Dialysis: What to Expect

The first month is about finding your rhythm: a steady schedule, a comfortable chair setup, and small habits that make treatments easier. Plans vary by center—this is a plain-English overview.

Your weekly rhythm

Schedule: most people go 3 days/week (e.g., Mon–Wed–Fri or Tue–Thu–Sat).
Session length: usually 3–5 hours on the machine, plus check-in and wrap-up.
Energy curve: you may feel tired after; many people plan quiet time post-treatment.

First visit flow (typical)

Check-in: weight, blood pressure (BP), symptoms, any new meds or changes.
Access prep: catheter dressing check or fistula/graft cleaning; numbing if used.
Needles (if AVF/AVG): two needles go in—one pulls blood to the dialyzer, one returns it.
Heparin: a blood-thinner during treatment to keep the circuit from clotting.
During treatment: BP and symptoms watched; fluid removal (ultrafiltration) adjusted to keep you comfortable.
Coming off: needles out with pressure and bandages; re-check weight and BP; a brief look for bleeding or dizziness.

Comfort & routine in the chair

Clothing: sleeves that roll up easily; layers—rooms can feel cool.
Setup: pillow/blanket, headphones, a book or show downloaded, charger.
Motion: gentle ankle pumps and wiggles help reduce cramps; ask what’s OK with your access.
Food & drink: centers differ—ask what’s allowed during treatment.

Access basics (quick)

Catheter: keep dressing clean/dry; no tugs; report fever or redness.
Fistula/Graft: protect the arm (no BP/IVs), feel the thrill daily; call if it’s weak/gone.
Needling style: rope-ladder or buttonhole—your center will explain what they use and why.

Fluid, weight, and “dry weight”

Target (dry) weight: your “no-extra-fluid” weight—dialysis aims to bring you close to this.
Between sessions: many people limit fluid and salt to avoid large gains (which can cause cramps and low BP).
Tips: smaller sips spread out, ice chips, lemon wedges, sugar-free gum, and lower-salt meals help thirst.

Common feelings & fixes

Low BP/light-headed: tell staff; they can lower fluid removal, lay you back, give fluids, or adjust next time.
Cramps: slow fluid removal, warmth, gentle stretches; ask about tweaks for the next session.
“Dialysis hangover” (fatigue, fog): hydrate as directed, a snack after, and a planned rest window often help.
Itchy skin: moisturize; ask about phosphorus control and other causes if persistent.

Labs & medicines (clinic side)

Monthly labs: hemoglobin, iron markers, electrolytes, albumin, and more to fine-tune care.
In-center meds: some get IV iron or ESA injections; nurses will explain timing and side effects.
At home: phosphate binders with meals/snacks, BP meds, vitamins—bring a list with exact times/doses.

Between treatments

Track: daily weight, home BP (if you have a cuff), swelling, shortness of breath, new symptoms.
Meals: balanced protein, mindful sodium; ask the dietitian for a simple plan that fits your life.
Movement: short daily walks or light exercises can improve energy and cramps.
Logistics: reliable rides, backup plans, and an alarm/calendar reminder reduce missed sessions.

People you’ll meet

Dialysis nurse/tech: day-to-day treatment, access care, and blood pressure/cramp troubleshooting.
Nephrologist: rounds regularly; sets your prescription and long-term plan.
Dietitian: food, fluids, phosphorus/potassium, and weight goals.
Social worker: stress, transportation, work/benefits paperwork, and community resources.

When to call (don’t wait)

Call the clinic now: fever, chills, new redness/pus at access, bleeding that won’t stop, severe cramps, chest pain, or shortness of breath.
Go to ER/911: severe trouble breathing, chest pain that doesn’t ease, confusion, or you faint.

Questions to ask: What’s my current dry-weight goal? How do we adjust if I cramp or get dizzy? Which symptoms mean “call now” vs. wait for my next session?

Educational only. Your dialysis team will tailor the plan to you.