What Is Dialysis Really Like? First Month on Treatment

Medicine Made Simple Summary 

Starting dialysis can be confusing and scary. In simple terms, dialysis is a way to clean your blood when your kidneys can’t. Your first month brings big changes—new routines, diet adjustments, physical sensations, and emotions. You’ll learn what happens during sessions, how your body reacts, and how to stay positive. This guide explains everything—from your first treatment day to how to feel more in control and what to expect long term. Read on to understand dialysis in plain language and begin your journey with confidence.

Why Dialysis Is Needed: The Basics

Your kidneys are powerful filters that remove waste, extra water, and chemicals from your blood. They also help control blood pressure, bone strength, and red blood cell production. When they lose about 85–90% of their function—often due to chronic kidney disease—you may feel weak, swollen, and tired. Dialysis steps in to do some of this essential work.

Think of dialysis as a life support system that replaces the kidney’s cleaning role. It helps remove waste, extra salts, and fluid, keeping your body in balance. Without it, harmful waste builds up, leading to serious complications.

Types of Dialysis Explained Simply

There are two main kinds of dialysis. Both aim to clean your blood, but they work differently.

Hemodialysis uses a machine outside your body to clean your blood. Blood flows through tubes into a special filter called a dialyzer. This filter removes waste and extra fluid, then returns clean blood to your body.

You’ll usually have treatment three times a week. Each session lasts about four hours. Most people do this in a dialysis center, though some eventually switch to home hemodialysis once trained.

Before you start, your doctor creates an access point in your body (often in your arm). It’s called a fistula or graft. This allows easy, safe blood flow during dialysis.

Peritoneal Dialysis

In peritoneal dialysis, your own body helps clean the blood. A soft tube is placed into your abdomen. Fluid called dialysate is poured into your belly through the tube. It stays there for a few hours and absorbs waste. Then it’s drained out and replaced with fresh fluid.

This type is done daily—often at home—and is quieter and gentler for some people. It’s also a good option if you want more independence.

Your First Dialysis Session: Step-by-Step

Your first dialysis day can be emotional. Many people describe feeling nervous, uncertain, or relieved that something is finally being done to help. Here’s what to expect.

When you arrive, nurses check your blood pressure, temperature, and weight. They’ll calculate how much fluid to remove. They then clean your access area and connect you to the machine.

Once treatment begins, you’ll sit in a reclining chair. Your blood starts flowing through the tubes and filter. You won’t feel the blood moving, but you may feel cold or sleepy. Some people experience cramps or slight dizziness, especially during early sessions.

The treatment usually lasts about four hours. Nurses watch you closely throughout. Afterward, they remove the needles or disconnect the tube, and you rest for a short time before going home.

It’s normal to feel tired afterward. Your body is adjusting to this new process of cleaning your blood. Most patients say the first few sessions are the hardest. Within a couple of weeks, you’ll begin to know what to expect and how your body reacts.

The First Month: Physical Changes and Feelings

Week 1: Adjustment and Fatigue

Your body may feel drained. It’s processing fluid and chemical changes it hasn’t managed well for months. It’s okay to nap often, stay hydrated (within your doctor’s limits), and eat small, balanced meals.

Week 2: Routine Setting In

You start to understand the rhythm—treatment days, rest days, diet tracking. You learn your care team’s faces and how to prepare your arm or abdomen for treatment. You might notice fewer swelling episodes or better appetite.

Week 3: Emotional Rollercoaster

Many people feel emotionally heavy during this stage. The reality of needing dialysis may sink in. You might grieve your old lifestyle or feel anxious about your future. This is normal. Talking with a social worker or other patients can help.

Week 4: Confidence and Comfort

By the end of the first month, most patients find comfort in routine. They recognize the importance of treatment, know how to manage side effects, and regain some energy. You start to plan life around treatment instead of feeling trapped by it.

Common Side Effects and How to Cope

• Fatigue: Rest after each session and don’t push yourself too soon.
• Cramps: Caused by fluid shifts—stretch gently, and tell your nurse.
• Low blood pressure: Happens when too much fluid is removed. Move slowly after treatment.
• Headaches or nausea: Common early on but usually improve as your body adjusts.
• Access site soreness: Keep it clean, dry, and report redness or swelling to your nurse.

All these are temporary in most cases. If symptoms are severe, your care team will adjust your settings or medication.

Emotional and Mental Health in the First Month

Dialysis is as much an emotional journey as a physical one. Many patients describe feeling angry, scared, or isolated in the beginning. You’re not alone—these feelings are shared by many others.

Some people find comfort in talking to others during treatment. Dialysis centers often feel like small communities, where nurses and patients chat and support one another.

If anxiety or sadness linger, speak to your doctor. Social workers and mental health counselors are part of your dialysis team. Emotional support is treatment too.

Diet and Fluid Control Made Simple

Your kidneys can’t remove extra water, so controlling fluid intake becomes critical. You’ll be given a “dry weight”, which is your healthy post-dialysis weight. The goal is to return to that weight after every session.

To manage fluids:
Drink slowly, use smaller cups, and avoid salty foods that increase thirst. Hidden fluids (ice cream, soups, watermelon) count too.

Eating Right on Dialysis

• Protein: You’ll need more, since dialysis removes some. Eggs, chicken, fish are great options.
• Sodium: Keep it low to prevent swelling and high blood pressure.
• Potassium: Too much can affect your heart rhythm. Avoid excess bananas, oranges, and potatoes.
• Phosphorus: Too much harms your bones. Cut down on processed foods, dark sodas, and cheese.

A dietitian will customize a plan just for you. This is one of the most helpful relationships you can build early on.

Building a Sustainable Routine

Dialysis takes time—roughly 12–15 hours a week. You’ll need to plan around it. Many people schedule sessions in the morning to have afternoons free, or in the evening after work.

Prepare for treatment days like any other important appointment. Eat lightly, bring entertainment, and wear comfortable clothes.

You’ll soon find your rhythm. Some people even call dialysis “me time,” when they read, watch shows, or nap while their blood is cleaned.

Consistency matters most. Skipping or shortening sessions lets toxins build up, which can make you feel sick again. Think of it like taking your life-saving medicine three times a week.

Life Beyond the Dialysis Chair

Dialysis doesn’t mean life stops. Many patients continue to work, study, travel, and live full lives. The key is planning.

If you want to travel, ask your care team about temporary dialysis arrangements in another city or country. There are global dialysis networks for travelers.

Exercise helps too. Gentle walking, stretching, and light activity boost mood and circulation. Ask your doctor before starting new workouts.

Many patients also pursue hobbies they can enjoy during dialysis—knitting, journaling, even online courses. Finding joy in everyday moments keeps you emotionally strong.

When to Call Your Dialysis Team

It’s vital to recognize warning signs early. Call your dialysis center or doctor immediately if you experience:

• Fever, chills, or signs of infection at your access site
• Swelling, redness, or pus at your fistula or catheter
• Shortness of breath or chest pain
• Unexplained weight gain between sessions
• Dizziness, fainting, or confusion

Never ignore symptoms—you know your body best. Quick communication prevents small issues from becoming serious problems.

The Role of Your Dialysis Team

You’re not alone in this journey. Your team includes:

• Nephrologist (kidney doctor): Oversees your treatment plan.
• Nurses and technicians: Run your sessions and ensure safety.
• Dietitian: Guides you through eating and fluid habits.
• Social worker: Helps with emotional health and support programs.

These people are your partners. Ask questions, no matter how small. Understanding your care empowers you to live well.

The Emotional Turning Point: Acceptance and Hope

At some point, often by the end of the first month, many patients realize dialysis is not the end of life but the start of a new chapter. You begin to feel gratitude for the treatment that keeps you alive. You adapt. You build confidence.

Acceptance doesn’t mean you stop hoping. Some patients move on to kidney transplants, others find balance on long-term dialysis. What matters most is focusing on quality of life—family, goals, and self-care.

Conclusion

If you or someone you love is about to start dialysis, share this article with them. Keep learning, ask questions, and talk openly with your dialysis team. The first month may feel difficult, but it’s also when you begin to take control. You’re not defined by your treatment—you’re defined by your courage. Stay informed, stay engaged, and move confidently toward better health.