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Assessment Options Terms Resources
Simple patient guide + checklist

Learn about dialysis and check how ready you are.

This page helps patients and families learn the next steps for dialysis, transplant, or supportive care. It uses simple words and a short checklist.

You can bring your answers to your kidney doctor visit.

Checklist Symptom checker Simple visuals Helpful links
Start checklist See patient links
Important

Dialysis usually starts because of symptoms and lab problems, not one number alone.

Doctors look at the whole picture. That includes swelling, shortness of breath, poor appetite, low energy, and dangerous lab changes.

Get urgent help now for severe chest pain, severe shortness of breath, fainting, confusion, or fast-worsening swelling.

Dialysis readiness checklist

This is the main tool. Answer the questions below. Then build a plan to discuss with your kidney doctor.

Questionnaire

Pick the answer that fits you best.

Progress 0 of 12 answered
Do you have stage 4 kidney disease?
Stage 4 often means eGFR 15 to 29 for at least 3 months.
If your kidney doctor says it is time, are you open to dialysis?
Have you had teaching about dialysis and transplant choices?
Would you like home dialysis if it is a good fit?
If you want hemodialysis, have you had vein mapping?
This is an ultrasound of the blood vessels in your arm.
Have you seen a vascular surgeon for a fistula or other permanent access?
If you want peritoneal dialysis, have you been checked to see if it fits you?
If your eGFR is under 20, have you been referred to transplant?
Do you already have a fistula, or are you scheduled for a PD catheter?
Has the dialysis company contacted you about home setup or an outpatient dialysis spot?
Are you already listed for transplant, or is transplant testing in progress?
If you do not want dialysis or transplant, are you thinking about supportive care, palliative care, or hospice?

Your discussion plan

Complete the questionnaire and click Build my plan.

Snohomish Kidney Institute note: As kidney disease gets worse, most patients need more visits, more lab checks, and more treatment planning.

Symptom checker

This does not diagnose kidney failure. It helps you know when to call your kidney team sooner.

Select symptoms, then click Check symptoms.

Your options

Most patients do better when they learn all of their options early.

Home option

Peritoneal dialysis (PD)

PD is a home treatment. A soft tube in the belly lets dialysis fluid go in and out.

Center or home

Hemodialysis (HD)

HD cleans blood with a machine. It can be done in a dialysis center and sometimes at home.

Early referral helps

Kidney transplant

Transplant testing often starts when eGFR is under 20 or heading there soon.

A real choice

Supportive care

Some patients choose symptom-focused care instead of dialysis. Talk openly with your kidney doctor.

Learn the terms

These visuals explain common words you may hear in clinic.

Vein mapping

An ultrasound of the blood vessels in the arm. It helps plan a fistula or graft.

Fistula

A surgery that joins an artery and a vein, usually in the arm, for long-term hemodialysis access.

PD catheter

A soft tube in the belly used for peritoneal dialysis.

Peritoneal dialysis

A home dialysis treatment that uses the belly lining as the filter.

What usually happens next

These are common next steps. Timing can change based on symptoms and medical needs.

1

Learn your choices

Try to learn about PD, HD, transplant, and supportive care before dialysis becomes urgent.

2

Plan access early

If HD may be needed, vein mapping and a surgeon visit may be arranged early because a fistula can take time to mature.

3

Place PD catheter or create fistula

PD catheters often need healing time. Fistulas often need weeks to months before regular use.

4

Training, setup, and transplant workup

PD training often takes 1 to 2 weeks. Transplant testing may take weeks to months.

Simple tips

These can help you know what to ask at your next visit.

Start early

Ask for dialysis education before things become urgent.

Look at the whole picture

Dialysis is usually started because of symptoms or serious lab problems, not just one eGFR number.

Ask about home options

If you want more flexibility, ask if PD fits your body, home, and daily life.

Ask about transplant early

Transplant referral often starts once eGFR is under 20 or is heading there soon.

Patient resources

These are good places for patients and families to read more.

NIDDK: Peritoneal Dialysis

Simple overview of PD, training, and home setup.

NIDDK: Hemodialysis

Overview of in-center and home hemodialysis.

NIDDK: Choosing a Treatment for Kidney Failure

Compares transplant, PD, hemodialysis, and supportive care.

National Kidney Foundation: Vascular Access

Information about fistulas, grafts, and access planning.

KDIGO CKD Guideline

Professional guideline source for CKD planning.

OPTN Transplant Information

Information about transplant evaluation and listing in the U.S.

Ready to talk with a kidney specialist?

Use this page and your checklist answers to start the conversation with Snohomish Kidney Institute.

Next step

Schedule a nephrology visit

Bring your questions about dialysis, transplant, symptoms, or supportive care.

  • Review symptoms and lab trend
  • Discuss when planning should start
  • Ask about transplant referral
  • Compare home and in-center options
Bring this page

What to bring to your visit

Your symptoms, your questions, your lab values if you have them, and your checklist answers from this page.

Do I start dialysis at a certain eGFR?

Usually no. Symptoms, swelling, breathing trouble, and lab problems often matter more than one number alone.

Why plan a fistula early?

A fistula often needs time to mature before it can be used.

Can I talk about transplant before dialysis starts?

Yes. Many patients are referred early, especially once eGFR is under 20 or is heading there soon.

What if I do not want dialysis?

Supportive care, palliative care, and hospice can be discussed with your kidney doctor.

Important disclaimer: This page includes AI-generated educational content. Use it only together with conversations with your nephrologist or kidney care team. It is not medical advice and should not be used by itself to decide on dialysis, transplant, emergency care, or medicine changes.