Einstein's team of expert nephrologists specialize in treating high blood pressure, diabetes and other diseases that affect
kidney function. Using the latest medications, nutritional guidance and lifestyle modification, our kidney specialists work
with patients to help slow or prevent the progression to kidney failure. When a patient’s kidneys begin to fail (end-stage
renal disease), treatment options include dialysis or
transplantation.
Dialysis
When kidneys are not functioning, dialysis takes over the job by: clearing the body of waste and excess fluid, helping keep
nutrients such as potassium in balance, and controlling blood pressure. People who have lost 85 to 90 percent of their kidney
function need dialysis or a new kidney to live. Patients typically go for dialysis three times a week with each treatment
taking three to four hours. Albert Einstein Medical Center has its own Dialysis Center for inpatients located on the ground
floor of the Levy Building.
There are two types of dialysis —
hemodialysis and
peritoneal dialysis.
Hemodialysis
In hemodialysis, an artificial kidney removes waste, extra chemicals and fluid from your blood. To send your blood into the
artificial kidney and return it to your body, your doctor creates an access to your blood vessels called an AV (arterial venous)
fistula. To create an AV fistula, Einstein kidney surgeons perform a minor surgery to join an artery and vein together, usually
in the forearm. Connecting the artery to the vein causes more blood to flow into the vein. This makes the vein grow larger
and stronger, which helps make repeated needle insertions easier. For most people, the best kind of vascular access is an
AV fistula which takes a while after surgery to develop. Studies show that AV fistulas are less likely than other kinds of
vascular access such as catheters or arterial venous grafts, to form clots or get infected. In addition, AV fistulas usually
last many years, longer than any other kind of vascular access.
Peritoneal Dialysis
In peritoneal dialysis, a plastic tube called a catheter is placed in your abdomen (belly) to make an access. When you are
hooked up to the artificial kidney, cleansing fluid is sent through the catheter into your belly, where it draws waste products
out of your bloodstream.
While dialysis does some of the work of healthy kidneys, it does not cure kidney disease. Patients on dialysis will have to
continue this treatment for the rest of their lives unless they are able to get a kidney transplant.
Physicians, nurses and ancillary personnel at Einstein Medical Center have the expertise to establish reliable dialysis access,
including fistulas, grafts, and peritoneal catheters. In addition, the Einstein Kidney Transplant Team has the surgical and
interventional radiologic skills to manage difficult access problems that may include clotted access, graft revision, and
catheter infections.
