Home hemodialysis

During at home hemodialysis, blood is sent from the body to an outside machine (dialyzer) that filters out the waste and extra fluids then returns the blood to the body. Hemodialysis is typically conducted in a dedicated facility with specialized nurses and technicians who specialize in hemodialysis.

However, dialysis can also be done in a patient's home, known as at home hemodialysis. Once you and your doctor have determined that at home hemodialysis is right for you, you will begin a comprehensive safety and training program that is tailored to your specific medical and learning needs.

In most cases, you will learn to perform at home hemodialysis treatments with a dialysis partner. An access will have to be created to allow blood to flow from your body to the dialyzer, so it can filter waste and remove extra fluid from your body. There are different ways to create an access, and you will discuss with your doctor which one is right for you and your treatment.

Types

There are three types of at home hemodialysis:

• Short Daily at Home Hemodialysis
  Performed five or six times a week, typically for two to three hours per session.
• Traditional at Home Hemodialysis
  Performed three times per week, typically for about four hours per session. This is similar to the treatments received at a local dialysis center.
• Nocturnal Home Hemodialysis
  Performed during sleep, typically six to eight hours a night, three or more nights a week. Many patients enjoy the ability to spend the night dialyzing and not lose time during the day that could be spent at work or with family.

Equipment options

It is important to note there are various home hemodialysis equipment options available to accommodate/support these treatment choices.

Home hemodialysis vs. peritoneal dialysis

Advantages

Advantages	Peritoneal dialysis		Home hemo dialysis
	CAPD	APD	Short daily	Traditional	Extended / Nocturnal
Flexible treatment time
Fewer diet and fluid restrictions
Portable for ease of travel			1
Needle-free treatments
Dialyze while you sleep
Fewer peaks and valleys
Doctor visits and labs performedonce a month at the clinic

1. Using NxStage prepackaged fluids for travel

Disadvantages

Disadvantages	Peritoneal dialysis		Home hemo dialysis
	CAPD	APD	Short daily	Traditional	Extended / Nocturnal
Requires space for supplies			1
Potential weight gain
Requires modifications to home (electrical and plumbing)
Care partner required

1. Using NxStage prepackaged fluids for travel

Training and check ups

Treatment	Training frequency (days per week)	Length of training (weeks)	Length of each training session (hours)	Frequency of clinic visit (visits per month)
CAPD	3 - 5	1 - 3	4 - 6	1-2
APD	3 - 5	1 - 3	4 - 6	1-2
Short daily	5	3 - 4	4 - 6	1-2
Traditional	3	4 - 5	4 - 6	1-2
Extended / nocturnal	3	4 - 5	4 - 6	1-2