How does dialysis work and how long can people live on it?

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1. 1

   Kidney dialysis (Wikipedia)

   WikipediaPublished Oct 10, 2026Checked Oct 15, 2026

   “Kidney dialysis is the process of removing excess water, solutes, and toxins from the blood in people whose kidneys can no longer perform these functions naturally. Along with kidney transplantation, it is a type of renal replacement therapy. Dialysis may need to be initiated when there is a sudden rapid loss of kidney function, known as acute kidney injury (previously called acute renal failure), or when a gradual decline in kidney function, chronic kidney failure, reaches stage 5. Stage 5 chronic renal failure is reached when the glomerular filtration rate is less than 15% of the normal, creatinine clearance is less than 10 mL per minute, and uremia is present. Dialysis is used as a temporary measure in cases of acute kidney injury or for those awaiting kidney transplant and as a permanent measure in those for whom a transplant is not indicated or not possible. In West European countries, Australia, Canada, the United Kingdom, and the United States, dialysis is paid for by the government for those who are eligible. The first successful dialysis was performed in 1943.”

2. 2

   Survival Outcomes with High-Volume Hemodiafiltration Versus High-Flux Hemodialysis in Incident Patients: A Multicenter Analysis Propensity Score Matched Study from the Argentine NEFRA Network.

   Kidney360 (Puddu et al.)Published Sep 9, 2026Checked Oct 15, 2026

   “The primary outcome was all-cause survival comparing hemodiafiltration with high-flux hemodialysis in the propensity score-matched cohort. Secondary and exploratory outcomes evaluated survival by delivered substitution volume and vascular access type. Propensity score matching used age, sex, diabetes, vascular access, and baseline laboratory values. Survival was estimated using Kaplan-Meier methods and compared using the log-rank test.ResultsAfter matching, 1154 patients were included, with 577 per group. For the primary outcome, mean survival was longer with hemodiafiltration than with high-flux hemodialysis (1446 versus 1231 days; log-rank P ConclusionsIn this Argentine incident cohort, hemodiafiltration was associated with longer survival than high-flux hemodialysis. Higher substitution volume and arteriovenous fistula use were associated with the most favorable outcomes. Findings should be interpreted considering the observational design and potential residual confounding.”

3. 3

   Personalized Hemodialysis Approaches in Frail Older Individuals.

   Geriatrics (Basel, Switzerland) (Gembillo et al.)Published Apr 7, 2026Checked Oct 15, 2026

   “It is consistently associated with older age, female sex, diabetes, lower serum albumin, cardiovascular disease, longer dialysis vintage, and lower physical activity. Compared with non-frail patients, frail hemodialysis patients have a substantially higher risk of death (approximately two-fold in pooled analyses). Seminal trials and large observational programs that shaped hemodialysis targets underrepresented very old, frail, and highly comorbid patients, limiting generalizability. In frail older adults with limited life expectancy and substantial comorbidity burden, standard thrice-weekly schedules, higher ultrafiltration intensity, and a uniform 'fistula-first' approach may increase treatment burden without clear proportional gains in patient-centered outcomes. This review examines evidence supporting individualized hemodialysis strategies in frail older adults. As the dialysis population continues to age, proficiency in goal-concordant, personalized prescribing is increasingly important for nephrologists and dialysis teams.”

4. 4

   Ten tips for the first hemodialysis sessions.

   Clinical kidney journal (Hecking et al.)Published Aug 12, 2026Checked Oct 15, 2026

   “Here, we aim at providing "suggestions for colleagues" rather than guideline-like recommendations. In our six tips regarding dialysis consent, transplant candidacy, pill check, vaccination, exercise, and nutrition, we cover the direct patient-doctor axis. In our four tips on volume management, modality, anticoagulation, and incremental hemodialysis, we provide advice that may benefit patients through the prescription itself. Our choice of items is incomplete, as important aspects like vascular access, anemia management, mineral bone disorder, patient-reported symptoms, and dialysate composition are missing. Altogether, we hope that our contribution can emphasize, that hemodialysis may be viewed as the cradle rather than the dead end of nephrology, and enthusiasm for the accomplishments of hemodialysis over the years can ultimately outperform frustration over the burden it imposes on patients. Today's many options to modify hemodialysis for the better represent professional challenges, but these can ultimately be used, right from the start, such as to build the perfect, individualized patient package that should be hemodialysis treatment today.”