Questions About Dialysis

Dialysis is a treatment that does the work of healthy kidneys when they are no longer able to function properly. It removes waste products, excess fluid, and balances electrolytes in the blood. Children may need dialysis if they have:

• Acute kidney injury (sudden kidney failure)
• End-stage kidney disease (chronic kidney failure)
• Severe electrolyte imbalances
• Fluid overload that doesn't respond to medication

Dialysis is not a cure but a life-sustaining treatment that helps children feel better and stay healthy while awaiting recovery or transplantation.

There are two main types of dialysis used for children:

Dr. Hashim Raza Bukhari will recommend the best type based on your child's age, medical condition, family situation, and lifestyle.

Many children on dialysis lead full, active lives. Here's what to expect:

• School: Most children can attend school. Hemodialysis may require missing some school time, but many centers offer tutoring. Children on peritoneal dialysis can attend school normally.
• Activities: Children can participate in most activities. Contact sports may be limited due to access sites.
• Diet: Dietary restrictions continue during dialysis, though sometimes they become less strict.
• Travel: Travel is possible with planning. Dialysis centers can arrange treatments at other locations.
• Emotions: It's normal for children to feel anxious or frustrated. Our team includes counselors and social workers to support your family.

A vascular access is the site on the body where blood is removed and returned during hemodialysis. There are three main types:

• Arteriovenous (AV) Fistula: Created by connecting an artery and a vein under the skin. This is the preferred type as it lasts longer and has fewer complications.
• AV Graft: A synthetic tube is used to connect an artery and a vein. Used when veins are too small for a fistula.
• Central Venous Catheter: A tube inserted into a large vein in the neck or chest. Usually used for short-term or emergency dialysis.

Good care of the access site is essential to prevent infection and ensure effective dialysis.

Common side effects may include:

• Low blood pressure (especially during hemodialysis)
• Fatigue after treatments
• Muscle cramps
• Itching
• Sleep problems
• Fluid weight gain between treatments
• Risk of infection at access sites

Our medical team monitors your child closely and can adjust treatments to minimize side effects. Report any concerns immediately.

Dietary restrictions often continue during dialysis, though they may differ from pre-dialysis restrictions:

• Fluids: Usually need to limit fluids between treatments (especially for hemodialysis)
• Potassium: May need to limit high-potassium foods
• Phosphorus: Usually need to limit phosphorus-rich foods
• Sodium: Low-sodium diet is typically recommended
• Protein: May need more protein than before dialysis

Our dietitian will work with you to create an appropriate meal plan for your child.

Dialysis may be temporary or permanent depending on the situation:

• Temporary dialysis: For acute kidney injury, dialysis may be needed for days to weeks until kidneys recover.
• Bridge to transplant: Many children with end-stage kidney disease use dialysis while waiting for a kidney transplant.
• Long-term dialysis: Some children remain on dialysis for many years, especially if transplantation is not immediately possible.

Dr. Hashim Raza Bukhari will discuss long-term plans, including transplant evaluation, with your family.

Emotional support is crucial for children on dialysis:

• Be open and honest about what to expect
• Encourage your child to express feelings
• Connect with other families through support groups
• Work with child life specialists and counselors
• Help your child maintain friendships and activities
• Celebrate small victories and milestones
• Take care of yourself – your well-being matters too

Our team includes psychologists and social workers who specialize in supporting children with chronic conditions.