What You Need to Know - National Kidney Foundation

HEMODIALYSIS:

What You Need to Know



National Kidney Foundation's Kidney Disease Outcomes Quality Initiative

Did you know that the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (NKF-KDOQITM) offers guidelines and commentaries that help your doctor and healthcare team make important decisions about your medical treatment? The information in this booklet is based on those recommended guidelines.

Stages of Kidney Disease

There are 5 stages of kidney disease. They are shown in the table below. Your doctor determines your stage of kidney disease based on the presence of kidney damage and your glomerular filtration rate (GFR), which is a measure of your level of kidney function. Your treatment is based on your stage of kidney disease. Speak to your doctor if you have any questions about your stage of kidney disease or your treatment.

STAGES OF KIDNEY DISEASE

Stage Description

Glomerular Filtration Rate (GFR)*

1

Kidney damage (e.g., protein in the urine) with normal GFR

90 or above

2

Kidney damage with mild decrease in GFR

60 to 89

3 Moderate decrease in GFR

30 to 59

4 Severe reduction in GFR

15 to 29

5 Kidney failure

Less than 15

*Your GFR number tells your doctor how much kidney function you have. As chronic kidney disease progresses, your GFR number decreases.

TABLE OF CONTENTS

When will I need to start treatment for kidney failure?. . . . . . . . 5

What does dialysis do to keep me healthy?. . . . . . . . . . . . . . . 6

How does hemodialysis work? . . . . . . 6

How does the dialyzer clean my blood?. . . . . . . . . . . . . . . . . . 8

Where is hemodialysis done? . . . . . . . 9

How long will each hemodialysis treatment last?. . . . . . . . 9

How do I know if I am getting the right amount of dialysis?. . . . . . . . 10

Can hemodialysis be done at home?. 12

Home hemodialysis versus a center: Pros. . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Cons. . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Can dialysis cure my kidney disease?.17

I have heard I might have to reuse my dialyzer for each treatment. Is this safe?. . . . . . . . . . . . . . . . . . . . . . 19

Will I need to follow a special diet? . . 19

What insurance coverage is available for dialysis? . . . . . . . . . . . . 21

Will dialysis change my lifestyle? . . . 22

Can people on dialysis travel?. . . . . . 22

Can people on dialysis continue to work?. . . . . . . . . . . . . . . . 23

Understanding your lab values. . . . . 24

My dialysis care team. . . . . . . . . . . . . 26

Where can I get more information? . 26

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Healthy kidneys clean your blood and remove extra fluid in the form of urine. They also make hormones your body needs for some important functions. When kidney failure occurs, treatment is needed to replace some of the important jobs your kidneys do. The treatments for kidney failure are hemodialysis, peritoneal dialysis, and kidney transplant. Learn all you can and speak to your doctor about which is the best choice for you.

This booklet is about hemodialysis. It is written for people who are already receiving hemodialysis, and for those who soon may need to start treatment for kidney failure. Information is based on recommendations from the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (NKFKDOQITM) Clinical Practice Guidelines.

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NATIONAL KIDNEY FOUNDATION

When will I need to start treatment for kidney failure?

Treatment is needed when someone has stage 5 chronic kidney disease (CKD), or kidney failure. Your doctor can tell your stage of kidney disease by checking your glomerular filtration rate (GFR). Your GFR can be estimated from the results of a blood test for creatinine, a waste product from muscle activity.

If your GFR falls below 15, you have kidney failure (CKD stage 5), and you will need to have a kidney transplant or dialysis treatment to replace the function of your kidneys.

If your GFR is less than 30, your doctor should talk to you about the different treatments for kidney failure. Ask about information classes in your area where you can learn more about treatment options for kidney failure. Learn all you can to make the best treatment choices for yourself and your family.

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