Studies show that the more you know about your treatment and the more you do on your own, the better you are likely to do on dialysis. Conventional home hemodialysis: You do this three times a week for three to four hours or longer each time. You and your care partner are trained to do dialysis safely and to handle any problems that may come up.
Training may take from several weeks to a few months. Short daily home hemodialysis: This is usually done five to seven times a week using new machines designed for short daily home treatment. Treatments usually last about two hours each. You and your care partner are trained over several weeks. Because you are doing dialysis more often, less fluid generally needs to be removed each time. Nocturnal home hemodialysis: Long, slow treatments done at night while you sleep. You may do this kind of dialysis six nights a week or every other night.
This depends on what your doctor prescribes for you. Treatments usually last about six to eight hours. Some centers monitor your treatments by sending information from your dialysis machine to a staffed location by telephone modem or the Internet.
More hours of dialysis each week can result in more waste removal. It is also possible to combine daily and nocturnal home hemodialysis. Whether you can combine treatments depends on your needs, your medical condition and your machine. Whatever treatment option you choose, it is important to know if you are getting the right amount of dialysis.
Tests should be done regularly to check the amount of dialysis you receive. For more information, speak with your doctor and your dialysis care team. New, easy-to-use machines are being developed for home hemodialysis.
These are easier to set up, clean and disinfect. With some newer machines you have fewer supplies to store. If you think home hemodialysis is a good choice for you, ask your doctor about the best equipment for you. Home hemodialysis is not a good fit for everyone.
You need to learn a lot about it. You need to be willing to be responsible for your own treatment. Finding a center that offers home hemodialysis can be a challenge. If your center does not offer home hemodialysis, see below for Web sites that can help you find centers that offer home hemodialysis.
Along with your doctor or nurse's advice, you can choose your time for treatments, so you have more flexibility for work or school or other social activities. You don't need to leave home for treatment, which saves on travel time and transportation costs, plus alleviates weather-related travel worries. You or your care partner will put in your own needles, which some people prefer. You have more freedom with your diet if your doctor prescribes more frequent dialysis treatments.
What do you need to succeed at home hemodialysis? Anywhere from 4 to 6 weeks of training—along with your care partner a family member or friend , if you need one. If you have a care partner, he or she needs to be dependable—to commit to either participating in your home hemodialysis treatments or staying with you to monitor them. You or your care partner must be willing to set up for treatments and clean up afterward. Before you begin, check with your health insurance provider—or your social worker—so you know whether more frequent at-home hemodialysis treatments will be covered.
Nocturnal nighttime at-home hemodialysis treatment These are long, slow treatments done while you sleep—they usually last 6 to 8 hours. They can be done nightly or every other night, depending on what your nephrologist prescribes. Mix and match at-home hemodialysis At-home hemodialysis allows you and your nephrologist to create a schedule that will fit your life, while giving you the best duration and frequency of treatments for your body.
Your doctor may decide that combining daytime and nocturnal treatments will give you optimal care. Find out if starting or switching to home dialysis treatment is right for you. That means you get the benefits of home and the comfort of knowing help is there if you need it. Setting up your access Your access for hemodialysis HD is quite literally your lifeline—a way to reach and clean your blood and return it safely to your body. If you are switching from in-center hemodialysis, you will already have an access in place, although your doctor may discuss other access options if you have a hemodialysis catheter.
If you are starting HD for the first time—or switching from peritoneal dialysis PD —you will need a minor surgical procedure to create your new access. Planning ahead for your hemodialysis access is key There are 3 types of access sites for at-home hemodialysis: fistula , graft or catheter. Azura Vascular Care, an affiliate of Fresenius Kidney Care, offers minimally invasive, outpatient dialysis access surgery.
If you're interested in doing solo home hemodialysis, ask your nurse about training. You can still enjoy the company of your pets.
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