Dialysis: Questions and Answers

If you have chronic kidney disease (CKD) that progresses to end stage renal disease (ESRD), you will want to know all of the dialysis choices that are available to you. Below are some frequently asked questions.

If I have kidney disease, will I need dialysis?

The early stages of CKD can last for many years and you don’t need dialysis. But if your kidneys fail, dialysis or a kidney transplant will be needed to keep you alive.

If I have kidney disease, how long will it be before I need to start dialysis?

That depends on what stage your CKD is in and how quickly it progresses.

Can I take a tour of a dialysis center before I start dialysis?

Yes. To arrange your tour at a DaVita dialysis center, call DaVita Guest Services at 1-800-244-0680. 

My doctor said I will need to go on dialysis in six months to a year. What does this mean?

It’s time for you to learn about all the treatment options for kidney failure: peritoneal dialysis (PD), hemodialysis and kidney transplant. You have some choices to make. If you do PD, which is a home dialysis option, you will need to have a tube surgically placed in your abdomen. If you do hemodialysis, whether in center or at home, you will need to have surgery soon to create a vascular access and allow it to heal. If you want a kidney transplant, talk with your nephrologist about how to get on the transplant list or ask a friend or family member to donate a kidney.

When should I start dialysis?

National Kidney Foundation (NKF) guidelines recommend you start dialysis when your kidney function drops to 15 percent or less—or if you have severe symptoms caused by your kidney disease, like shortness of breath, fatigue, muscle cramps or nausea and vomiting. Your doctor will help you decide, based on lab tests that measure how much kidney function you have left and on your symptoms.

How is dialysis paid for?

Private insurance generally covers treatment for kidney failure. If you don't have private insurance, you may be able to get coverage through federal or state-funded healthcare programs, such as Medicare or Medicaid.

Most people qualify for Medicare when they need dialysis or a transplant, even if they are under age 65. Medicare pays for 80 percent of treatment for kidney disease when kidney function has dropped to 10-15 percent, or when your doctor justifies it.

It’s important to get ready for dialysis or a transplant well in advance—when your kidney disease reaches stage 4 chronic kidney disease. Any type of dialysis will require surgery—usually outpatient—to create an access for your treatments.

I can't have a transplant—can I do dialysis for the rest of my life?

Yes, dialysis is something you can do for the rest of your life. And, most people on dialysis enjoy a good quality of life. Some people have been on dialysis for 30 years or more without getting a transplant. How long you can live on dialysis, and how well you do, will depend on a number of things, including how healthy you are, your attitude, your quality of healthcare and how much you take an active role in your care.

Sign up for no-cost Kidney Smart® education class to learn more about kidney disease. Also, check into joining a kidney patient organization or the DaVita.com discussion forums to connect with others like you..

If I start hemodialysis, how often will I have to get treatments?

The usual schedule for in-center hemodialysis treatments is three times a week. You will likely have the same morning or afternoon time for each treatment. The length of your treatment depends on what is prescribed. Three to four hours is common.

If I start PD, how often will I have to get treatments?

PD is commonly done on a nightly basis using an automated cycler machine while a person sleeps. A patient will typically be connected to the cycler for 8 to 10 hours each night and be free of dialysis during the day. Some people will choose to do manual PD, which usually means doing four to five exchanges per day. Each exchange takes 20 to 30 minutes, and they need to be spread out over the whole day to clean the blood well. 

Know your options

There are several dialysis treatment options available. Talk to your doctor about the types of dialysis and which one would be best for your health and lifestyle needs.