On this page: Understanding Your Choices

Your doctor may have told you that you have chronic kidney disease (CKD) or advanced kidney disease; or, you may be in kidney failure, and may have to make a decision about dialysis rather quickly. This is a big decision that will have an impact on your daily life.

Why is it important to think about this decision now?

When your kidneys start to fail, it is difficult to predict when they will fail completely. The sooner you begin to think about your options, the more time you will have to plan for the treatment that best fits your lifestyle and preferences.

You may be feeling a lot of emotions at this time: overwhelmed, shocked, confused, angry. You may also be feeling a sense of loss or grief. This is ok. Many people in your situation have had some of these same feelings.

Experiences & StoriesI was angry at everything. I was angry with myself. I was angry with God, too. I wondered, ‘How did I get here? How did this happen to me?’ But through all of that anger, I realized I had to do what I had to do. I felt like, ‘OK, I’m here, and now I need to figure out how to move forward.

Remember, this is your choice, but you are not alone. Your health care team is there to help you with this decision, and you should feel free to ask them any questions. Your loved ones may be a part of the decision, too. No matter who else is involved, we encourage you to have a strong voice in choosing the type of dialysis that is right for you.

In the United States, more than 96% of patients who need treatment for kidney failure (also called renal failure) start either in-center hemodialysis (HD) or peritoneal dialysis (PD). We focus on these two types of dialysis since they are the most common. However, keep in mind that there are other options not included on this website:

To learn more about these treatments, please see Additional Resources.

Everyone's situation is different

Here are some stories from people who started dialysis.

When it’s not your choice

Sometimes, a person’s body may not allow for a certain type of dialysis. Other times, someone might be in an emergency situation, and the health care team has to make the choice. If this is your situation, it doesn’t mean that you have lost control of the rest of your dialysis journey. Remember, you will still have the opportunity to be the leader in your dialysis care.

Experiences & StoriesBecause of some of the scarring that I have internally, PD wasn’t a good option for me. The fluid for dialysis wouldn’t fit in my body, so my doctor recommended that HD would be the best for my situation.

The dialysis journey

Remember, each journey is different. Here's an overview of what you may experience when starting dialysis.

Research described on this web site was partially funded through a Patient-Centered Outcomes Research Institute (PCORI) Award (1109). The statements and views presented here are solely the responsibility of the authors and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute (PCORI), its Board of Governors or Methodology Committee.