At DCI, we believe in empowering you to take an active role in your kidney health. When deciding on a treatment option for chronic kidney disease, we encourage you to talk with your care team and choose the option that works best for you. Home dialysis is a great option that provides you with more control and flexibility in your treatment schedule, particularly if you are concerned about the set schedule necessary with in-center hemodialysis.
Home dialysis allows you to dialyze when it is most convenient for you, which means that you can continue with the daily activities that make the most sense for your life, such as hobbies, work, school or enjoying time with your family and friends.
DCI’s home dialysis training program has experienced staff who will walk you through each step of the process to prepare you to confidently and safely perform in-home dialysis treatments.
Peritoneal Dialysis
Peritoneal dialysis (PD) is an alternative to hemodialysis and can be performed at home during the day or at night, offering schedule flexibility so you can dialyze when it works for your schedule. PD equipment is portable for travel and requires no needles. PD also requires fewer dietary restrictions because it is done daily, which is more consistent with how the healthy kidney works.
Rather than requiring access to your bloodstream like hemodialysis, PD uses the peritoneal membrane in your abdomen as a filter to remove excess waste and toxins. To prepare for PD, a surgeon will place a small semi-permanent tube called a PD catheter into your abdomen. The home dialysis staff will then train you on all aspects of PD. This training usually takes from seven to 10 days. With any home dialysis therapy, someone is available and on call 24/7 to answer any questions.
PD requires a pre-packaged solution called dialysate, a mixture of minerals and sugar dissolved in water. The dialysate goes into your abdomen through the PD catheter and “dwells” for the amount of time prescribed by your doctor. While dwelling, the PD fluid draws waste and extra water from your blood through the peritoneal membrane and into the solution. The solution containing waste is then drained from the abdomen into a drainage bag. This process of filling the abdomen with new PD solution, allowing the solution to dwell, and draining the used solution is called an exchange. Exchanges are typically performed at least four times per day or as prescribed by your doctor. No equipment is required, and you can move around and complete normal activities during the dwell time (four to six hours).
Another type of PD uses a machine called a cycler to fill and empty your abdomen while you are sleeping or in a resting position. The cycler is programmed to allow the fluid to remain in the abdomen for the prescribed dwell time. The machine then drains the used dialysate into an empty bag, and this process is repeated three to five times.
Before starting PD, a nurse will visit your home to ensure there is enough space for PD supplies and determine if any adjustments are needed to safely perform your treatment there.
Once patients start PD at home, they will still be seen monthly in the home dialysis clinic for blood work and to see their doctor and care team. Some doctors prefer to see patients twice a month, once for blood work and another time to discuss the results and meet with the home care team. Some visits may also be done remotely by telehealth.
Home Hemodialysis
Home hemodialysis (HHD) is another treatment option that allows for schedule flexibility and can be performed in the comfort of your home, around your work schedule, with or without a partner, and even while traveling.
Home hemodialysis requires that patients complete a training course. You (and your partner) will learn how to do the treatments in the clinic while working with a dialysis nurse. The length of training will vary for each patient, partner and dialysis facility, but usually lasts four to five hours a day, three to four days per week for three to six weeks. In some locations, DCI also offers online remote monitoring of treatments.
HHD is currently available in selected areas. If you are interested in this treatment option, you should talk with your care team to discuss the requirements of HHD and locations where home dialysis is currently available.