Life With Home Dialysis

Earlier this month we began our discussion on home dialysis with an overview of what it is, how it works, and its benefits. This week’s blog aims to dive into more abstract and nuanced questions such as patient experience, quality of life, support systems, and more. Keep reading to explore this side of home dialysis and our team’s thoughts on the subject!

Reviewing the Pros and Cons of Home Dialysis

Peritoneal Dialysis (PD) can be advantageous for patients with low blood pressure because the control of fluids is much more gentle with a better tolerance than home/in-clinic hemodialysis. 

However, peritoneal dialysis may not be compatible with individuals who have had extensive abdominal surgeries due to the scar tissue that develops – this makes it difficult for the catheter to be placed and function well. In the past, Polycystic Kidney Disease used to be an issue for PD as well, but this is no longer the case – a huge pro! The general cons of home dialysis can be the need for space to store and install equipment/supplies and limited face-to-face support.

Patient Experience

In many cases, patients love the flexibility of home dialysis and the way it can be integrated into their daily lives! Not only are home dialysis options more convenient, but they are also gentler on the body. However, some people may not be candidates for home dialysis – recall the need to be high functioning and/or have a support system. Further, the availability of home dialysis is very limited for those residing at long-term care facilities or nursing homes. Preference is also a large decision-making factor! Having nurses and technicians helping can be comforting and helpful for those who enjoy close-by medical support.

A common adjustment for patients going the home dialysis route is equipping their home environment to be more suitable for the process. One struggle people experience with home dialysis is that there can be a space issue for storing materials and equipment. For pet households, there becomes a need to closely monitor your furry friends. Pets cannot sleep in the same bed with you if you do peritoneal dialysis, as this can compromise patients’ catheters. Despite the challenges, however, many patients report feeling more empowered through home dialysis as they get to manage their health more directly.

Technical and Practical Considerations

Before selecting a route for dialysis, patients get referred. For each type of home dialysis, patients can be initiated outside of the hospital, which typically involves several weeks of training to learn how to conduct home dialysis. Over time, patients begin practicing with nurses during home visits to ensure things go smoothly and help troubleshoot. Over time, patients gain independence and can transition to completing dialysis on their own. Even after patients graduate from initiation, they always have access to the nurse triage line to connect with a home-hemodialysis or peritoneal dialysis nurse.

Support Systems and Resources

We typically recognize that the better a patient’s support system at home, the better their outcomes on home dialysis. Dialysis can be overwhelming and can be a lot of info that’s hard to take in by yourself, so having a family member come to appointments as a second set of ears can be helpful.

In addition to a strong support system, patients retain access to a variety of resources that can help them along their home dialysis journey. The National Kidney Foundation is a great source of credible kidney information. DaVita is also a useful organization to reference – they organize free Kidney Smart classes both online and locally for patients to learn more about treatment options, financing assistance, and more.

For patients who prefer, you can even reach out to dialysis units near you for walkthroughs and Q&A sessions with home dialysis nurses prior to selecting home dialysis as your preferred modality. You can either ask your provider to connect you or reach out on your own! 

The ultimate goal is to make you comfortable with administering home dialysis. At ANC, we’re here to support you! Receiving ongoing support from healthcare providers and peers in managing home dialysis is so important. From a provider perspective, we can look at your labs and say everything looks great on paper but if you don’t feel right, or notice changes in your health telling you otherwise, a doctor is going to be able to investigate why that may be, beyond the numbers. Remember that your providers are here to listen to you!! Be sure to communicate any concerns to them as needed.

ANC’s Advice

Our team’s advice to patients interested in going the route of home dialysis? Seek out as much information as you can. Kidney Smart is a huge resource we promote since it is not only accessible but introduces you to so many options allowing you to determine which one best works for you. The more informed you are as a patient, the better off you are to succeed in your dialysis journey. Reach out to our team with any of your kidney questions to be connected with a provider who can help you!