Questions to Ask Before Your First Dialysis Session

Receiving a recommendation for dialysis can feel overwhelming. There are new terms to learn, routines to plan and concerns that are entirely natural. Being informed before your first dialysis: what to expect and what to ask, can make a significant difference to how prepared and settled you feel going in. 

This guide covers the essential questions patients and families should raise before starting treatment, drawing on medically accurate information to support confident decision-making.

Why Asking Questions Before Dialysis Matters?

Dialysis is a long-term commitment for most patients. According to the National Kidney Foundation, end-stage kidney disease (ESKD) affects millions globally and dialysis is one of the primary renal replacement therapies available. Knowing what lies ahead reduces anxiety, improves adherence to treatment and helps patients build a constructive relationship with their care team.

Patients who understand their treatment tend to cope better emotionally and physically. This is where a starting dialysis guide becomes valuable but as a framework for ongoing conversations with your nephrologist and dialysis team.

What to Expect During Your First Dialysis Session?

Understanding what happens during a session is one of the most common concerns for new patients. Here is what a typical first dialysis session experience looks like:

• You will be weighed before and after each session. This helps monitor fluid removal.
• In hemodialysis, needles are inserted into your access site (fistula, graft or catheter). Most patients report mild discomfort only during insertion.
• Blood flows from your body into a dialysis machine, passes through a filter (dialyser) to remove waste and excess fluid and is returned to your body.
• Sessions typically last three to five hours and are conducted three times a week, though this varies by prescription.
• In peritoneal dialysis, sterile fluid is introduced into the abdominal cavity through a soft catheter. It sits there for a dwell time, then drains, carrying waste with it.
• You may feel some fatigue or mild dizziness after your first few sessions. This is common as the body adjusts.
• Medical staff are present throughout to monitor blood pressure, fluid status and general well-being.
• Patients at NephroPlus centres can access In-Clinic Dialysis with continuous nursing supervision, making the transition into treatment more reassuring.

Key Questions to Ask Your Doctor Before Starting Dialysis

The following questions form the backbone of any solid preparation for dialysis treatment conversation. Do not hesitate to raise any of these with your nephrologist or care coordinator:

• Which type of dialysis is recommended for me and why?
• What kind of vascular access will I need and how is it created or placed?
• How many sessions per week will I need and how long will each session last?
• What are the signs of complications I should watch for between sessions?
• Are there alternatives to in-centre treatment? For example, can I consider Home Hemodialysis or a Dialysis on Wheels service if travel is difficult?
• How will dialysis affect my existing medications?
• Will my kidney function continue to decline or can dialysis stabilise it?
• What happens if I miss a session?
• Are there support groups or patient counsellors I can connect with?
• If I travel frequently, does the facility offer Holiday Dialysis arrangements?

Questions About Diet and Lifestyle for Dialysis Patients

Diet plays a critical role in managing kidney disease and supporting dialysis outcomes. Patients should discuss the following with their renal dietician:

• Which foods are high in potassium, phosphorus and sodium that I should limit?
• How much fluid can I have each day and does this include water in fruits and vegetables?
• Should my protein intake increase now that I am on dialysis? (Dialysis removes some protein, so requirements often rise.)
• Are there any over-the-counter supplements or herbal remedies I should avoid?
• How should I manage my diet if I am also diabetic or have cardiovascular disease?
• Will my dietary restrictions differ between hemodialysis and peritoneal dialysis?
• On the lifestyle side, it is equally important to ask:
• Can I continue to work during dialysis treatment?
• Are there restrictions on exercise and what types of physical activity are safe?
• How does dialysis affect sleep and what can help manage fatigue?
• How does dialysis affect sexual health and fertility?

How to Emotionally Prepare for Your First Dialysis Session

The emotional dimension of starting dialysis is just as real as the physical one. Feelings of fear, grief or frustration are common and valid. Here are practical steps to support your emotional well-being:

• Talk to someone who is already on dialysis. Many dialysis centres facilitate peer support connections and hearing from those with lived experience can be reassuring.
• Speak to your care team about how you are feeling. Psychological support is a recognised part of dialysis care and many centres have access to counsellors.
• Bring a support person to your first session. Having someone familiar alongside you can ease anxiety considerably.
• Allow yourself time to adjust. Most patients report that dialysis feels more manageable after the first few sessions as it becomes part of their routine.
• Focus on what you can control, your diet, your attendance, your questions. This sense of agency can help offset feelings of helplessness.
• Understand that feeling low initially is normal. Chronic illness carries emotional weight and acknowledging that is part of coping healthily.

Conclusion

Starting dialysis marks a significant change in daily life but it does not have to be a frightening one. Preparation, honest conversations with your medical team and the right support network can make an enormous difference. Use this guide as your starting point for those conversations, every question you ask is a step toward greater confidence and control.

If you or a family member is navigating kidney disease and would like to understand your dialysis options, including In-Clinic Dialysis, Home Hemodialysis, Dialysis on Wheels, Holiday Dialysis or Dialysis on Call, speak with the team at NephroPlus. Our specialists will help you identify the approach that best fits your medical needs, lifestyle and personal circumstances.

FAQs

What should I ask my doctor before my first dialysis session?

Before your first dialysis session, focus your questions on the type of dialysis recommended for you and the reason for that recommendation. Writing your questions in advance and bringing a family member can help you retain the information shared during the appointment.

How do I prepare for my first dialysis treatment?

Preparing for dialysis treatment involves following any dietary or fluid guidelines given by your team beforehand, arriving well-rested and wearing comfortable, loose-fitting clothing that allows easy access to your arm or abdomen. Bring identification and any medication lists.

What happens during a first dialysis session?

During a hemodialysis session, blood is drawn from your body into a dialysis machine, filtered through a dialyser to remove waste products and excess fluid and returned to your body. Nursing staff monitor your blood pressure and fluid levels throughout. During peritoneal dialysis, a sterile fluid is introduced into your abdominal cavity through a catheter, dwells for a prescribed period and is then drained. 

Can I eat or drink before my dialysis session?

Guidelines on eating and drinking before dialysis vary by the type of treatment and your individual prescription. Always confirm what is appropriate for your specific situation with your nephrologist or renal dietician, as individual recommendations can vary based on your medical status.

How long does a first dialysis session take?

A standard hemodialysis session lasts approximately three to five hours, with most patients attending three times a week. The overall duration of your sessions will be prescribed based on your kidney function, body size and lab results, so it may differ from another patient’s schedule.