A client with diabetic nephropathy has end-stage renal disease and is starting dialysis. What should the nurse teach the client about hemodialysis?

Choice A reason: Standard maintenance hemodialysis is typically not performed daily in a clinical setting. While some home hemodialysis programs offer more frequent, shorter sessions, the conventional schedule for the vast majority of patients in outpatient centers involves three sessions per week. Daily dialysis is usually reserved for acute, unstable patients in intensive care units. Choice B reason: The description of a catheter inserted into the abdomen refers to peritoneal dialysis, not hemodialysis. Hemodialysis requires vascular access, such as an arteriovenous fistula, graft, or a central venous catheter in the chest or neck. Peritoneal dialysis uses the peritoneal membrane as the filter, whereas hemodialysis uses an external artificial kidney machine. Choice C reason: In the United States and most clinical protocols, the standard frequency for outpatient hemodialysis is three times per week, with each session lasting approximately 3 to 5 hours. This schedule is designed to sufficiently remove metabolic waste products and excess fluid that accumulate when the kidneys have reached end-stage failure. Choice D reason: End-stage renal disease (ESRD) is characterized by permanent, irreversible kidney damage. Unlike acute kidney injury, where the kidneys may eventually heal and resume function, ESRD requires lifelong renal replacement therapy (dialysis) or a kidney transplant. Teaching the client that the kidneys will "heal" provides false hope and inaccurate medical information.