The start of dialysis can be a very scary experience for both patients and their families.

Even if patients and families have received pre-dialysis care from nephrologists and nurses for long periods of time, dialysis initiation can sometimes be a shock and a very difficult transition. Patients feel like their lives have been turned upside down, “sentenced” to live on dialysis with no hope for the future. While dialysis is not a cure for kidney disease, it is a life-sustaining treatment, and it will help you feel much better. Although it does not work immediately, after a few dialysis treatments, patients generally report feeling improved, with increased energy levels and appetite and decreased itching, weakness, and nausea.

Everyone has different emotions and experiences during dialysis initiation, and people sometimes feel scared because they don’t know what to expect, and they don’t know if what they are experiencing is normal. This section will describe what patients and families can expect as they start dialysis. Read more about different topics on dialysis below.


Patients can experience a wide range of symptoms leading up to dialysis and during the first few dialysis treatments. Some of these symptoms could include: Feeling tired, weak, and low in energy…
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Emotional Reactions

Many patients and families feel angry and scared when they need to start dialysis. Patients may feel angry that they got sick and they may feel like this should never have happened to them…
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Changes in Daily Life

Kidney disease and dialysis can be a very distressing experience, both physically and emotionally. Patients and families often feel like their lives have been flipped upside down, and that nothing will ever be the same.
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Sexual dysfunction is a common occurrence among chronic kidney patients. Fatigue is a common issue among chronic kidney disease and dialysis patients, and feeling tired and having limited energy is one of the main reasons for sexual problems.
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When your kidneys are only able to function at 10 to 15%, dialysis is needed. Dialysis acts as an artificial kidney outside of your body, since your kidneys are no longer able to remove excess water and waste.
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Choosing to Not Have Dialysis

When deciding which treatment for kidney failure is the best choice for you, it is important to know that along with dialysis and transplantation, another option is not to have dialysis.
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Conservative Care

There are many treatment options available for kidney patients, including choosing not to pursue a kidney transplant or dialysis. Conservative care can eventually evolve to increased palliative care needs, with a wish for less medical interventions or a decrease in medications.

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A kidney transplant is considered to be the best treatment for kidney disease, and it provides patients the greatest ability to live a normal life.
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Advance Directives

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Above image by Helen Taylor. Licensed under CC BY-NC 2.0