Hemodialysis uses a machine to filter your blood. Most people have hemodialysis treatment in an outpatient dialysis center near home. When you travel, we can help you arrange treatment at a dialysis center near your destination.

In hemodialysis, providers need a way to carry blood from your body to the machine and back. Before dialysis starts, we will create a hemodialysis access, usually in your arm, known as an AV (arteriovenous) fistula or AV graft. If an emergency hemodialysis access is needed, your doctor may insert a hemodialysis catheter.

• AV fistula: A surgeon creates this by connecting an artery directly to a vein to allow for adequate blood flow for dialysis treatments
• AV graft: A surgeon creates this by joining an artery and a vein using a short, soft tube. This also allows for adequate blood flow for dialysis treatment.
• Catheter: A flexible tube is inserted into a large vein, usually a vein in the neck. The catheter has two lumens.
• Ellipsys Vascular Access System: Replaces the need for a surgical incision with a single, needle puncture in the arm.

During hemodialysis treatment:

• We insert two needles into the hemodialysis access. Each needle is connected to a soft, flexible tube that goes to the dialysis machine.
• If your hemodialysis access is a catheter, the flexible tubes are connected to the lumens
• Blood leaves your body through one of the flexible tubes
• Blood goes through a filter (dialyzer) in the dialysis machine to remove waste products and excess fluids
• Filtered blood returns to your body through the other flexible tube

At-Home Hemodialysis

We also offer at-home hemodialysis services for eligible patients. To participate in home dialysis, you will need to have a safe place with access to electricity where you can complete your dialysis treatment and a caregiver to support you.

We supply the necessary equipment and train you and your caregiver to manage your treatment. Our team provides 24-hour support if you have questions or concerns about hemodialysis.

Peritoneal dialysis is an at-home treatment that uses your abdominal lining (peritoneum) as a natural filter to remove waste products and extra fluid from your body. You use a special fluid (dialysis solution) to flush your abdomen in a process called an exchange.

Our dialysis experts are available by phone 24 hours a day if you have questions or concerns. We supply all the equipment you need and teach you and your caregiver how to manage your treatment.

There are two types of peritoneal dialysis:

Continuous Ambulatory Peritoneal Dialysis

You complete three to four exchanges each day. Each exchange takes under an hour to complete. The number of exchanges you need depends on whether your kidneys still have some function or don’t function at all.

During continuous ambulatory peritoneal dialysis, you:

• Empty a bag of dialysis solution into your abdomen through a catheter placed in the muscle of the abdominal wall
• Wait a few hours for your peritoneum to filter the solution
• Use the catheter to drain the used solution from your abdomen
• Discard the used solution

Continuous Cycling Peritoneal Dialysis

We provide you with a machine called a cycler. You connect the catheter to the cycler and exchanges happen automatically (typically at night while you are resting or asleep). Typically, you will also have fluid exchanges once or twice during the day, depending on your remaining kidney function.

Our nephrologists offer continuous renal replacement therapy for critically ill people who require intensive care. CRRT uses a machine to continuously remove waste products from blood. Our nephrology team manages the CRRT process to stabilize blood pressure and protect your heart from the stress of dialysis.