Preparation for kidney dialysis depends on the type of treatment being used. Hemodialysis can begin with little preparation by using a temporary access site. When time allows, a surgeon prepares a vascular access, the place on the body where blood is siphoned and returned. This surgically prepared site, usually in the forearm, provides a more stable access area for repeated hemodialysis.

The hemodialysis machine is often described as an artificial kidney. However, dialysis cannot replace all of the kidneys’ roles, which in addition to removal of wastes and excess fluid and salt include creation of hormones, activation of vitamin D and balancing of electrolytes.

Individually prescribed dialysis solution pumped around the machine’s filter draws impurities and excess fluids from the blood. Each session is usually performed two to three days a week and lasts three to five hours.

Hemodialysis patients pass the time with activities such as reading, computer work, socializing, napping or light exercise. People often experience fatigue after a session, but the treatment is generally painless except for insertion of needles. Hemodialysis is usually performed at a dialysis center and sometimes at a hospital. In some cases patients can use it at home.

Peritoneal dialysis (PD) requires more preparation. A surgeon inserts a catheter near the navel to allow access to the abdominal (peritoneal) cavity. A few inches of the catheter show outside the abdomen. This catheter remains within the patient, even between treatments. A full schedule of dialysis usually starts after a few weeks to allow healing.

The most popular form of peritoneal dialysis uses gravity to fill and empty the abdomen. A bag of dialysis solution is hung from a pole next to the patient. A tube connects the bag to the catheter in the patient’s abdomen. The solution passes into the abdominal cavity and the patient is disconnected when the bag is empty. The patient is allowed to resume normal activities while the solution remains in the abdominal cavity (dwell time).

After several hours, the patient connects the catheter to an empty bag on the floor. This bag is filled with the used dialysis solution and discarded. Draining and filling takes about half an hour. This exchange procedure is typically completed several times a day and through the night. Some forms of PD use a machine to help fill and empty the abdomen at night during sleep.