Is dialysis always permanent?

Not always. When dialysis is started for sudden kidney injury, kidney function sometimes recovers enough that treatment can stop. When it is started for long-standing chronic kidney disease, it is generally ongoing unless a transplant becomes possible.

Can dialysis be done at home?

Yes, and more patients are candidates than commonly assume. Both peritoneal dialysis and home hemodialysis are done at home after training. Suitability depends on your medical situation, home setting, and willingness to take on the routine.

How long does an in-center treatment take?

A typical in-center hemodialysis session runs about four hours and is done three times a week, though the prescription is individualized based on body size, remaining kidney function, and laboratory results.

Can I still be considered for a kidney transplant on dialysis?

Yes. Being on dialysis does not rule out transplant, and referral for evaluation can happen before, during, or after dialysis has begun. Earlier referral generally means more options.

Dialysis Care

Dialysis care and planning, in-center and at home

The best dialysis experience starts months before the first treatment, with an unhurried conversation about which approach fits your life.

Last updated August 28, 2026

What is dialysis and when is it needed?

Dialysis takes over part of the work the kidneys can no longer do, removing waste products and excess fluid from the blood. It is usually considered when kidney function falls to roughly ten to fifteen percent of normal, or sooner if symptoms demand it. There are two broad approaches. Hemodialysis filters blood through a machine, either at a dialysis center about three times a week or at home on a more frequent schedule. Peritoneal dialysis uses the lining of your own abdomen as the filter and is done at home, either overnight on a machine or through exchanges during the day.

What are the dialysis options?

In-center hemodialysis is the most familiar form. Treatments typically run about four hours, three days a week, at a dialysis facility with staff handling everything. It suits people who prefer not to manage treatment themselves or who do not have space or support at home.

Home hemodialysis uses the same principle on a schedule you run yourself, usually shorter sessions more often. Many patients report feeling steadier between treatments because fluid and waste do not build up as much between sessions.

Peritoneal dialysis avoids needles entirely. A soft catheter placed in the abdomen allows fluid to be cycled in and out, most often overnight by a machine while you sleep. It offers the most day-to-day freedom and travels well, but it requires a clean space at home and consistent daily routine.

How do you prepare before dialysis begins?

Preparation is the part that most affects how well things go. Hemodialysis works best through an arteriovenous fistula or graft, created surgically in the arm, and a fistula needs weeks to months to mature before it can be used. Starting dialysis with a temporary catheter because there was no time to plan carries more risk of infection, so referral for access is made well ahead of the anticipated start.

Peritoneal dialysis requires its own catheter, placed some weeks before use. Alongside the surgical planning, there is training, and a transplant evaluation is started for patients who are candidates, because a transplant can sometimes be arranged before dialysis is ever needed.

How do you choose between dialysis options?

There is rarely one medically correct answer. The choice comes down to your other medical conditions, your work and travel patterns, whether you have support at home, how you feel about needles, and how much control you want over your own schedule. The decision is also not permanent. Patients move between modalities as circumstances change, and that is a normal part of long-term care rather than a setback.

What does ongoing care look like once dialysis has started?

Dialysis is one part of the plan, not the whole of it. Regular review covers whether treatments are removing enough waste and fluid, blood pressure and weight between sessions, anemia, bone and mineral levels, nutrition, and medication adjustments. Care is coordinated with your dialysis unit and your other physicians so nothing falls between them.

When should you ask for a nephrology referral?

Any of the following is a reasonable reason to be seen. If you are unsure, call the office and we will help you work out whether an appointment makes sense.

An eGFR below 20 that is continuing to fall
Fatigue, nausea, poor appetite, or itching that has come on alongside declining kidney function
Fluid retention or shortness of breath that is not responding to diuretics
A wish to understand home dialysis options before a decision is needed
A need to plan dialysis access ahead of time

Common questions

Is dialysis always permanent?: Not always. When dialysis is started for sudden kidney injury, kidney function sometimes recovers enough that treatment can stop. When it is started for long-standing chronic kidney disease, it is generally ongoing unless a transplant becomes possible.
Can dialysis be done at home?: Yes, and more patients are candidates than commonly assume. Both peritoneal dialysis and home hemodialysis are done at home after training. Suitability depends on your medical situation, home setting, and willingness to take on the routine.
How long does an in-center treatment take?: A typical in-center hemodialysis session runs about four hours and is done three times a week, though the prescription is individualized based on body size, remaining kidney function, and laboratory results.
Can I still be considered for a kidney transplant on dialysis?: Yes. Being on dialysis does not rule out transplant, and referral for evaluation can happen before, during, or after dialysis has begun. Earlier referral generally means more options.