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By Robert Provenzano, M.D., F.A.C.P.
Since home dialysis was first developed in the 1960s, hundreds of thousands of people have used this safe and effective treatment as an alternative to regular dialysis center visits. With home dialysis, you can receive the care you need while maintaining the freedom you value. In my experience, nearly anyone can do home dialysis if they have the dedication and motivation to take greater control of their care. But I also recognize that for some people, the idea of getting started on home dialysis can seem overwhelming. I often get questions from those considering home dialysis about where to start.
The first and most important thing to do if you're interested in beginning home dialysis is to talk candidly with your doctor. Ask about the potential benefits and any medical risks. Ask about your treatment options and how your choice may affect your schedule, home, diet, lifestyle and overall health. I encourage my patients to ask every question they can imagine and get the answers they need to feel satisfied and comfortable with their choice. I remind those considering home dialysis that each person's medical and lifestyle needs are unique, and what is best for one patient might not be best for another.
If you and your doctor decide that home dialysis is a good option for you, the next step is to work with a home dialysis provider to participate in a comprehensive safety and training program. Your training program will be customized to meet your specific medical and learning needs. It will provide you the education, tools and support needed to stay healthy and safe while enjoying the many benefits home dialysis can offer. The length of training programs varies depending on the type of home dialysis you choose, but most people can usually learn how to safely perform their own peritoneal dialysis within a couple of weeks and home hemodialysis treatments within three to five weeks.
One of the most important things you'll learn as you begin your safety and training program is that you're never alone when you perform dialysis treatments at home. Although you may not visit a dialysis center three times a week, you will maintain regular contact with your doctor and dialysis nurses who will closely monitor and track your care. In most cases, you'll also make a monthly visit to meet with your health care team and talk regularly by phone about any issues or concerns. With the support of your doctor and health care team, you should feel at ease with your treatment program.
Some of my patients who choose home hemodialysis also want or need a friend or family member as a partner to help with their treatments. If you choose to have a dialysis partner, that person will go through the safety and training program with you and learn how to assist you as needed.
When getting started with home dialysis, getting your home ready is another important thing to consider. Since you'll be performing your treatments from home, you'll need to make room to store equipment and supplies. Although the equipment and supplies you need vary based on your choice of treatment, it's essential to make sure you have a comfortable and sanitary environment dedicated for your treatments. Also, some treatment options might require minor plumbing or electrical modifications. Before you choose a treatment option, your health care team will work with you to find a solution that works best for your home.
And finally, whenever I'm talking with patients about home dialysis as a treatment option, they often raise questions about the cost. The truth is that home dialysis is as cost-efficient as going to a dialysis center for treatment. Medicare and most private insurance plans provide coverage for home dialysis for qualified patients. And it's important to know that Medicare is not just for people over the age of 65. In fact, Medicare benefits have been extended to all adults with end stage renal disease who meet certain conditions.
Robert Provenzano, M.D., F.A.C.P., is Chief of Nephrology at St. John Hospital and Medical Center in Detroit.
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