You have been given this leaflet as your (or your child’s) kidneys are now working at a very low level.
We need to support the kidneys with a treatment called dialysis.
What is dialysis?
The kidney has many jobs but it’s main job is to ‘clean rubbish/waste’ from the blood and to remove extra water from the body. When the kidneys are not working properly, the rubbish/waste and water collect in the body and this makes you feel poorly. Dialysis is a treatment that helps the kidneys by removing water and rubbish/waste from the body.
Dialysis is usually used as a treatment until a kidney transplant is possible. How long the dialysis treatment will be needed will vary from person to person.
What types of dialysis are there?
There are two main types of dialysis:
Haemodialysis (He-mo-dye-a-lee-sis) or HD: This is a treatment that can be performed in hospital or at home. To have haemodialysis you need an operation to put a haemodialysis tube (catheter) into the side of the neck. Sometimes you can have an operation to have a fistula (which is where two blood vessels in the arm are joined under the skin) instead of a haemodialysis tube.
A dialysis machine is connected to the haemodialysis tube or to needles put into the fistula. The machine then removes blood from the body, cleans it and removes water and then the blood is given back. This does not hurt.
Peritoneal dialysis (Pe-ri-toe-neil dye-a-lee-sis) or PD: This treatment is done at home usually overnight. For this type of dialysis you need an operation to put in a different type of dialysis tube called a PD catheter. This tube goes into the tummy.
Whilst you sleep at night time, a dialysis machine is connected to the PD tube and a small amount of fluid is pumped around your tummy. This is left for about an hour and during this time the rubbish/waste and extra water gradually mix with the fluid and then everything is pumped out by the dialysis machine.
This happens again and again over night during sleep. This does not hurt. By the morning lots of the waste products and water have been removed and the dialysis machine can be carefully removed from the PD tube.
How do we decide which type of dialysis is the
right one?
There is no right type of dialysis – it is more important that the chosen type suits you and your family the best. With help from the children’s nephrology team, a shared decision will be made. Each type of dialysis has different good points and bad points.
Sometimes one of the types of dialysis may not be right for you. If this is the case the children’s nephrology team will tell you. Once you have had time to think about the different dialysis treatments, we will provide you with more information. If you have any questions, please ask the children’s nephrology team
Quick Guide to Dialysis Types
Hospital Haemodialysis (HD)
What will I need to have dialysis
- A dialysis catheter ‘tube’ (picture A) or a fistula (picture B).
How often do I need it?
- Daytime treatment. 3-4 times per week.
- 3-4 hours each session (plus travelling time).
What restrictions will there be?
- Contact sports and swimming (with catheter/tube).
How long will I need to stay in hospital?
- 1-2 nights to have catheter/tube put in or fistula formed.
- Attendance to hospital for each dialysis session.
Who does the dialysis?
- Dialysis nurses.
What training is needed?
- No training requirement.
Will school have be missed?
- Yes – when travelling to and attending dialysis.
- Hospital teachers are available during HD sessions.
What are the common side effects/risks?
- Vomiting, headache, tiredness, leg pains.
- Line infection (if dialysis catheter present), fistula infection/bleeding (if fistula present).
Home Haemodialysis (HHD)
What will I need to have dialysis
- A dialysis catheter ‘tube’ (picture A) or a fistula (picture B).
How often do I need it?
- Daytime/Evening treatment. 3-5 times per week.
- 3-5 hours each session.
What restrictions will there be?
- Contact sports and swimming (with catheter/tube).
How long will I need to stay in hospital?
- 1-2 nights to have catheter/tube put in or fistula formed.
- Once training complete, clinic once every 4 weeks.
Who does the dialysis?
- Parent/carer or young person.
What training is needed?
- Technical to learn.
- Training to perform dialysis will take a number of weeks.
Will school have be missed?
- No.
What are the common side effects/risks?
- Vomiting, headache, tiredness, leg pains. (These are less common than with hospital HD).
- Line infection (if dialysis catheter present), fistula infection/bleeding (if fistula present).
Peritoneal Dialysis (PD) at home
What will I need to have dialysis
- A peritoneal dialysis ‘PD’ catheter seen in picture E.
How often do I need it?
- Overnight treatment.
- 6-7 nights per week. 8-12 hours each session.
What restrictions will there be?
- Contact sports.
- Swimming (for the first 6 weeks after insertion).
How long will I need to stay in hospital?
- 1-2 nights to have the PD catheter put in.
- 1-2 nights once starting on PD (usually 2 weeks later).
- Clinic once every 4 weeks once established on dialysis.
Who does the dialysis?
- Parent/carer or young person.
What training is needed?
- Training to perform dialysis usually takes 2-3 weeks.
- Easier to learn.
Will school have be missed?
- No.
What are the common side effects/risks?
- Infection (around the tube: ‘exit site infection’ or within the abdomen ‘peritonitis’), poor appetite, abdominal pain (when starting PD-usually temporary), hernia, testicular swelling (known as hydrocele).
Further information
Useful Websites
infoKid – YouTube video
Charities/support groups
Contact details
The specialist nursing team
Please contact the specialist nursing team to discuss your/your child’s options further. They can then provide further information about your chosen dialysis option.
The specialist nursing team can be contacted on the telephone numbers below (Monday to Friday 9am – 5pm).
