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MEDICAL ANIMATION TRANSCRIPT: Your doctor may recommend dialysis, a procedure that removes waste products from your blood, if your kidneys are not functioning properly. Healthy kidneys filter out waste, excess fluid, and electrolytes like potassium and sodium from the blood. These waste products exit the body through the urethra in the form of urine. If you have kidney disease, your kidneys gradually lose function, leading to an accumulation of harmful waste and excess fluid in your body, increased blood pressure, and bone or blood problems. Dialysis can also be done to treat acute kidney failure, which occurs when your kidneys stop working suddenly, or to remove drugs or poisons from your body. In one type of dialysis, called hemodialysis, your doctor will use a machine called a dialyzer to clean your blood outside your body. Some weeks or months before you begin hemodialysis, your doctor will prepare a vascular access site on your body. Your doctor will create either an arteriovenous graft or an arteriovenous fistula to access your bloodstream. To begin, he or she will numb the area with local anesthesia. To construct an arteriovenous graft, your surgeon will make a small incision in your forearm, and insert a soft plastic tube called a graft to connect an artery to a vein. To create an arteriovenous fistula, your surgeon will make a small incision in your skin, and connect an artery with a vein to make a larger vessel called a fistula. Once your vascular access site has healed, your doctor can start hemodialysis. To begin, your dialysis nurse will insert two needles into your AV fistula or graft. Once the circuit is set up, your blood will flow slowly out of your body and through the dialyzer. Inside the dialyzer, your blood will encounter filtering fibers and an absorbent cleaning solution called dialysate. The fibers will remove waste and excess fluids and electrolytes from your blood. Your cleaned blood will emerge from the dialyzer and continue through the tubing back into your body through the second needle at your access site. When your hemodialysis session is complete, the needles and tubing are removed, and you can go home. In another type of dialysis, your doctor will use the membranes lining your abdomen, called the peritoneum, to clean your blood without removing it from your body. Before you begin peritoneal dialysis, you will have an operation to implant a soft tube called a catheter. Your surgeon will insert the catheter near your belly button, creating a port through which the dialysate will enter and leave your abdomen. Each peritoneal dialysis session is called an exchange. First, you will use your catheter to fill your abdomen with dialysate for a period of time determined by your doctor. Through the peritoneal membrane, waste products and extra fluid are continuously drawn out of your blood into the dialysate. Along with the waste materials it absorbed, the dialysate will drain out of your abdomen into a disposable collection bag during your exchange.