SMG nurses provide hemodialysis services to hospitalized patient who require ongoing care for End Stage Renal Disease (ESRD) or who have developed Acute Kidney Injury (AKI) and whose kidneys cannot adequately remove fluid and toxins from the body. The hemodialysis machines are maintained and operated in the hospital in conjunction with the hospital staff. Dialysis may be performed at the bedside or in a room designated for the purpose of providing hemodialysis treatments. After the dialysis treatment, the machine is returned to secure location in the hospital or the patient is returned to their hospital room. For patients with established ESRD, a pre-existing vascular access will be utilized to access the circulation and perform dialysis. In patients with newly diagnosed Kidney Failure, a temporary vascular access may be placed and utilized.