What Is Hemodialysis?
When the kidneys do not function properly, toxins and excess fluid build up in the bloodstream. Hemodialysis works by taking blood from the body, and the dialysis machine cleans it, helping to remove the toxins. Blood is taken out of the body and run through a filter. Toxins are removed from the blood and incorporated into the dialysis fluid, which is then disposed of.
What Is Home Hemodialysis?
Home hemodialysis is when the dialysis treatment takes place in an individual's own home. Dialysis can be carried out by oneself or with the support of a family member or a friend who has been trained to help the individual.
Who Can Have Home Hemodialysis?
Most of the individuals receiving hemodialysis are suitable for home hemodialysis if the kidneys are stable. It is essential to talk to the dialysis team if the individual is interested in home hemodialysis and will be able to arrange a home visit to see if the option is suitable for the individual and the individual’s accommodation.
What Equipment Is Required for Home Hemodialysis?
The dialysis machine will be provided and installed by the hospital and all the equipment the individual needs for home hemodialysis free of charge. Home hemodialysis machines are of different types, and the dialysis team will assess which is the best for the individual.
Space will be required to store the supplies, which will include the dialysis fluid, needles and cleaning products. It is essential to keep away from damp or direct heat in a dry area. A member of the patient’s kidney team will visit the home to review the arrangements before the patient starts home hemodialysis.
The supplies will be delivered directly to the patient's house on a monthly basis. If there is limited storage space, a two-week delivery schedule can be arranged. The delivery driver will move the supplies to the chosen storage area and stack them for the patient.
What Are the Benefits of Home Hemodialysis?
The benefits of home hemodialysis are:
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Home hemodialysis is one of the right choices if it suits an individual's medical and physical condition.
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If the dialysis is at home, it gives flexibility, including being able to have the treatment at a time that suits the individual.
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The dialysis schedule can be canned by the individual to suit the lifestyle.
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The individual will be able to have the treatment in an environment that is familiar to them and can avoid frequent hospital visits. In consultation with the kidney team, the individual might choose to have more dialysis than would receive in hospital, and this can improve the blood tests allowing more freedom with the diet and possibly fluid intake as well.
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They become more confident about hemodialysis by learning how to manage an individual's own treatment and understanding how it works and what works for the individual. This can help the individual to manage their chronic kidney disease more effectively and to make choices about the treatment that is right for the individual.
What Are the Pros and Cons of Home Hemodialysis?
The pros of home hemodialysis are:
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Easier to fit into a patient's daily schedule.
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Easier to keep working if one has a job or wishes to return to work or school.
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No need to travel to the dialysis center three times a week.
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Independence and being in control of one’s own treatments.
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Likelihood of better health outcomes over time.
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During treatment, the comfort and privacy of being in one’s own home.
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During treatment, having access to a telephone, family members, and visitors.
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Being able to eat or drink if the patient wishes to during treatment.
The cons of home hemodialysis are:
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Training for home hemodialysis is not offered by all dialysis centers.
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More space is required in the home for equipment and supplies.
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A care partner is generally required to be with the patient during treatments.
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Training might take three to eight weeks or longer, with three to five-hour training sessions per week.
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Some plumbing and wiring changes might be required at home, but newer machines use standard household outlets.
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Electric, gas, and water bills may increase slightly.
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Some new machines are portable, but it is necessary to find a dialysis center to provide support when traveling.
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Less social interaction compared with going to the dialysis center.
What Are the Different Types of Home Hemodialysis Treatment?
There are three types of hemodialysis that can be performed at home. They are:
Conventional Home Hemodialysis:
This hemodialysis is done three times a week for three to four hours longer each time. The care partner and the patient are trained to do dialysis safely and to handle problems that may come up. Training might take several weeks to a few months.
Short Daily Home Hemodialysis:
This hemodialysis is done five to seven times a week using a new machine designed for short daily home treatment. Treatment will usually last about two hours each. The patient and the caretaker are trained over several weeks as the dialysis is done more often, and less fluid needs to be removed each time. This will help to reduce symptoms like nausea, headache, cramping, and feeling washed out after treatment.
Nocturnal Home Hemodialysis:
This hemodialysis is a long, slow treatment done at night while sleeping. This dialysis can be done six nights a week or every other night. This will depend on what the doctor prescribes. Treatment will usually last for six to eight hours. The patient and the caretaker are trained over several weeks. Some centers will monitor the treatment by sending the information from the dialysis machine to a staffed location by telephone modem or the Internet. More dialysis hours each week can result in more waste removal.
Conclusion
Hemodialysis is a treatment that will replace the work of the individual’s own kidneys to clear the wastes and extra fluid from the blood. A special filter called a dialyzer or artificial kidney is used to do this. Home hemodialysis is not a good fit for everyone. The patient and the caretaker need to learn a lot about it and need to be responsible for one’s treatment. However, at home, the patient might be better able to fit the treatments into their daily schedule.
