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What to Expect During Your First Dialysis Treatment: A Step-by-Step Guide
Facing your first dialysis treatment can feel overwhelming, but knowing what to expect can ease your anxiety. Whether you're starting hemodialysis (in-center or home) or peritoneal dialysis, this guide walks you through the entire process—from preparation to recovery—with clear, compassionate advice.
Key Takeaway: While dialysis is a major life adjustment, millions of patients lead active, fulfilling lives with treatment. This step-by-step breakdown will help you feel prepared and in control.
What to Bring
- Comfortable, loose-fitting clothing (preferably with short sleeves)
- Blanket or sweater (treatment rooms can be chilly)
- Books, tablet, or other quiet entertainment
- List of current medications
- Insurance cards and ID
Medications to Discuss with Your Team
- Blood pressure medications (may need adjustment)
- Phosphate binders (often taken with meals)
- Erythropoietin (EPO) for anemia
- Avoid diuretics unless directed
Dietary Guidelines for First-Timers
- Limit fluids (typically 32–50 oz/day)
- Reduce high-potassium foods (bananas, potatoes)
- Control phosphorus (dairy, nuts, soda)
- Eat protein-rich meals (eggs, lean meats)
Pro Tip
Ask your clinic for a renal dietitian consultation—most are covered by insurance.
1. Arrival and Check-In (30 mins early)
- Paperwork and insurance verification
- Tour of the facility
- Meet your care team (nephrologist, nurses, techs)
2. Vital Signs and Assessment
- Weight check (determines fluid removal goal)
- Blood pressure, pulse, temperature
- Access site inspection (fistula, graft, or catheter)
3. Vascular Access Preparation
- Fistula/Graft: Needle insertion (numbing cream available)
- Catheter: Dressing change and connection
- For PD: Abdomen examination for peritoneal catheter
4. The Dialysis Process (3–4 hours for HD)
- Blood flows through dialyzer (artificial kidney)
- Machines monitor blood pressure, fluid removal
- You can read, sleep, or watch TV
5. Monitoring During Treatment
- Nurses check for:
- Muscle cramps (from rapid fluid removal)
- Nausea or dizziness
- Blood pressure drops
First-Time Reality Check
It's normal to feel tired afterward—plan to rest for the evening.
Side Effect | Cause | Solutions |
|---|---|---|
Fatigue | Fluid/electrolyte shifts | Nap after treatment; adjust dry weight |
Low BP | Too much fluid removed | Reduce inter-dialysis weight gain |
Muscle Cramps | Electrolyte imbalance | Stretching; adjust calcium/magnesium |
Itchy Skin | Phosphorus buildup | Take binders; use fragrance-free lotion |
When to Seek Help
Chest pain, severe shortness of breath, or confusion.
- Schedule: Typically 3x/week for HD; daily for PD
- Lab Work: Monthly blood tests to adjust treatment
- Follow-Up: Nephrologist visits every 1–3 months
- Lifestyle Adjustments:
- Fluid intake tracking
- Exercise plans (walking, light weights)
- Emotional support (peer groups, counseling)
Needle insertions cause brief discomfort, but most patients adjust quickly. Topical anesthetics help.
Yes! Many clinics arrange "guest dialysis" nationwide. PD offers more flexibility.
Most notice improved energy within 2–4 weeks as toxins clear.
Your first dialysis session is a milestone—not an endpoint. With today’s technology and support systems, patients enjoy active lives for years or decades.
Action Plan:
Pack your dialysis bag (use our checklist above).
1
Write down questions for your care team.
2
Connect with peer mentors (ask your clinic).
3
You’ve Got This: Thousands have walked this path before you—and thrived. For personalized guidance, request a patient advocate through your clinic
