Hospitalization Tips for People on Home Dialysis

Disclaimer: This article is for informational purposes only and is not intended to be a substitute for medical advice or diagnosis from a physician.

There may be times when home dialysis patients have to be admitted to the hospital or a long-term care (LTC) facility, whether the hospital visit is associated with their kidneys or an entirely separate health matter. DaVita® has some recommendations and tips to help coordinate your kidney care while in the hospital or LTC so you can recover quickly.

Hospitalization tips for all home dialysis patients

  • Whenever possible, contact your dialysis nurse before going to the emergency department or hospital.
  • Upon admission, request that your home dialysis nurse and nephrologist are contacted in regards to your hospital stay.
  • Do not bring your dialysis equipment into the hospital. Your hospital will provide the equipment for your treatments during your stay.
  • If you feel that the hospital is not equipped to handle your dialysis request, discuss options with your nephrologist.
  • Provide an updated medication list, including Epogen®/ESA and IV iron if applicable, and request that the hospital contact your nephrologist for Epogen and phosphate binder orders, if needed.
  • Communicate with your care partner so that in the event you are unable to explain your needs, he or she is aware of best demonstrated practices for the hospital or LTC facilities.
  • If you regularly take phosphate binders with your meals, make sure that you get them with your hospital meals if your doctor has ordered them.

Hospitalization tips for patients on peritoneal dialysis (PD)

  1. If you have received a new PD catheter, you should be in contact with your PD nurse within 24 to 48 hours of your surgery.
  2. If you need to go to the emergency department because of possible peritonitis, drain your abdomen first and bring the drained fluid with you.
  3. A new PD catheter should have a sterile dressing changed weekly by a qualified renal nurse, not by you or a qualified care partner.
  4. Remind all caregivers, staff or visitors to wear a mask and wash their hands prior to all PD connections and disconnections.
  5. Request a private room. If one is not available, roommates and guests should wear masks during connections and disconnections.
  6. Request that experienced dialysis staff assist with exchanges.
  7. You should have daily care of your chronic exit site. Remind the doctor to ensure this is being addressed.

Hospitalization tips for patients on home hemodialysis (HHD)

  1. If you have a buttonhole access, your hospital caregivers will need to use special blunted needles for your dialysis treatment. If blunted needles are not available, the fistula can be cannulated with regular needles, but sites need to be away from the buttonholes and rotated.
  2. Do not allow blood pressure, lab draws or other procedures to be done on your access arm.
  3. It may or may not be possible for you or your care partner to self-cannulate while in the hospital; discuss it with your doctor.
  4. Remember that the dialysis equipment in the hospital may be different from what you use at home, so your treatment times may vary.

You may not need to be hospitalized for a prolonged period of time, but it's still good to know your options as a home dialysis patient if such a situation was to arise.

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