Dialysis
Haemodialysis and peritoneal dialysis — how each one works, how to look after the access, how to recognise early signs of trouble, and how to stay well between sessions.
Key Points
- Dialysis replaces what the failed kidneys can no longer do — it removes the waste products and the extra water from the blood, but it does not cure the underlying kidney disease.
- Haemodialysis is usually given three times a week, four hours each session, through a fistula in the arm (the first choice), a graft, or a tunneled catheter in the neck or upper chest.
- Peritoneal dialysis uses the lining of the belly as a natural filter, with a soft catheter placed through the abdominal wall — either four exchanges a day by hand, or one long overnight session by a machine.
- Daily exit-site care for the peritoneal catheter is the single most important thing you can do to prevent peritonitis: gentle cleaning with chlorhexidine, a thin layer of mupirocin or gentamicin ointment as your centre instructs, careful hand washing, a dry dressing, and a scheduled dressing change.
- Call the centre immediately for cloudy bag fluid, fever, belly pain, or any redness, swelling, or pus at the catheter exit — these are early signs of infection that need same-day treatment.
- For a haemodialysis fistula, feel for the buzz (the thrill) every morning; if you cannot feel it, call the centre right away — a fistula can clot off in hours.
- Between sessions, keep to your fluid and salt limit, take your phosphate binders with meals, take your blood-pressure medicines on schedule, and keep the anaemia injection appointments.
- Both haemodialysis and peritoneal dialysis are bridges that can be used for many years; many patients move between them as their situation changes, and most are working toward a kidney transplant when one is suitable.
Clinical review
Reviewed by Dr Osama Ashry Gheith, Consultant Transplant Nephrologist. Kuwait Center for Nephrology and Kidney Transplantation (KCNKT). Mansoura Urology and Nephrology Center, Egypt. Reviewed 1 August 2026.
About the Transplant Patient Portal
This chapter is part of ASNRT's bilingual (Arabic / English) transplant patient-education portal — 14 clinical chapters covering kidney transplantation from preparation through long-term follow-up, plus decision-aid tools for Ramadan fasting, drug-food interactions, and red-flag symptom triage.
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