In Home Dialysis Treatment

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Kidney failure, also known as renal failure happens when a person’s kidneys are unable to filter waste products from the bloodstream. This can happen suddenly or over time. When this happens suddenly it is usually from trauma or sudden damage to the kidneys. Overtime is from chronic illnesses or conditions. There is a better chance of recovery for the kidneys when it happens suddenly versus chronic illness damage. If the kidneys lose their ability to filter waste products levels rise to a dangerous level in the bloodstream. This will then cause the chemical components of the blood to get out of balance. Whether it is an acute or chronic renal failure both situations have the potential to be life-threatening. Most patients are hospitalized for a period of time. The optimal goal is to restore the kidneys to normal function but this is not always possible. Patients then have to be placed on a treatment call hemodialysis. There are two options for outpatient dialysis. The first option is in center dialysis such as in a clinic. The second option is in home dialysis therapy. With today’s technology, the home kidney dialysis machine has been a blessing to many patients.

When a patient is first released from the hospital with renal failure this is a scary and overwhelming time in their lives. Patients usually become confused, angry, and overwhelmed in the first few weeks after being told they have renal failure and need dialysis treatment. During this time a patient needs to familiarize themselves with the dialysis treatment procedures and options they have for the types of treatment available. Patients must take an active role in treatment if they plan to be successful while receiving dialysis. 

Hemodialysis is a procedure the function of the kidneys to remove wastes and extra fluids from the bloodstream. This is accomplished by pumping the blood out of the body through the tubing. It is then sent to a dialyzer also know as the artificial kidney. While in the dialyzer the blood is cleaned and returned to the body through a separate tubing. The tubing is attached to two needles that are inserted into a patients vascular access site. The dialysis machine controls the amount of fluid and waste that is removed from the body and monitors the time length a patient remains on dialysis. It also monitors the temperature of the blood and the pressures during removal. 

Hemodialysis can be performed in-center where a technician or nurse performs the treatment and monitors the patient while on dialysis. These treatments are usually performed three times during the week at a pre-scheduled time. Dialysis can be performed in the home setting where the patient is performing the dialysis and monitoring on themselves. 

When performing dialysis in the home the patient can better manage their daily routines. Data has proven that the more a patient knows about their treatments and their treatment goals the more the patient can perform on their own. In turn, means the better success rate a patient has to perform in-home kidney dialysis treatment. 

There are three types of in-home dialysis treatment. Conventional home hemodialysis is the first one. This is performed three times a week for approximately three to four hours per session. The patient and a caregiver are trained to perform dialysis safely and to be able to troubleshoot any problems that arise. The training may last anywhere from a few weeks to as long as several months. The second type is short daily dialysis. In this type of dialysis, the frequency is increased to five up to seven times per week. There is a new dialysis machine that is specifically for daily dialysis treatments.

The sessions are approximately two hours in length each time. Because treatments are more frequently performed during daily dialysis the less fluid and waste needs to be removed during each session. The training time for this is also less because of the frequency of treatments. The more frequent the treatments the fewer side-effects are noted. Then there is the third option which is nocturnal home hemodialysis. These treatments are performed overnight and are long and slow treatments performed while the patient is sleeping. The frequency is either up to six nights a week or every other night. The training time for nocturnal dialysis is over a period of a few weeks. If the patient and caregiver are not comfortable performing treatments extra training can be given. Nocturnal treatments usually last about six to eight hours. The new machines will submit the dialysis data to the clinic via telephone modem or the internet to be reviewed by healthcare staff. If one dialysis option is not effective sometimes daily and nocturnal dialysis treatments are combined. The more dialysis time the more waste removal. The frequency of dialysis will be ordered by the nephrologist.


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