Home hemodialysis takes effort and may not be for everyone. The following are crucial steps when practicing home hemodialysis:
- Maintenance of the dialysis machine is required
- Setup machine for each treatment
- Complete each treatment as specified by doctor
- Sanitize the equipment properly after each treatment
- Keep necessary supplies stocked and ordered
You essentially become a nurse, dialysis tech, and patient within one or two people. Providers will likely recommend you have a care partner to assist you during this process.
Pros and cons of home hemodialysis
Pros may include convenience, flexibility with treatment, and not having to go out in public with potential exposure to Coronavirus.
Pros:
- Easier to fit into your daily schedule
- Easier to keep working if you have a job or you wish to return to work or school
- Not having to travel to a dialysis center three times a week
- Independence and being in control of your own treatments
- Likelihood of a better health outcome over time
- The comfort and privacy of being in your own home during treatment
- Having access to telephone, family members, and visitors during treatment
- Being able to eat and drink if you choose to during treatment
Cons:
- Initial fears about duties and caring for the dialysis machine
- Training for home hemodialysis is not offered by all dialysis centers
- More space is needed in your home for equipment and supplies
- A care partner is generally needed to be with you during treatments
- Training may take three to eight weeks or longer, with three- to five-hour training sessions per week
- Some new machines are portable, but you will have to find a dialysis center for support when traveling
- Less social interaction compared with going to the dialysis center
- Your care partner may tire of this role
Types of At Home Hemodialysis
Conventional home hemodialysis
Conventional home hemodialysis is a treatment you do yourself at home, with the help of a partner. Both you and your partner must be trained to use the machine and to insert the needles into your vascular access. A home hemodialysis machine is a small version of the in-center hemodialysis machine that does the same job. This type of dialysis may let you have a more flexible treatment schedule because you can do your treatments when it is convenient for you.
However, you must follow your doctor’s instructions about how many times per week you need to do your treatments and how long each treatment should last. Most people who choose conventional home hemodialysis do their treatments three times per week for three to five hours each time. It is very important that you do not skip your treatments!
Nocturnal home hemodialysis
If you work, go to school or have other commitments during the day, you may choose to do nocturnal home hemodialysis. This treatment schedule allows you and your care partner to do your treatments at home, while you sleep. Each treatment session lasts six to eight hours and can be done every other night or more often, depending on what your doctor thinks is best for you.
Having your treatments more often and for longer periods of time means that fluid is taken out of your blood more slowly and more often. This may help you feel better between treatments and may allow you more freedom with your diet and fluid intake.
Short daily home hemodialysis
Short daily home hemodialysis is done for about two hours, every day of the week or almost every day. Your doctor can tell you how often you should do your treatments. This type of hemodialysis can be done at any time of the day that is convenient for you and your care partner. Having your treatments more often means that fluid is taken out of your blood more slowly and more often. This may help you feel better between treatments.
Explore what is right for you!
Research your options, talk with other kidney disease patients, talk with your doctor and your family to decide if at home hemodialysis is right for you. Midwest Nephrology is available to discuss this option with you and provide you with the resources you need.
Resources:
https://www.kidneyfund.org/kidney-today/dialyzing-at-home-during-the-pandemic.html
https://www.kidney.org/sites/default/files/11-10-0329_homehemo.pdf
https://www.kcercoalition.com/covid-19
https://www.kidneyfund.org/kidney-disease/kidney-failure/treatment-of-kidney-failure/hemodialysis/
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