Dialysis

Treatment for Patients with Kidney Disease and Failure

When a patient's kidney fails, the body cannot remove waste or regulate fluids and chemicals in the blood. Dialysis treats kidney failure by removing harmful substances in the blood that the kidneys are unable to filter out.

Loyola doctors and the staff at the Loyola Center for Dialysis on Roosevelt will work closely with you, your family and your nephrologist to coordinate all aspects of your dialysis care, whether hemodialysis is provided at the center or you do peritoneal dialysis at home.

The outpatient dialysis center provides hemodialysis six days a week, and a special team sets up and trains patients who choose to do peritoneal dialysis at home. When needed, acute inpatient dialysis is available at Loyola University Medical Center.

Why Choose Loyola for Dialysis?

Loyola’s nephrologists have extensive experience treating acute and chronic kidney diseases in children and adults. They actively participate in research, including the development and evaluation of new dialysis therapies. As faculty at Loyola University Chicago Stritch School of Medicine, our doctors perform and teach the latest in medical treatments, patient care and surgical techniques.

The Loyola Center for Dialysis on Roosevelt is dedicated to serving each individual’s needs, whether a patient is newly diagnosed with kidney failure or requires maintenance treatments for chronic kidney failure. Our goal is to help you live your life comfortably and conveniently.

The center is fully staffed and open 5:30 am – 9:30 pm, Monday – Saturday. The patient-to-dialysis technician ratio is 4:1. A peritoneal nurse is at the facility weekdays and on call 24 hours a day Saturday and Sunday.

Loyola’s dialysis center physicians and staff work closely with the kidney transplant team and will keep you in optimal health if you are waiting for a transplant. Loyola started performing kidney transplants in 1971, and our surgeons are skilled in both kidney and multi-organ transplants.

If you have questions about kidney disease and dialysis, our healthcare team is here to answer your questions even before you are a dialysis patient. We invite you to schedule a consultation with your care team to discuss these topics and more:

• Financial and insurance issues
• Hemodialysis
• Home dialysis
• Medications
• Renal nutrition
• Transplant surgery
• Transportation

What Does Kidney Dialysis Do?

There are two types of dialysis that treat chronic and end-stage kidney disease:

• Hemodialysis, which removes blood from the body, sends it across a filter to remove harmful substances and then returns the blood to the body.
   
• Home peritoneal dialysis, which uses the blood vessels in your abdominal lining (peritoneum) rather than your kidneys; it uses a fluid that aids filtration and flows in and out of your abdominal lining. After thorough training, patients can give themselves treatments at home or while traveling.

Patients who receive hemodialysis usually have treatment three times a week, and each treatment takes about three to four hours. Treatment starts by linking blood vessel access to the hemodialysis machine; you then will relax in a recliner chair until the process is complete.

Apart from the initial needle insertion, it is a painless treatment, and Loyola’s staff will monitor you for fluctuations in blood pressure. Learn more about kidney dialysis.

Peritoneal dialysis treatments are done at home seven nights a week while the patient is sleeping. Patients and caregivers are taught how to handle the equipment, initiate the dialysis treatment, keep treatment records and monitor the machine and blood pressure. Supplies are delivered to your home, and you will have blood tests about once a month to monitor how well the procedure is working for you.

In addition to removing wastes from the body, dialysis can also help relieve some of the symptoms of kidney failure, which include:

• Increased blood pressure
• Itchiness
• Jaundice (yellowness of the skin)
• Nausea
• Pericarditis (inflammation of the sac surrounding the heart)
• Respiratory problems
• Swelling
• Tiredness

What to Expect with Kidney Dialysis

To optimize dialysis, access to your bloodstream needs to be created to allow continuous and high volumes of blood to circulate through the hemodialyzer.

Creating the access portal is a minor surgical procedure. If your kidney disease has progressed quickly, you may not have time for the placement of an AV (arteriovenous) fistula or AV graft prior to starting dialysis. But if it is possible, patients should set up vascular access well before starting dialysis, as AV fistulas and AV grafts both need time to mature before they are ready for use.

Dialysis access procedures can be performed at Loyola as an outpatient, take about two hours and can be performed under local anesthesia. They are performed several weeks prior to starting dialysis in the case of a fistula or a graft. If dialysis is urgently needed, the placement of a catheter in the neck, groin or abdomen may be the best course of treatment.

You can expect the following with each kind of dialysis access procedure:

• Fistula — This is the most preferred treatment, which connects an artery to a vein to increase blood flow into the vein. Depending upon the quality of your artery and vein, your vascular surgeon will try to construct the fistula with one incision in the forearm of your nondominant arm. An AV fistula causes extra pressure and extra blood to flow into the vein, making it grow large and strong. The larger vein provides easy, reliable access to blood vessels. An AV fistula is recommended because it provides good blood flow for dialysis, lasts longer than other types of access and is less likely to cause dialysis complications for patients. After surgery, the fistula maturation process takes three to six months. The vein increases in size and may look like a cord under your skin.
   
• Graft — If you cannot receive a fistula because of a too small or blocked vein, your vascular specialist may construct a graft using a plastic tube, which acts as a vein and can be used for dialysis access. Your doctor sews the graft to one of your veins and connects the other end to an artery. The graft may be placed straight or form a loop under the skin either in your lower arm, upper arm or sometimes in the leg. A graft placed between an artery and vein usually can be used for dialysis within two to six weeks, after it has healed sufficiently.
   
• Catheter — This is used as a temporary access, where a catheter is inserted into a vein in the neck, chest or leg near the groin. A nephrologist or an interventional radiologist performs the venous catheter placement procedure. If a patient needs to start hemodialysis right away, a venous catheter will work for several weeks or months until a surgeon can perform a long-term access surgery and the AV fistula or AV graft has time to mature.

What are the Risks of Dialysis?

Dialysis can help end-stage kidney disease and chronic kidney disease (CKD) patients live longer, more productive lives. However, you should know that complications are possible. The risks of dialysis include:

Hemodialysis and peritoneal dialysis are painless, but you may experience some discomfort when the needles are placed in your fistula or graft. If you experience a drop in blood pressure, you may feel nausea, confusion, have a headache or cramps or vomit.

You may also feel some fullness in the abdomen. Patients using peritoneal dialysis also may experience an abdominal infection (peritonitis) as an occasional complication, although this will become infrequent as you learn how to perform the process.

You should talk with your doctor about which form of dialysis best suits you. Peritoneal dialysis may not be appropriate for patients who have had numerous abdominal surgeries or you are obese.

Our Dialysis Team

Vinod K. Bansal, MD Nephrology	Julia Schneider, MD Nephrology
David J. Leehey, MD Nephrology	Kavitha Vellanki, MD Nephrology
Benjamin Ling, DO Nephrology	Anuradha Wadhwa, MD Nephrology