Hemodialysis: What It Is and What to Expect
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor provides Hemodialysis?
A nephrologist, a doctor who specializes in kidney problems, prescribes hemodialysis. At the start of each treatment, a dialysis nurse or technician places two needles into your arm. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What it is
Hemodialysis is a treatment to filter wastes and water from your blood, as your kidneys did when they were healthy. During treatment, your blood goes through a filter, called a dialyzer, outside your body. Hemodialysis helps control blood pressure and balance important minerals, such as potassium, sodium, and calcium, in your blood. Hemodialysis can help you feel better and live longer, but it is not a cure for kidney failure.
Why a doctor might recommend it
Kidney failure is the last stage of long-term kidney disease. Usually, you will go on dialysis when you have only 10% to 15% of your kidney function left. You also may need dialysis if your kidneys suddenly stop working.
How to prepare
One important step before starting hemodialysis is having minor surgery to create a vascular access. This is the place on your body where you insert needles so that your blood can flow out and back during dialysis.
- An AV fistula is the best type of long-term access. A surgeon connects an artery to a vein, usually in your arm. An artery is a blood vessel that carries blood away from your heart.
- If problems with your veins prevent a fistula, you may need an AV graft, which uses a man-made tube to connect an artery to a vein.
What happens during it
The dialysis machine pumps blood through the filter and returns the blood to your body. Waste products from your blood move into a dialysis solution. At a dialysis center, you usually have treatment three times per week. Each session lasts about 3 to 4 hours. Home hemodialysis is usually done three to seven times per week, with sessions that last between 2 and 10 hours.
Recovery
Standard hemodialysis can make you feel tired or washed out for several hours after each treatment. Wash the area around your access with soap and warm water every day. You will also have to change what you eat and drink.
Risks and side effects
A problem with your vascular access is the most common reason someone on hemodialysis needs to go to the hospital. Any type of access may become infected. An access may also have poor blood flow or blockage from a blood clot or scar. Sudden changes in your body's water and chemical balance during treatment can cause muscle cramps. They can also cause a sudden drop in blood pressure, called hypotension. Hypotension can make you feel weak, dizzy, or sick to your stomach.
Contact your provider if you notice signs of infection. These include redness, swelling, soreness, pain, warmth, or pus around the site. Contact your provider if you have a fever over 100.5°F (38.0°C). Also contact your provider if the arm where your catheter is placed swells and the hand on that side feels cold.
Call 911 or go to the emergency room if you have trouble breathing, chest pain or discomfort lasting two minutes or more, fainting or loss of consciousness, or bleeding that will not stop.
Who performs it
At a dialysis center, your team may include nurses, health care technicians, a dietitian, and a social worker. Your nephrologist works with a vascular surgeon, a surgeon who works with blood vessels, so that your access is in place in time.
Common questions
How long does a hemodialysis session last?
A session at a dialysis center lasts about 3 to 4 hours. Treatments are usually three times per week.
Does hemodialysis do everything healthy kidneys do?
No, hemodialysis can replace part, but not all, of your kidney function.
Can I have hemodialysis at home?
Yes, you can receive hemodialysis at a dialysis center or at home. Most dialysis centers require that you have a trained partner in your home during treatments.
How will I know if my hemodialysis is working?
You will know mostly by how you feel. Blood tests also show how well it works, and your dialysis center will test your blood once a month.
How does a direct primary care or concierge doctor fit in?
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
Sources
- National Institute of Diabetes and Digestive and Kidney Diseases - Hemodialysis
- MedlinePlus - Dialysis - hemodialysis
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
