Your First Dialysis Session: What to Expect

Most of the worry about a first dialysis session comes from not knowing the shape of it. The treatment itself is quiet and routine — you will be sitting in a chair, awake, for a few hours. Here is what the day looks like from arrival to going home.

What to bring and when to arrive

Come a little before your scheduled time. The first visit involves paperwork and a longer assessment than later ones, so arriving early means you are not starting the day rushed.

Bring:

• Your PhilHealth details and any assistance paperwork you have already arranged
• Your referral, clinical abstract, and recent laboratory results
• A complete list of every medicine you take, including the dose and the time of day
• A jacket or blanket — treatment rooms are kept cool, and many people find they feel cold partway through
• Something to occupy the hours: a phone and charger, a radio with earphones, or reading
• Any food or drink your team has told you is allowed during the session

Wear loose clothing with sleeves that push up easily, so your access site can be reached without you having to undress. If someone is coming with you, ask beforehand how long they are able to stay — policies on companions vary between centers.

What happens from check-in to discharge

The session follows the same sequence every time, which is one of the things that makes it easier after the first few.

1. You are weighed. This is the single most important measurement of the day — the difference between your current weight and your dry weight tells the team how much fluid to remove.
2. Your blood pressure, temperature and pulse are checked, and a nurse examines your access site.
3. You are settled into a chair and connected. Two needles go into a fistula or graft; a catheter is connected directly to its lines. There is a sharp moment with the needles, and then no ongoing pain.
4. Treatment runs. Your blood travels through soft tubing into the machine, passes through a filter called a dialyzer where waste and excess fluid cross into the dialysis fluid, and returns to you cleaned. Most people in a center have treatment three days a week, and each session commonly takes between three and five hours.
5. You are disconnected. Pressure is held on the needle sites until bleeding stops, and you are weighed again to confirm how much fluid came off.

Throughout, a nurse is watching your blood pressure and how you are tolerating the fluid removal. You are awake the whole time. People read, sleep, listen to something, or talk to the person in the next chair.

How you may feel afterwards

Feeling very tired after a session is common, particularly in the first weeks while your body adjusts. Some people go back to their day; others need to rest for several hours. Both are normal, and the pattern often settles once your team has your prescription tuned.

During or shortly after treatment, some people experience low blood pressure, muscle cramps, headache or nausea. These are recognised effects of removing fluid and waste over a few hours, and they are not something to endure quietly. Tell the nurse while it is happening — the team can adjust how quickly fluid is being taken off, and small changes to the prescription often prevent it recurring.

Before you leave, make sure you know three things: when your next session is, who to call if something does not feel right at home, and what you were told about fluid and diet until then. If bleeding restarts from a needle site after you get home and does not stop with steady pressure, contact your center by phone straight away.

The first session is the hardest one, largely because it is unfamiliar. Ask the nurses as many questions as you need to during it — they run this every day and would rather explain something twice than have you guess. For anything urgent between sessions, call your center directly rather than waiting for your next visit.