For people on dialysis who are stable, and who desire more control and flexibility over their treatments, home hemodialysis is another treatment option. With home hemodialysis a patient, along with a partner in most cases, will set up a dialysis machine in his or her home and learn to perform dialysis. This requires a patient, and/or partner, to learn how to self-cannulate, or put the needles into the access, set up the dialysis machine, monitor the machine, take and record vital statistics during treatment. Home hemodialysis patients must have a room in their home capable of accommodating the dialysis machine and water treatment (depending of the type of machine selected). They will go through extensive training, usually from four to six weeks with a home dialysis training RN to learn how to perform dialysis and troubleshoot any issues that may occur.
While a nephrologist will prescribe a dialysis prescription that the patient must follow, there is more flexibility when dialyzing at home. Some people perform home hemodialysis three times per week for three to five hours like done in the dialysis center. Other patients perform nocturnal dialysis while they sleep for eight hours three nights per week. Another option is short-daily dialysis where the patient performs hemodialysis four to seven days a week for three to four hours. Many patients report that with more frequent or longer treatments they feel better. And, it often allows them to have a more relaxed diet.
People who do home hemodialysis are able to dialyze when it is convenient for them so they aren’t dependent on the schedule of a hemodialysis center. They enjoy the freedom of arranging their own dialysis schedule around work and family obligations. Many also prefer the comfort of being in their home during treatment. There are still some diet and fluid restrictions for many of those who perform home hemodialysis and they must still be followed by a nephrologist and have their lab work done to determine treatment and diet prescriptions.
Pros and Cons of Home Hemodialysis
- Flexibility in scheduling treatment
- No need to go to center three times a week
- Comfort of being at home for treatment
- Need to have a partner to help
- No medical professional present to monitor care or troubleshoot problems
- Need to take have space in home to set up machine