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  • Chronic Kidney Disease (CKD)

    • What is renal replacement therapy (RRT)?

    Renal replacement therapy (RRT) is recommended for people experiencing ESKD. If your kidneys are not working properly, extra fluid and waste will build up in your blood. RRT essentially replaces your filtration capabilities one of two ways:

    1. Kidney transplant — This procedure replaces one of your kidneys with a healthy kidney, allowing you to filter your blood naturally.
    2. Dialysis — This process filters your blood artificially. Hemodialysis filters your blood with a machine. Peritoneal dialysis involves filling your abdominal cavity with a solution that absorbs extra fluid and waste over time, after which it is drained and replaced.

    ESKD in the United States

    Nearly 808,000 people in the United States are living with ESKD.1

    31%

    with a kidney transplant1

    69%

    on dialysis1

    What is hemodialysis?

    Hemodialysis is the most common way to treat ESKD. If you have ESKD, you will need to receive dialysis indefinitely or until you receive a kidney transplant.

    What happens during hemodialysis?

    During hemodialysis, your blood is filtered through a machine that removes waste and excess fluid (water). Then the clean blood is returned to your body. The process takes about three to five hours and is typically done two to four times a week.

    Side effects of dialysis2

    People undergoing hemodialysis may experience side effects. Keep in mind, not everyone experiences all of them. Ask your care team about how to manage them.

    • High or low blood pressure
    • Muscle cramps
    • Anemia
    • Bone disease
    • Fluid overload
    • Itching
    • Sleep problems
    • Depression
    • Joint pain and stiffness
    • High or low potassium levels

    Choosing a dialysis site

    Hemodialysis can be done in a dialysis center, a hospital, or even at home. The site you choose affects how often you receive dialysis.

    Dialysis center or hospital

    Dialysis centers are located across the country. If you choose a dialysis center or hospital, you can expect to receive dialysis three times a week. Each session takes three to five hours.

    At-home dialysis

    You can receive hemodialysis at home, using a machine that is specifically designed for home use. If you choose at-home dialysis, you can expect to receive dialysis six or seven days a week. Each session takes about two hours.

    What is hemodialysis access?

    Hemodialysis involves repeatedly gaining access to your bloodstream, so it can be moved to the dialysis machine and back again. There are three ways to do this. Your doctor will explain more about each option and help you choose what is best for your body.

    1. Arteriovenous (AV) fistula

    An AV fistula is the most common access type. It is made by connecting an artery and a vein, typically in the arm. An AV fistula increases blood flow for efficient dialysis. It also widens the vein, making access easier. An AV fistula usually takes four to sixteen weeks to prepare.

    2. AV graft

    An AV graft requires a minor surgery to connect the vein and artery by placing a small tube (implant) between them. An AV graft increases blood flow for efficient dialysis. An AV graft is often placed about two weeks prior to hemodialysis.

    3. Catheter

    If you need to have hemodialysis before your AV fistula or AV graft are ready, or if those options won’t work for you, your doctor may choose to place a catheter for access. A catheter is made of soft plastic tubing and is placed in a large vein in the neck or upper chest. It can be used immediately after it is placed.

    How do you care for your AV fistula?

    It is very important to take good care of the fistula. If your fistula isn’t working well, you may not be getting enough dialysis.

    Sometimes, however, there can be issues with your fistula. The most common issue is when a fistula narrows because your body sends extra cells to “repair” the fistula. These cells can build up, slowing blood flow and making dialysis less effective.

    If your fistula has narrowed, you may need a maintenance procedure to treat it.

    Treating a narrowed fistula

    There are several minimally invasive maintenance (nonsurgical) options doctors use to open a narrowed fistula. Two of the most common include:

    Traditional balloon

    During this procedure, an inflatable balloon is placed into the fistula through a small tube (catheter). The balloon is inflated in the narrowed section of the fistula to open it back up again. Then the balloon is deflated and removed.

    Drug-coated balloon (DCB)

    A DCB uses the same procedure as a traditional angioplasty balloon, but with one important difference. This balloon is coated with a specialized drug called paclitaxel that can help delay the re-narrowing of your fistula in the future. So, it not only widens the fistula, but it also helps keep it open longer.

    Proactive treatment, fewer options

    The Medtronic IN.PACT™ AV DCB uses specially formatted technology to keep your fistula open longer than other options.†,3

    Discover IN.PACT™ AV DCB

    Treatment with the IN.PACT™ AV DCB is prescribed by your doctor. This treatment is not for everyone. Please talk to your doctor to see if it is right for you. Your doctor should discuss all potential benefits and risks with you. Risks may include pain, hemorrhage, arterial or venous aneurysm/thrombosis, dissection, infection, perforation or rupture, death. Although many patients benefit from the use of this treatment, results may vary.