Are you about to start dialysis or do you have a relative who is about to start dialysis? You probably want to know what to expect during this big step and what the classic daily routine on hemodialysis looks like.
Are you affected by kidney disease yourself and will soon have to undergo dialysis for the first time? Or do you have friends or family who regularly undergo dialysis and are wondering how it all works? First of all, you should know that there are two different types of dialysis: peritoneal dialysis (PD) and hemodialysis (HD).
Peritoneal dialysis continuously cleans your blood via your peritoneum using a special fluid. The fluid must be changed regularly. Hemodialysis uses a dialyzer to clean the blood outside the body in a machine. To do this, people requiring dialysis usually go to a dialysis center three times a week for 4 to 5 hours. There are also some people who are fit enough to do this treatment themselves at home. You can find more info about the different types of treatment in other articles in the Mizu app.
In this article, we will focus on what the typical weekly rhythm is for a person doing hemodialysis at the center. Depending on whether it's a dialysis or non-dialysis day, the daily routine is fundamentally different. So what does a typical daily routine look like and what is there to consider?
Daily routine on dialysis days
The daily routine of a person undergoing dialysis can vary depending on the time of therapy. Usually, you have your fixed dialysis days (e.g. Monday, Wednesday and Friday) and a fixed time period when you dialyze. The situation is somewhat different if you do hemodialysis at home. Many dialyze daily, but for a shorter period of time. From a medical point of view, this is often healthier for your body.
1. What do I need to know before dialysis?
Preparation for dialysis often varies. Generally, you take your scheduled medications in the morning. In addition, it may be helpful to rub numbing cream on your shunt. This will prepare your arm for dialysis and significantly reduce pain during dialysis. Be careful not to wet your arm too much, however, or your vascular access attachment patch will have difficulty sticking to your skin. You should discuss the use of an anesthetic cream with your medical team beforehand.
Depending on the dialysis center, meals may be provided during dialysis. If this is not the case, you should eat a balanced meal that is adapted to dialysis beforehand. It is best to clarify this with your dialysis center and the doctor in charge before your first dialysis session.
In addition, it is recommended that you wear comfortable clothing and pack a few items to pass the time during dialysis. This could be a tablet, an exciting book or some headphones to listen to music.
Once you have made these preparations, you are ready to go to the dialysis center. As a rule, a cab company will take you there. It's best to contact your health insurance company directly to find out if the costs will be covered.
2. How does the preparation for dialysis proceed at the center?
When you arrive at the dialysis center, the first step is to go to the scales. This is necessary to find out how much water was removed from your body during dialysis by comparing your weight before and after dialysis. Why is this important, you may ask? Healthy kidneys produce urine, but in kidney failure this is sometimes no longer the case or is reduced. Therefore, the treatment must remove harmful substances as well as fluids that have accumulated in your body.
After the weighing you can already sit down on the place intended for you. As a rule, everyone has a fixed place, so you will get to know your room neighbors well over time during your dialysis sessions.
Then you wait for the first visit, during which your blood pressure is checked and your arm is disinfected and punctured. For this, two needles (=cannulas) are placed in your arm. The blood from your body flows into the dialysis machine via one needle, and the purified blood is returned to your body via the other.
3. How does dialysis work and what can you do during it?
Now the actual dialysis can begin. It usually lasts 4-5 hours. During this time, many centers have a second visit with the nurse or doctor to discuss your blood work, which is done at regular intervals, or to talk about adjustments to your medication.
Some centers also offer snacks or meals during dialysis. It is best to discuss this with your dialysis center in advance and take something yourself if needed.
What do you do during treatment? Some people use the time to read, sleep, work or listen to music. It is best to find an activity that you enjoy. The only important thing to know is that you must remain seated or lying down during the entire dialysis session, otherwise the needles could slip out of place.
You don't have to worry, though. Dialysis treatment is routine and the dialysis team will be here during the entire time. If you are not feeling well, you can always ask a nurse (sometimes by ringing a bell) for assistance. Also, you are not alone. The other people in your room are usually familiar with dialysis and will definitely be happy to help you.
4. I'm done with dialysis - now what?
When the dialysis is finished, the next step is to take out the needles. Then you squeeze the affected areas yourself with a swab for 5-10 minutes to completely stop the bleeding. Depending on your preference, the two accesses are pulled and squeezed at the same time or one after the other.
After a short break of about 15 minutes, you will be done with dialysis and will be picked up by your transportation service and taken back home.
The rest of the day varies from person to person. Some are very exhausted after dialysis and first take a nap or eat something. In general, you should avoid physically strenuous activities on the day of dialysis.
If you experience side effects after dialysis, such as headaches, dizziness, nausea or a drop in blood pressure, talk to your dialysis team directly. These symptoms can usually be managed by changing your medication.
Daily routine on non-dialysis days
There are usually 1 to a maximum of 2 days between two dialysis sessions. But how do these differ from days with dialysis and what should be considered?
1. How do non-dialysis days differ from dialysis days?
People with kidney failure usually spend a lot of time on dialysis. That makes it all the more important to think about how you want to use dialysis-free days. So plan - if you feel like it - activities with friends and family, exercise or consciously take time for yourself. Some people also find it helpful to talk to like-minded people about dialysis-related topics. The best way to do this is to find out about groups or patient associations in your area.
2. What should I keep in mind on dialysis-free days?
Even though it is important to take a break on dialysis-free days, there are still a few things you should keep in mind.
- Keep an eye on your diet - especially if the intervals between dialysis appointments are somewhat longer over the weekend. The topic of nutrition may seem extremely complex at first glance, but you are not on your own. Your dialysis team and nutrition counseling can help. Mizu also supports you with a nutrition guide and numerous dialysis-friendly recipe ideas.
- Also, make sure you stay hydrated outside of dialysis hours. Regular visits to the sauna and sports activities can help you with this through sweating. You can find more details about this and also other tips in other articles in the app.
If you feel tired and exhausted even on dialysis-free days, or if other symptoms occur, talk to your dialysis team about it. Especially in the beginning, it is often possible to adjust the individualization of your therapy and medication so that you can better enjoy your dialysis-free days!
