Blog Post

Navigating Dialysis: A Guide to Ongoing Care Management


Starting dialysis treatment is a life-altering event. Whether conducted at home or in a treatment center (a dialysis unit), dialysis requires a significant time commitment, modifications to one’s diet and lifestyle, and regular medical oversight. This guide is intended to help patients and their loved ones understand various aspects of dialysis treatment so they can successfully participate in their ongoing kidney care management.


Understanding Dietary and Fluid Adjustments

For patients receiving dialysis treatments, a significant lifestyle change focuses on eating and drinking. As kidney function declines, the body relies on dialysis to eliminate excess water and normalize certain electrolytes such as potassium and phosphorus. However, dialysis is not perfect, and most people on dialysis must learn to decrease these key elements—which include sodium (salt), potassium, and phosphorus—in their diets in order to stay healthy. A nephrologist or renal dietitian can offer guidance regarding which foods should be avoided, with an emphasis on minimizing intake of sodium, potassium, and phosphorus when appropriate. Members in Healthmap Solutions’ Kidney Health Management program have access to Registered Dietitians who can help them develop a personalized meal plan that meets their nutritional and kidney health needs.

With kidney failure, or end-stage kidney disease (ESKD), it is common for people to urinate significantly less than people with healthy kidneys. Some people on dialysis may report only urinating once per day or not at all. Without dialysis, there would be no way to remove the fluid that a person drinks every day from the body. When fluid buildup occurs, it can lead to uncomfortable swelling, heart strain, or difficulty breathing. For this reason, it is very important to keep a close eye on fluid intake and institute limitations. Minimizing fluid intake will not only help keep a patient at a safe or “ideal” body weight, but it will also help dialysis sessions feel less fatiguing. The amount of fluid a person should consume each day varies per individual. Patients on dialysis should talk to their doctor about their ideal weight and how much fluid should be consumed between dialysis sessions.

Monitoring Blood Pressure, Blood Glucose, and Cholesterol

Regular monitoring of blood pressure, blood glucose levels (for people with diabetes), and cholesterol is important for all people with ESKD. For example, even if a patient’s blood pressure is checked regularly while on dialysis, it’s a good idea to keep track of their blood pressure on days they are not receiving dialysis. Keeping these different measures under control can significantly improve a person’s health while on dialysis. Managing them through dietary adjustments, medications, and lifestyle changes is an effective and important way to prevent complications.

The Significance of Routine Blood Work and Laboratory Tests

People receiving dialysis require regular laboratory tests. These assessments are performed to evaluate the effectiveness of dialysis treatments and help determine whether adjustments are necessary. Regular testing plays a vital role in averting complications and optimizing the effectiveness of treatment.

Medication Management

Patients with ESKD are typically prescribed several different medications. These may include drugs to manage blood pressure, mitigate bone disease secondary to kidney disease, and regulate the levels of specific nutrients in the bloodstream, among others. Strict medication adherence is imperative to ensure effective treatment. If a patient has questions about a medication or experiences side effects, it’s best to discuss these concerns with a nephrologist prior to stopping the medication.

Regular Consultations with Healthcare Professionals

In addition to seeing a nephrologist, people with ESKD often see multiple other health specialists such as a primary care provider, cardiologist, endocrinologist, transplant doctor, and others. All of these different checkups are important, help facilitate ongoing health monitoring, and ensure treatment adjustments are performed as needed.

Lifestyle Changes and the Advantages of Home Dialysis

How a person receives their dialysis can significantly impact their lifestyle and quality of life. While many people receive dialysis in a dialysis unit, this can often be burdensome, as this type of treatment requires travel to and from a treatment center multiple times a week on a strict schedule. In addition, when dialysis is performed less frequently (as when performed in a dialysis unit), dialysis treatments tend to be more fatiguing, and patients often report longer recovery times following their treatments.

Home-based dialysis is an effective and safe way for people to dialyze in their own homes. Not only is this option more comfortable, but it is also more convenient. Patients who dialyze in the home setting usually feel better and report greater healthcare-related quality of life compared to those who dialyze in a treatment center. Like any person receiving dialysis, they continue to see their nephrologist and healthcare team on a regular basis. As a kidney health management company, Healthmap believes strongly that each person with advanced chronic kidney disease (CKD) or ESKD should receive education about the different options for dialysis and understand the pros and cons of each option so that they can make an informed decision about which dialysis modality is best for them. Healthmap’s Care Navigation team is available to discuss dialysis and the different treatment options with members in our program.

Emotional Well-being

Maintaining emotional well-being is important for one’s overall health. It is not uncommon for people on dialysis to experience emotional and mental challenges during their dialysis journey. Some communities or dialysis centers offer peer-support groups, which can be highly beneficial in coping with these difficulties. If such a group does not exist in a patient’s community, the National Kidney Foundation offers a free peer-support program called NKF PEERS, which connects patients to trained peer mentors who have experience living with dialysis, a transplant, and/or living kidney donation. Healthmap members may also contact their Care Navigator for help with finding support groups and services. While patients receiving dialysis are usually screened for depression annually through their dialysis provider, it is important for patients to inform their provider right away if they experience any signs or symptoms of anxiety or depression.

Every patient's treatment journey is unique. Therefore, it is vital for patients to work closely with their healthcare team, including all their providers, as they develop a personalized care plan. Patients and their loved ones should aim to stay well-informed, be proactive, and never hesitate to reach out to the Healthmap Care Navigation team for additional support whenever needed.