Why would someone need dialysis?

Dialysis is a life-sustaining treatment used when the kidneys can no longer remove enough waste, extra fluid, and potassium from the blood. This guide is for people facing kidney failure, their families and caregivers, and liver patients who have developed kidney problems. The Liver Hope Foundation is a nonprofit educational resource in Henderson, Nevada; we are not a medical provider. Your kidney care team can explain whether dialysis is right for your individual health needs.

Frequently asked questions about needing dialysis

A dialysis recommendation can bring up many questions. Explore these clear, practical answers to understand why dialysis may be needed, what treatment can look like, and how to prepare for a conversation with your healthcare team.

What is dialysis, and why is it needed?

Healthy kidneys filter waste and extra fluid from the blood, help control minerals such as potassium, and support blood pressure regulation. Dialysis takes over part of this filtering work when the kidneys are no longer able to do enough on their own. It helps prevent dangerous buildup in the body and can help you feel better.

What are the most common reasons for kidney failure?

Diabetes is the leading cause of kidney failure, followed by high blood pressure. Other causes include glomerular diseases, such as glomerulonephritis and IgA nephropathy, as well as inherited conditions such as polycystic kidney disease. A kidney specialist, called a nephrologist, can help identify the cause and discuss treatment options.

Can someone need dialysis after an acute kidney injury?

Yes. A serious illness, infection, surgery, medication reaction, severe dehydration, or other event can cause acute kidney injury. Dialysis may be used temporarily when kidney function drops suddenly and the body cannot safely manage fluid, waste, or electrolyte levels. Some people recover enough kidney function to stop dialysis; others may need ongoing treatment. Your care team will monitor your recovery closely.

Can liver disease lead to dialysis?

Advanced liver disease can sometimes affect the kidneys. One serious condition, hepatorenal syndrome, can cause kidney function to decline in people with severe liver disease. In some situations, dialysis may be used to support the body while the care team treats the underlying problem or as a bridge to liver or kidney transplant evaluation. This requires specialized medical care.

How do doctors decide it is time to start dialysis?

The decision is based on the whole picture—not one lab result alone. Your care team considers kidney function, symptoms, fluid buildup, potassium and acid levels, nutrition, and whether medical treatments are controlling these concerns. Symptoms can include shortness of breath from fluid overload, severe swelling, nausea, itching, fatigue, confusion, or poor appetite. Seek urgent medical help for severe shortness of breath, chest pain, fainting, confusion, or other emergency symptoms.

Is dialysis permanent?

Not always. Dialysis can be temporary after acute kidney injury, and it may be used as a bridge while someone awaits a kidney transplant. For people with permanent kidney failure, dialysis can provide ongoing support. Your treatment plan may change as your health and goals change.

What choices are available for dialysis treatment?

You may have choices about where and when treatment happens. Hemodialysis may be provided at a dialysis center or at home, with daytime or overnight schedules. Peritoneal dialysis is a home-based option that uses the lining of the abdomen to filter blood. Not every option is right for every person, so ask your nephrologist and dialysis team what fits your medical needs and daily life.

Does dialysis hurt, and can people still live full lives?

The dialysis treatment itself is usually not painful, though access placement, needle sticks for hemodialysis, and treatment adjustments can be uncomfortable for some people. Many people on dialysis continue to work, travel, enjoy hobbies, and spend meaningful time with family. You do not have to navigate this alone: your care team, other patients, caregivers, and The Liver Hope Foundation can offer education and support.

You do not have to face dialysis alone

Dialysis is a treatment that helps keep you living. Download Dialysis: The Complete Guide and use its worksheets to write down questions for your kidney care team. For additional support, ask your dialysis center or hospital Social Work department about local services, financial guidance, transportation, and caregiver resources.

Medical note: The Liver Hope Foundation provides education and support, not medical diagnosis or treatment. Please discuss your symptoms, test results, and treatment decisions with your healthcare provider.