What are the stages of dialysis?

Learning that dialysis may be part of your kidney care can feel overwhelming. You are not alone. Although dialysis does not have official medical “stages,” many people move through four practical phases: preparing, starting treatment, ongoing care, and looking ahead. This guide from The Liver Hope Foundation explains what may happen in each phase, what questions to ask, and where to find support.

The Liver and Kidney Hope Foundation provides education and support—not medical treatment. Your nephrologist and healthcare team can help you make decisions based on your health, goals, and daily life.

Frequently asked questions about the stages of dialysis

Whether you are newly diagnosed, preparing for treatment, or supporting someone you love, it is normal to have questions. Explore these clear, practical answers to better understand the dialysis journey and your next steps.

Does dialysis have official stages?

Not exactly. Dialysis is a treatment for kidney failure rather than a disease with numbered stages. However, the experience often follows four helpful phases: preparing for dialysis, starting treatment, ongoing dialysis care, and looking ahead to transplant or other care options.

What happens during the preparation phase?

When kidney function declines to late-stage chronic kidney disease, your care team will explain treatment choices and help you consider which option fits your health and life. If dialysis is planned, an access is usually created ahead of time: a fistula or graft in the arm for hemodialysis, or a catheter in the abdomen for peritoneal dialysis. Planning months ahead, when possible, gives the access time to heal and be ready.

What types of dialysis might my care team discuss?

The two main types are hemodialysis and peritoneal dialysis. Hemodialysis filters blood through a machine and may be done at a dialysis center or, for some people, at home. Peritoneal dialysis uses the lining of the abdomen to filter waste and is usually done at home. Your healthcare team can explain the benefits, responsibilities, and possible risks of each choice.

What is it like when dialysis first starts?

The first days and weeks are an adjustment period. You may be learning a new routine, receiving training for home treatment, and having your prescription adjusted based on symptoms and lab results. It is common to feel tired, uncertain, or overwhelmed. Tell your care team how you are feeling and ask for help with practical or emotional concerns.

What should I bring up with my care team before treatment starts?

Ask which dialysis option may fit your medical needs and daily routine, when access placement should happen, where treatment will occur, how transportation will work, what costs or insurance questions to plan for, and what changes to diet, fluids, medicines, work, or travel may be needed. Writing questions down and bringing a support person can help.

What does ongoing dialysis care involve?

Ongoing care includes dialysis on a regular schedule, periodic lab work, medication review, and guidance about fluids, food, and activity. Your team monitors how treatment is working and adjusts your plan when needed. Many people gradually find a routine that supports family life, work, rest, and the activities that matter to them.

Will I need to follow a special diet or fluid plan?

Many people on dialysis need individualized guidance about sodium, potassium, phosphorus, protein, and fluid intake. Needs vary by treatment type, lab results, medicines, and other health conditions. Follow the plan from your kidney care team or renal dietitian rather than using general advice from the internet.

Can I change dialysis types later?

Sometimes. A person may switch between in-center and home hemodialysis, move to or from peritoneal dialysis, or need a different plan as health needs and life circumstances change. Discuss changes, symptoms, and concerns with your nephrologist and dialysis team before making decisions.

What does the “looking ahead” phase mean?

Dialysis care includes planning for the future. Some people may be evaluated for a kidney transplant. Others may change dialysis approaches or talk with their team about supportive care options that reflect their goals and quality of life. Families should be included in these conversations whenever the patient wants them involved.

How can The Liver and Kidney Hope Foundation help?

At every phase, The Liver and Kidney Hope Foundation offers education and encouragement. Dialysis: The Complete Guide and its worksheets can help you organize questions for your care team. Chapters and community support can connect new patients and families with people who understand the adjustment. Our education also covers daily-life topics, transplant options, and available resources, while the Social Work department can help connect people with support services. We provide education and support; medical decisions remain with your healthcare team.

What should I do after reading this guide?

Use the worksheets in Dialysis: The Complete Guide to write down your questions, then review them with your kidney care team to discuss which dialysis option best fits your life. Consider connecting with a TLHF chapter or support group, too—dialysis is easier to navigate when you do not have to do it alone.

Take your next step with support

Bring your questions to your healthcare team, explore trusted kidney education, and connect with support for you and your family. The Liver Hope Foundation is here to help you feel more prepared for what comes next.