What Does Dialysis Feel Like?

Before starting dialysis, your first question may be, Is dialysis painful? In fact, beyond any complications, there are few circumstances that cause pain during dialysis.

If you’re on hemodialysis (HD) and have a graft or fistula, getting needles inserted (known as cannulation) can sting. However, the pain should go away quickly once needles are in. If needed, you can request numbing cream or cold therapy to provide relief. As you get used to cannulation, it should become less painful. Learning to cannulate yourself can also help reduce pain from needles because you’re in control and can tell immediately if something doesn’t feel right.

Apart from needle sticks, HD shouldn’t be painful. You should be able to comfortably read, watch TV, talk, use computers, or sleep while dialyzing. If you’re dialyzing at a center, you’ll also have care team members nearby to answer any questions and help give you a positive experience. Side effects can occur, so if you feel discomfort during treatment—including dizziness, nausea, cramping, or pain—tell a member of your care team. It could be a sign that your therapy needs to be adjusted or interrupted.

Blood is not involved in peritoneal dialysis (PD) therapy, which means needles are not part of treatment. Instead, your PD catheter brings fluid (dialysate) into your abdomen, where it sits (dwells) for several hours and then gets drained. PD is typically painless, but discomfort can happen if the catheter inside your abdomen pushes up against the abdominal wall while you’re filling or draining. Laxatives or a drainage method called tidal PD (which only partially fills the abdomen with dialysate) can provide relief.

Whether you choose in-center HD, home hemodialysis (HHD), or PD, you will experience physical sensations. Some feelings are related to your dialysis access, the entry point in your arm, neck, chest, groin, or belly where dialysis therapy starts. Fistulas and grafts (recommended access types for HD) require needles to access your blood for treatment, while PD and HD catheters do not.

Some sensations of dialysis are caused by the flow of blood or fluid in and out of your body. During HD, you can feel whether your blood flow is strong. A healthy HD access makes a gentle vibration you can feel by touching the skin over the top of it. This vibration is also called a “pulse” or “thrill.”

You may also feel cold during HD or HHD treatments due to cool temperatures in the dialysis center and because your blood is circulated through tubes outside of your body. Many people on HD wear warm clothes—such as thick socks, sweaters, or even hats and mittens. You can also use a blanket and pillow—just be careful not to cover your access site.

During PD, your abdomen is often filled with dialysate, which can make you feel full or bloated. Eating may make the sensation of fullness more noticeable. However, eating well can help, as can planning your exchanges for after meals. If you start to avoid eating, talk to your dietitian about managing your diet. You should also watch your fluids and salt intake to prevent hypervolemia (fluid overload).

If you’re on PD and bloating happens often or won’t go away, notify your care team. They should be able to adjust the amount of fluid in your abdomen or suggest medications to help. Typically, PD causes no other sensations unless you have an infection or complication. If you’re experiencing any pain, tell a member of your care team.

Dialysis may cause pain or discomfort at times, but don’t get discouraged. There are practices that can help you avoid or relieve pain and feel better, both physically and mentally. To get the most out of dialysis therapy, focus on these 7 tips:

1. Use therapy time to relax. Dialysis can take a lot out of you physically and emotionally, so make your treatment time downtime. Read a book, watch your favorite show, or spend time with loved ones to give yourself a break.
2. Don’t skip treatments or cut them short. Your doctor will prescribe treatment times that are right for you. Completing every treatment helps you get the most benefits from dialysis. Skipping or shortening treatments can impact kidney health and survival for people on dialysis.
3. Eat well and manage fluids. There are foods you should and shouldn’t eat while on dialysis. You’ll also need to follow dialysis fluid restrictionsas directed by your care team.
4. Take medications as prescribed. Your prescriptions help your body regulate blood pressure, vitamins, minerals, and more.
5. Protect against infection. Keeping your access, surroundings, equipment, and supplies clean helps prevent dialysis infections.
6. Stay active. Exercising, working, hobbies, and socializing are all great ways to keep active and engaged and help you feel more like yourself.
7. Build a support network. Talking about dialysis, kidney disease, and your overall health with family, friends, and others can help you feel better and give them the information they need to support you. 

You’re not the first person to wonder, What Does Dialysis Feel Like? Any big change in your health brings on concerns, so it’s natural to be nervous about how treatments might feel. But by educating yourself, you can start your first treatment session with realistic expectations, not fear.

No matter which therapy option you choose, the purpose of dialysis is to help make you healthier. If you experience discomfort or any side effects, talk to your care team. They are available to provide the help and support you need.