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Home Dialysis

Home Hemodialysis

Many patients discover that they were not adequately informed of all of their treatment options when diagnosed with kidney disease. As a result, the questions below are frequently asked when patients realize that they have the option of doing their dialysis at home.

What is home hemodialysis?

Can anyone do home hemodialysis?

Is home hemodialysis safe?

What are the benefits to doing home hemodialysis?

So you are on hemodialysis. You have a regular schedule, three times a week, to report to a dialysis center to receive treatment. While certainly you are feeling better, imagine being able to be surrounded by your friends and family in an environment you are comfortable with. This is home hemodialysis, where you set your own treatment schedule. There are three types of hemodialysis that can be performed at home. They are:

  1. Conventional home hemodialysis: Done three times a week for three to four hours or longer each time.
  2. Nocturnal home hemodialysis: Treatments are done longer and slower at night while you sleep. Dialysis can be done six nights a week or every other night, depending on what your doctor prescribes for you. Treatments usually last about six to eight hours.
  3. Short daily home hemodialysis: This is usually done five to seven times a week. Treatments usually last about two hours each.

While most patients may be capable of learning how to do home hemodialysis, this option works best for patients who want to take greater responsibility for their care and seek more flexibility to dialyze on their own schedule.

Home hemodialysis is safe. Patients will typically identify someone who can assist them with their treatments. This may be a spouse, parent, child, professional caregiver or other responsible individual who can be relied upon to provide support during your treatments. There also are agencies who provide support services if needed. You and your caregiver will be trained over several weeks until you both are comfortable with the home hemodialysis treatment process. You will have 24/7 support from CKS medical staff. Your CKS doctor will also monitor you closely to make sure you are getting the right amount of dialysis.

One of the major benefits of doing home hemodialysis is that patients can dialyze more often, meaning less fluid generally needs to be removed during each treatment. This reduces symptoms like headaches, nausea, cramping and feeling “washed out” after treatments. Many reports indicate that home hemodialysis patients live longer, have better quality of life, have fewer and shorter hospital stays, have more energy for daily tasks, and sleep better. Your CKS doctor will talk to you about all of your dialysis choices. Together, we will decide the best treatment for you.

Peritoneal Dialysis

As awareness increases about home treatment options for dialysis, questions on Peritoneal Dialysis arise more frequently, leaving patients to wonder if it is a viable consideration. Hopefully the questions and information below will help you to decide.

What is Peritoneal Dialysis (PD)?

How does Peritoneal Dialysis (PD) work?

What are the benefits to doing PD?

Peritoneal Dialysis, or PD as it is commonly known, uses the inside lining of your abdominal cavity as a natural filter. Wastes are taken out using a cleansing fluid called dialysate, which is washed in and out of your stomach in cycles.

A soft plastic tube (catheter) is placed into your stomach surgically. A sterile cleansing fluid is inserted into your stomach through this catheter. After the filtering process is finished, the fluid leaves your body through the catheter.

There are two types of peritoneal dialysis, Continuous Ambulatory Peritoneal Dialysis (CAPD) and Automated Peritoneal Dialysis (APD). The basic treatments are the same for each. However, the number of treatments and the way the treatments are done differs.

CAPD is “continuous,” machine-free and done while you go about your normal activities such as work or school. You do the treatment by placing about two quarts of dialysate into your stomach and later draining it. When an exchange (putting in and taking out the fluid) is finished, the fluid (which now has wastes removed from your blood) is drained from your stomach and thrown away. This process usually is done three, four or five times in a 24-hour period while you are awake during normal activities. Each exchange takes about 30 to 40 minutes. Some patients like to do their exchanges at mealtimes and at bedtime.

APD differs from CAPD in that a machine (cycler) delivers and then drains the cleansing fluid for you. The treatment usually is done at night while you sleep.

With PD, you can control extra fluid more easily since dialysis is more continuous. This may reduce stress on the heart and blood vessels. For patients who have anxiety over the use of needles PD may be a viable treatment alternative. You are able to eat more and use fewer medications. You can do more of your daily activities and it is easier to work or travel.