Safety and Training for Home Dialysis

Traditionally, most dialysis treatments are performed in-center at a hospital or outpatient facility, but home dialysis has become an increasingly popular and safe alternative for some patients. If you are interested in performing dialysis at home, it is important to work with your doctors to discuss the quality of life benefits, as well as any medical risks, to jointly decide if home dialysis is right for you.

As with all forms of dialysis or other medical treatments, safety should always remain the top priority for anyone on home dialysis. In order to perform safe and effective dialysis at home, there are some basic requirements:

• Dexterity and vision - You and/or your care partner must have adequate manual dexterity and vision to operate the equipment, complete necessary paperwork, order supplies and perform other basic dialysis-related tasks.
• Ability to learn and adapt - At-home dialysis patients should be flexible and able to adapt easily to new situations. You must be attentive during the training process, confident in your ability to overcome challenges that may arise during treatment and open to the possibility of home modifications. In addition, you must be comfortable with a form of dialysis that may be slightly different than what you are used to receiving in-center.
• Reading and writing - All 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 safe home dialysis is recording basic information on each and every treatment so that your physician and dialysis provider can monitor and make adjustments to your care as needed.
• Initiative and motivation - In order for treatments to be effective, you need to have a strong desire to take greater responsibility for your care and closely follow training, safety and physician guidelines. Learning about the proper techniques, training to use the equipment, maintaining a hygienic environment and other elements of home dialysis takes time. But with the right dedication, you'll find it's worth it.

Training is the first step

Once you and your doctor have determined that home dialysis is right for your care, you will work with a home dialysis provider to participate in a comprehensive training program that is tailored to your specific medical and learning needs. A quality training program will provide the education, tools and support needed to stay healthy and safe while enjoying the many benefits home dialysis can offer.

Every patient and their treatment are unique and training needs vary, so home dialysis providers personalize training programs to help you understand how to perform your individual treatments. During your training, you will learn all the skills and procedures needed to regularly perform your treatments independently. The wide range of topics will include how to: use your equipment, create a hygienic environment, manage supplies, handle needles and keep an organized log of your treatments, among other essential tasks. The length of training programs varies, 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. The majority of training for at-home treatments is done at dialysis centers.

Some home hemodialysis patients will choose to have a dialysis partner to assist them. This can be a spouse, parent, child, professional caregiver or other responsible person who can be relied upon to provide support. If you have a dialysis partner, he or she will be trained with you.

Post-training: Ongoing monitoring and support

Even though home dialysis allows you the flexibility to manage your treatments according to your schedule, your nephrologist, who knows you and is familiar with your medical needs, will continue to direct your care. Your nephrologist's ongoing monitoring and support will help ensure your safety and health.

You will learn to record information about each treatment and maintain regular contact with your doctor and care providers so that progress is measured and changes in treatment can be made accordingly. Home dialysis patients also typically visit a dialysis center once or twice a month for an in-person check-up with their doctors.

You should familiarize yourself with your dialysis care provider’s support resources and make sure you have a list of important phone numbers handy in case you have any questions or issues while performing your at-home treatments. If a medical emergency arises, you should always call 911 immediately.