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How Does Dialysis Work?

How Does Dialysis Work?

Your kidneys are a vital part of your urinary system. They filter out excess waste and fluid from your blood. However, if you have kidney failure or end-stage kidney disease, these organs don’t work as they should. This is where dialysis comes in, taking over the work of your kidneys to keep you healthy.

At Metro Renal Associates, our team provides nephrology services to the communities in Washington, DC, and Capitol Heights, Maryland. Leading our team are three expert nephrologists: Kevin Griffiths, MDCosette Jamieson, MD; and Oyije Susannah Iheagwara, MD. We provide dialysis services when your kidneys aren’t working as they should.

Understanding the types of dialysis

Many things can lead to kidney disease or renal failure, including injuries, high blood pressure, and diabetes. When you reach end-stage renal disease, your kidneys aren’t able to function normally, causing toxic waste and excess fluid to build up in your blood. 

Dialysis is a way to filter the wastes and fluid in your blood when your kidneys aren’t healthy enough to do it themselves. It’s essentially a way to mechanically take over for your kidneys, either short or long-term.

There are two main forms of dialysis, which include:


During hemodialysis, you’re hooked up to a machine that takes the blood from your body, removes fluids and wastes in an artificial kidney, then returns it to your body clean. 

Most people need hemodialysis at least three times per week, with sessions lasting anywhere from three to five hours. You may also have hemodialysis done at home, which requires shorter sessions more often.

Peritoneal dialysis

Peritoneal dialysis uses your peritoneum, the lining of your abdominal cavity. This form of dialysis takes place at home and cleans your blood through a catheter in your abdomen. You can use a machine called a cycler, or perform it manually.

How hemodialysis works

Before you undergo hemodialysis, you need to have a procedure that allows the team to easily access your bloodstream. There are two ways to do this: an arteriovenous (AV) fistula or graft

With an AV fistula, the team connects one of your arteries and veins together. The team performs an AV graft if your vessels aren’t long enough to connect on their own.

Once you have the AV fistula or AV graft in place, you’re ready to begin dialysis. During hemodialysis, the team accesses the fistula or graft with a needle that connects to the dialysis machine.

The machine then removes your blood slowly through the access in your arm and cleans it. The blood goes through a filter, which cleans the blood using a special solution called dialysate. 

Once the blood is clean, it returns to your body through another needle and tube connected to a different area of your arm. The machine only removes a few ounces of blood at a time, and your blood pressure is constantly monitored to control the rate of blood being cleaned.

How peritoneal dialysis works

Similar to hemodialysis, you need to have a tiny surgical procedure before you start peritoneal dialysis. Instead of an AV fistula or graft, the team inserts a catheter into your peritoneum within your abdomen. About three weeks after this, you can start peritoneal dialysis. Peritoneal dialysis has two different subtypes: continuous ambulatory peritoneal dialysis (CAPD) and continuous cycling peritoneal dialysis (CCPD).

In a CAPD schedule, you connect the catheter to a tube that’s connected to a bag filled with fluid. This fluid flows into your peritoneal cavity. It takes around 10 minutes for the bag to empty, which is when you clamp off the tube and disconnect the bag from your catheter.

While the fluid is in your body, it collects excess waste and fluid from your peritoneal cavity. This process takes anywhere from an hour to an hour and a half. You are free to go about your normal activities during this time.

Once this part is done, you connect the catheter to an empty bag and allow the fluid to drain from your abdomen into the clean bag. You need to repeat these steps several times a day, and sleep with the fluid in your abdomen at night.

In a CCPD schedule, you use a machine called a cycler to automatically fill your abdomen with fluid and drain it multiple times throughout the night. There are different benefits and risks to hemodialysis, CAPD, and CCPD so our team can help you understand which is best for you. 

If you need dialysis and want to learn more about how it works, don’t hesitate to call one of our offices in Washington, DC, or Capitol Heights, Maryland today. You may also request a consultation using our convenient online booking tool.

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