common Side Effects & Risks
- Short-term side effects: Low blood pressure during hemodialysis sessions (causing dizziness, nausea, or muscle cramping), post-treatment fatigue, and itchy skin from waste buildup.
- Long-term risks: Access site infections, peritonitis (for peritoneal dialysis), anemia, weak bones from high phosphorus levels, and increased risk of cardiovascular disease.
- Your care team will monitor you with regular lab tests and check-ups to manage these side effects and reduce your risk of complications.
Medical Review Team
WellAlly Medical Editorial Team
This content is not a replacement for professional medical advice.
Recovery & management timeline
Weeks to months before starting treatment
Pre-Dialysis Planning
Meet with your nephrologist and dialysis care team to learn about hemodialysis and peritoneal dialysis options, choose the best fit for your lifestyle, and get your access (fistula, graft, or catheter) placed if needed. Start adjusting your diet and medication routine as directed by your care team.
0–30 days
First 30 Days on Dialysis
Attend all scheduled dialysis sessions, learn how to care for your access site or peritoneal catheter, work with a renal dietitian to adjust your meal plan to your new dietary needs, and track any side effects like dizziness, cramping, or bloating to share with your care team.
1 month and beyond
Ongoing Maintenance
Stick to your treatment schedule, follow dietary and fluid limits, take all prescribed medications, attend regular check-ups and lab tests with your nephrologist, and connect with support groups for people on dialysis to manage emotional and practical challenges.
Self-care steps
1Follow your renal diet guidelines
Work with a renal dietitian to create a personalized meal plan that limits potassium, phosphorus, sodium, and excess fluids to reduce waste buildup between dialysis sessions. Avoid processed foods, salty snacks, dark colas, and high-potassium foods like bananas, oranges, and potatoes if directed by your care team.
2Care for your dialysis access daily
For hemodialysis: Check your fistula or graft daily for a steady buzzing sensation (thrill) and report any loss of feeling, pain, redness, swelling, or drainage to your care team right away. For peritoneal dialysis: Follow strict sterile technique when connecting and disconnecting your dialysis supplies to prevent peritonitis (abdominal infection).
3Stay active within your limits
Light exercise like walking, stretching, or gentle yoga can boost energy, improve mood, and help control blood pressure. Talk to your care team before starting any new exercise routine to make sure it is safe for your health status.
4Track your symptoms and lab results
Keep a daily log of your weight, blood pressure, fluid intake, and any side effects like cramping, itching, or fatigue. Attend all scheduled lab tests to monitor your kidney function, anemia, and bone health so your care team can adjust your treatment as needed.
When to seek medical help
Seek urgent medical care immediately if you experience any of the following: Fever, chills, or redness/swelling/pus at your dialysis access site; Severe chest pain, shortness of breath, or difficulty breathing; Confusion, severe headache, or seizures; Rapid weight gain (more than 3–5 pounds in 1–2 days) from fluid buildup; Severe vomiting or diarrhea that prevents you from keeping fluids down; No urine output for more than 24 hours; Severe abdominal pain (a sign of peritonitis for peritoneal dialysis patients).
Frequently asked questions
Can I work while on dialysis?
Will I have to follow a strict diet forever?
Is dialysis painful?
Can I travel while on dialysis?
Sources
- 1
- 2
- 3Mayo Clinic - DialysisSource
- 4
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Medical Editorial Team · Last reviewed October 9, 2026. · Read our editorial policy