In-Center Kidney Dialysis: What Caregivers Can Expect

Chad Birt

Written by Chad Birt on Fri Jun 23 2023.

Couple holding each other.

People with kidney failure or end-stage renal disease (ESRD) often need dialysis to keep waste and other toxins from building up in their bloodstream. Dialysis uses a machine called a dialyzer to do the kidneys' job. It draws blood from the patient, filters it, and then returns the cleaned blood to the body. 

The procedure has helped countless people with kidney disease live healthier and more independent lives. But, like any chronic disease treatment, it’s crucial you and your family member or loved one know what to expect. 

There are several types of dialysis, including home hemodialysis, home peritoneal dialysis, and in-center hemodialysis. This article specifically discusses in-center hemodialysis and highlights things caregivers and their family members or loved ones can expect.  

Does Hemodialysis Require Surgery?

Yes. Before your loved one begins in-center hemodialysis, they undergo minor surgery to make it easier to access their bloodstream. Depending on your loved one’s age and health history, they may get:

  • Arteriovenous Fistula (AV fistula): An AV fistula connects an artery to a vein in the arm.

  • Arteriovenous graft (AV graft): An AV graft is a soft, hollow tube that connects an artery to a vein in the arm. Your loved one may need an AV graft if their arteries or veins are shorter-than-average.

Arteriovenous fistulas and grafts make it easier to filter blood from the body and speed up dialysis treatment.

What Can Someone Who’s Never Undergone In-Center Hemodialysis Expect?

In-center hemodialysis is a long-term commitment that will transform your caregiving routine. Let’s break it down:

Regular Visits

Your loved one will visit the dialysis center three times a week, with each appointment lasting between three and four hours. Before each session, a kidney specialist weighs your loved one to determine how much fluid weight they’ve gained since the last treatment and checks their blood pressure.

Potential Side-Effects

Dialysis appointments can be physically and emotionally draining.  “Try to have a positive attitude and remember that dialysis is essential for keeping your loved one healthy,” said Mark Joseph, founder of Parental Inquiries and a former dialysis caregiver. “It’s essential to know what to expect before each appointment - such as possible side effects.”

Kash Yap, MD, a general practitioner and former physician-on-duty at a Fresenius dialysis clinic, agrees. “Patients often complain of numbness and muscle aches after a session. As a caregiver, you can help manage these symptoms by massaging the affected areas. What’s more, underlying kidney problems cause dry, itchy skin. This can be relieved by creams and supportive treatment.”

Restricted Fluid Intake

People on dialysis need to restrict their fluid intake. “Your loved one might not be allowed to drink more than one liter of fluid per day,” Yap said. “This is difficult for many patients. Having a bottle with markers can help you budget water throughout the day. Ice chips also help.”

Coordinated Care

Chronic kidney problems increase the risk of heart disease and other medical issues. Continue visiting your loved one’s doctors throughout dialysis treatment, including their primary care physician, endocrinologist, and cardiologist. These specialists can coordinate all aspects of care and make living with chronic kidney disease easier.

What Can Caregivers Do to Make In-Center Kidney Dialysis Easier?

Now that you know what to expect from dialysis, let’s look at what you can do to make appointments easier.

Pack a To-Go Bag

Dialysis appointments can take up to six hours, so think through ways to pass the time. “I got in the habit of preparing a ‘to-go’ bag for each of my grandma’s appointments,” Joseph said. “It included snacks, entertainment options, and anything else she needed for the dialysis session.”

Bring a Blanket

Dialysis centers are kept cool to prevent bacterial and virus growth, but the low temperatures can make for a chilly experience. Pack a blanket or shawl that your loved one can cover up with.

Caregiver Tip: Many caregivers tell us they dress in layers when attending dialysis appointments. If it gets too hot, take the top layer off.

Provide Moral Support

Sitting in a sterile medical environment for over 12 hours a week takes a mental and emotional toll. So, if possible, stick around for at least some of each dialysis appointment. Holding your loved one’s hand or chatting with them can help pass the time, reduce anxiety, and keep them comfortable. 

Plan Your Schedule Around Dialysis Sessions

Dialysis saps your energy. Try to avoid running errands or scheduling other appointments on dialysis days. “I made sure to help plan and schedule my grandmother’s dialysis care around her daily obligations, such as doctors appointments and errands,” Joseph said. “This reduced conflicts and made life much easier.”

Prepare Kidney-Friendly Foods

Your loved one’s diet directly impacts the success of their dialysis treatment. “Help with grocery shopping and meal prep,” said María E. Rodríguez, MS, RD, CSR, LND, a kidney dietician with over a decade of experience working in dialysis centers. “Learn how to prepare low sodium, low phosphorus meals they enjoy. If potassium is a concern, help them follow their diet.”

Ask for Accommodations

No one considers dialysis fun, but the procedure offers countless benefits. If your loved one dreads their appointments, don’t be afraid to ask for specific accommodations.

“I always tried to make my grandmother’s dialysis appointments comfortable,” Joseph said. “Often, I would ask the staff to dim the lights or turn on some relaxing music to create a more calming atmosphere.” 

Stay Positive

Caring for a loved one is hard work, especially if they’re living with a chronic illness. At times, you will feel sad and tired…maybe even defeated. But remember that feelings are passing. They aren’t permanent nor do they say anything about you. Remember: A good attitude and a willingness to keep on keeping on can help you on this journey.


Learning your loved one needs kidney dialysis can be scary. But you can take steps to become their advocate and ensure treatment sessions are as comfortable and stress-free as possible. “It may take some time to adjust,” Joseph said. “But with enough planning and preparation, you can ensure your loved one does not miss out on their favorite activities, stays active, and manages the side effects of dialysis.”

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Chad Birt
Chad Birt

Chad Birt is a freelance medical writer who resides in Astoria, Oregon. When he isn't behind a keyboard, you can find him hiking, camping, or birdwatching with his wife Ella and their two dogs, Diane and Thoreau.