Your First Dialysis Session: A Complete Guide to What Really Happens

Starting dialysis for the first time can feel overwhelming, especially if you’re unsure what the process involves. Although dialysis eventually becomes a routine part of life for people with kidney failure, it’s normal to have questions before your first appointment. This guide walks you through every major step—from preparing your access site to what you can expect during your first treatment.

Preparing for Dialysis: Creating Your Access Site

Before dialysis can begin, you’ll need a reliable access point that allows your blood to travel to and from the dialysis machine. Most patients receive an arteriovenous (AV) fistula, which is considered the gold standard for long-term treatment.

What Is an AV Fistula?

An AV fistula is created by a vascular surgeon who connects an artery and a vein—usually in the arm or wrist. This connection strengthens the vein so it can handle frequent dialysis sessions. The procedure:

• Is performed in an outpatient surgical setting

• Can be done under local numbing or general anesthesia

• Typically takes only a few hours from check-in to going home

After surgery, the fistula needs time to mature. Over several weeks, increased blood flow helps the vein enlarge and thicken, making it strong enough for repeated needle insertions.

Other Access Options

While a radial-cephalic fistula in the wrist is a common choice, your surgeon may recommend another type depending on your anatomy and health needs. If dialysis must begin immediately, a temporary catheter may be used while your long-term access heals.

What to Expect at Your First Dialysis Treatment

Once your access is ready, you will attend your first dialysis session. During treatment:

1. Two small needles are inserted into the fistula—one to draw blood out, the other to return filtered blood to your body.

2. Your blood passes through the dialysis machine, where it is cleaned of wastes and excess fluid.

3. Your care team monitors your blood pressure, comfort, and the machine throughout the session.

Most new patients find that the process is easier and more comfortable than they expected.

How Long Does Dialysis Take?

A typical treatment lasts 3 to 4 hours, and most patients schedule appointments three times per week. Your nephrologist will customize your schedule based on your health, lab results, and lifestyle.

How to Stay Comfortable During Your Appointment

Dialysis is a great time to relax. Consider bringing:

• A phone or tablet with headphones

• A book or e-reader

• A small pillow or blanket

• Snacks or water (if allowed by your clinic)

Many patients nap during treatments, but having entertainment on hand is helpful just in case sleep doesn’t come easily.

Do You Need a Ride After Dialysis?

Dialysis is not usually painful, but it can leave you feeling tired or lightheaded. For that reason, many patients prefer not to drive themselves afterward.

If you need dependable, comfortable transportation to and from your appointments, we can help. We proudly offer specialized dialysis transportation in Polk County, FL, including discounted weekly rides for patients receiving treatment three times per week. Contact us today to book reliable transportation for your dialysis schedule.