Many dialysis patients are interested in home dialysis because of the many clinical and lifestyle benefits it brings to their lives. However, what many patients may not know is that the patient requirements for home dialysis are more liberal than they may think. Generally, most dialysis patients qualify for home dialysis, as long as they meet some basic requirements.
Dexterity and vision
Home dialysis patients must have adequate manual dexterity and vision to operate the equipment, complete necessary paperwork, order supplies and perform other basic dialysis-related tasks.
Reading and writing
Home dialysis patients must have basic reading and writing skills in order to read training manuals, order supplies and complete some simple, but important, paperwork. One of the most important elements of performing dialysis at home is recording basic information on every treatment so that the patient’s doctor and dialysis provider can monitor and make adjustments to his or her care as needed.
At-home patients will need home dialysis equipment, adequate space to store supplies, a clean place to perform treatments and the proper supplies. The type of dialysis treatment determines the type of supplies and equipment that are necessary. Home dialysis equipment is provided to the patient by their dialysis provider.
Space to store supplies
The amount of space needed for home dialysis supplies depends on the form of home dialysis chosen. In general, patients will need room to store boxes of supplies in a closet, some cabinets, a garage or a spare room. Once patients become familiar with the amount of supplies they use in a given period of time, they can adjust the supply delivery schedule so they need less space for storage.
Initiative and motivation
Learning about the proper techniques, learning how to use the home dialysis equipment, maintaining a clean environment for treatments and all the other elements of at-home dialysis takes time. In order for treatments to be effective, the patient needs to have a desire to take responsibility for his or her care and follow training and physician guidelines.
If a patient does not meet these basic requirements for home dialysis, they may still be able to dialyze at home if they have a care partner who meets these requirements and who will be there to assist them during every treatment.
In addition to the basic requirements, patients must meet other requirements specific to the type of home dialysis they choose.
Home hemodialysis (HHD) is dialysis done at home. The patient’s blood is cleaned the same way it is cleaned during in-center hemodialysis, but the patient has the added benefit of being able to dialyze at home and to dialyze more frequently.
HHD patients must have a vascular access placed before beginning therapy. Two types of vascular access include an arteriovenous (AV) fistula and an arteriovenous (AV) graft. Fistulas and grafts are surgically placed, usually in upper or lower arms or legs. Two needles are placed in the access during home hemodialysis to allow blood to flow to and from the body for cleansing.
Peritoneal dialysis (PD) uses the peritoneal membrane inside the body for dialysis. A dialysis solution is put into the peritoneal cavity where it dwells for a prescribed period of time, during which waste and fluids are filtered from the blood into the dialysis solution. When the dwell time is over, the dialysis solution is drained, taking the wastes and extra fluid with it. This drain, fill, and dwell process is called an exchange.
Successful peritoneal dialysis (PD) requires a patient to have a functioning peritoneal membrane that allows wastes and extra fluid to be adequately filtered through the membrane. The patient must have a catheter surgically placed in their abdomen that will allow dialysis solution to enter and leave the peritoneal cavity.
Home dialysis patients should be motivated, be able to hear or see alarms, be able to read instructions and have basic manual dexterity skills. They will also need to have the type of access required for the home dialysis they are going to do. In addition, they will need to have room in their home for their dialysis machine and supplies. Talk with your doctor today to find out if you are a good fit for home dialysis.
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