5 Things You Need To Know Before You Sign Up For Home Hemodialysis
End stage renal disease (ESRD) is managed by either dialysis or by replacing the lost kidney function by kidney transplantation. Sadly, due to limited availability of donor organs, kidney transplantation is not an easy option for a majority of ESRD patients. Hence, for majority of ESRD patients, dialysis is a mainstay for the survival.
Hemodialysis
The dialysis machine works by filtering a patient’s blood and removing waste products and excess fluids. The patient’s blood is passed through the AV Fistula into the dialysis machine through plastic tubing. The dialysis machine contains a large canister called the dialyzer, containing thousands of small fibers that form a semi-permeable membrane that filters out waste products. Fresh dialysis solution is pumped around the filters while the patient’s blood runs through it, separated by the thin membrane.
The dialyzer works on the principle of diffusion, therefore the waste products and excess fluids pass through the fibers in the membrane into the dialysis solution. The dialysis solution, also called the dialysate, helps to carry away the waste products and excess fluid from the blood and is then discarded. The newly filtered blood is passed through a bubble trap to ensure there are no air bubbles in the blood, and the blood is then returned to the patient’s body through the vein of the AV Fistula.
Home Hemodialysis (HHD)
Latest advancement in dialysis technologies allows the hemodialysis to be performed in the comforts of patients’ home. Smaller dialysis machine has been developed which can be placed on a nightstand; with simpler blood tubing and dialyzer connections. This has led to more number of patients to opt for this modality of dialysis to maintain their independence and high functional status. Although the duration varies from patient to patient, this form of dialysis can be customized with 5-6 times a week frequency as per patient’s requirement for dialysis with sessions ranging from 3-6 hours. Higher clearance is allowed with this type of home hemodialysis and also gives better freedom with regards to dietary restriction and life style choices.
Here are five things which you should know before choosing home dialysis:
1. It gives the patient a level of flexibility in setting up the scheduling time which is not possible in a center. According to other activities and social arrangements, the day or time can be opted by the patient and family.
2. In addition, some patients feel more comfortable when dialyzing in the comfort and known environment of their own home. In dialysis centers, normally food is not allowed but home patients can have their meals while on dialysis.
3. However, several families have found home dialysis extremely suitable and certainly preferable for them. Any previous experience is not required to perform this, but they should be well trained and should be aware on when to call for assistance. Without getting the demonstration of full capabilities by patient and his/her partner/family member, the dialysis center would not give permission to them to start the procedure at home.
4. The family member-therapist should be trained for atleast 6-8 weeks along with the patient on the procedure to be followed. This member should restrict himself to the same schedule as the patient to perform the dialysis. Psychologically, the member might be stressed or burdened of feeling accountable for the patient’s safety.
5. There might be situations wherein slight difficulties arise; the patient should be immediately taken to the center for dialysis.
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