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Hemodialysis: what happens, a center or home, your access, the problems, and living with it
For anyone starting or already on hemodialysis, anyone told they will need dialysis, anyone choosing between a dialysis center and home, and the family and friends beside them. It passes on, by name, what the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK, part of the NIH) says: what happens during a treatment, the choice of a center or home, how to get ready and protect your veins, the three kinds of vascular access, the changes to what you eat and drink, how to know it is working, the problems, and what happens if you decide to stop. It builds the questions to ask and prints a wallet card. Nothing is saved.
A word with a dotted line under it, like this, opens its official definition, quoted from a U.S. government glossary.
Right now
- Bleeding from your access that will not stop, chest pain, severe trouble breathing, or fainting? Call 911 (ours). NIDDK says you can lose blood if a needle comes out of the access or a tube comes out of the dialyzer.
- Your access is warm or red, you have a fever, or you cannot feel the vibration over it? NIDDK says check the access for signs of infection and let your dialysis center know if you cannot feel the vibration. Call your dialysis center the same day (ours).
- Thoughts of suicide, or all too much? Call or text 988, any hour, free (ours).
More help
- On this site: Kidney failure: choosing a treatment · Kidney disease · Anemia in kidney disease · Kidney disease and your bones · Kidneys, bladder and urine: find the right page.
- Alongside it: How your kidneys work · Caring for someone · Depression · Care at the end of life · My medicines.
- When it is hard to pay: When you need a doctor and can’t pay · Medical bills · Disability benefits. Getting ready: Get ready for your appointment.
- In an emergency: Help right now (988, 911). All our free tools.
Kidneys, bladder or urine, and not sure this is the right page? The pages on this site for bladder infections, kidney stones, blood in the urine, bladder pain, bladder leaks, the prostate, kidney disease and bedwetting, on one list.
Other guides on this site that go with this page
Free to read. We chose these ourselves; no professional did. Each guide was written with AI and has not been reviewed by a professional. They are general information, not advice.
- Peritoneal dialysis: how it works, by hand or by machine, the catheter, infection, and living with it: peritoneal dialysis: how it works, by hand during the day or a cycler at night, the catheter and the training, doing an exchange, infection and peritonitis, hernia and weight gain, food and liquids, and how to know it is working.
- Kidney transplant: the tests, the waiting list, the surgery, rejection, and living with a new kidney: kidney transplant: where a kidney comes from, the tests and the waiting list, a living donor, the surgery and your team, the first days, rejection and when to call the transplant center, the side effects of anti-rejection medicines, food, and paying.
- Amyloidosis and the kidneys: the types, the signs, the tests, and the treatment: amyloidosis and the kidneys: the five types (AL, AA, LECT2, hereditary, dialysis-related), who gets them, nephrotic syndrome and the other signs, the tests, the treatment for each type, caring for the kidneys, prevention and food.
- Paying for kidney failure treatment: Medicare, Medicaid, Social Security, insurance, and help with medicines: paying for kidney failure treatment: Medicare at any age, when it starts and ends, choosing a plan, a job plan and the 30 months, Medicaid and CHIP, SSDI and SSI, state programs, help for veterans and others, and help paying for medicines.
- Eating with kidney disease: salt, liquids, phosphorus, potassium, protein, and a dietitian: eating with chronic kidney disease (CKD), at any stage or on dialysis: why food matters, sodium and the 2,300 mg line, liquids, phosphorus and the PHOS additives, potassium and salt substitutes, protein, calories, heart-healthy fats, and medical nutrition therapy with a registered dietitian.
- Conservative management for kidney failure: care without dialysis, your right to decide, the care team, hospice, food, and how you may feel: conservative management for kidney failure: care without dialysis or a transplant; your right to decide; the care plan and team; who may choose it; hospice, which Medicare covers; food; how you may feel; and how long.
This page and its wording were written with AI (Claude) for Scarlet Beast (our AI policy). No doctor or nurse has reviewed it. The facts were read on October 20, 2026 on NIDDK’s (NIH) page Hemodialysis (last reviewed January 2018: an older page, so ask your team and your plan what is true for you today). The numbers (usually three times a week for about 4 hours at a center; three to seven times a week for 2 to 10 hours at home; home training of 4½ to 6 hours a day, 5 days a week, for 3 to 8 weeks; 2 to 4 weeks of supplies at home; almost a pint of blood a minute; a blood test once a month) are NIDDK’s, and we add none. Ours: the 911 line; calling the dialysis center the same day about a warm or red access, a fever, or no vibration; telling your team before you miss or stop a treatment; 988; the questions to ask; the card; the links to our other pages; and the order of the steps. What we left out: NIDDK’s reference, its pictures, its videos and its outside links; we name no medicines, no brands, no foods and no amounts of liquid (your dietitian sets them). Nothing you tick or type here is saved or sent.