A patient who needs hemodialysis has to undergo a vascular access surgery before starting the dialysis program. A vascular access is a vein that is artificially created to help remove blood from the body and return it once the blood has been purified by the dialyzing machine.
Dialysis treatment actually replaces the filtering functions of the kidneys for patients who have had kidney failure and hence have to depend on a machine called the dialyser that purifies the blood by removing harmful toxins and extra fluid from the body. This helps maintain proper chemical balance in the body.
Here are a few facts you need to know before opting for home hemodialysis.
Who is fit for home hemodialysis?
All kidney patients are not fit for home hemodialysis. It is usually the nephrologist who decides if a patient is fit for home dialysis. He/ she takes the following factors into consideration while deciding if the patient is a good fit for home dialysis:
*. The patient must be emotionally and cognitively competent.
*. His/her medical condition should be stable.
*. The patient should have a care provider, probably a family member or a friend who can help him/her with the treatment.
*. The patient should have sufficient space at home to accommodate the dialysis equipment, with enough electricity and water supply facilities needed for the treatment.
The factors involved in managing home dialysis
Here are some of the factors that a patient or his/her care giver should take responsibility for:
*. Setting up a suitable treatment area in the house
*. Taking care of the vascular access and placing the needles correctly before starting the dialysis
*. Taking the patient’s blood pressure before each session
*. Maintaining a treatment log that may come handy when the patient visits the nephrologist
*. Figuring out the amount of fluid to be removed during a home dialysis session
*. Following the diet and fluid restrictions
*. Cleaning and disinfecting the dialysis machine regularly
*. Ordering and storing the supplies needed for home dialysis
The different types of home hemodialysis
The home dialysis patient can opt for any one of the following treatment options.
*. Conventional home hemodialysis: Once the patient and his/her caregiver are trained, the conventional home dialysis can be done three times a week for 3 to 4 hours or longer each time. This is the same as getting dialysis treatment done in a dialysis centre.
*. Short daily home hemodialysis: This is usually done 5 to 7 times a week with each dialysis session lasting for about 2 hours. Since the dialysis is being carried out frequently, less fluid has to be removed each time, and this method reduces symptoms such as headache, nausea, cramping and tiredness after the treatment.
*. Nocturnal home dialysis: This is a long, slow home dialysis carried out at night when the patient is sleeping. The dialysis treatment is carried out six nights a week or on alternate nights and each session may last for 6 to 8 hours.
Sometimes a patient may combine daily and nocturnal home hemodialysis, but depends on the doctor’s prescription and the patient’s health condition.
All said and done, the patient needs to visit his/her nephrologist on a regular basis to keep a check on his/her progress. A consultation with the dietician is also necessary from time to time as he/she may want to make changes in your diet depending on your health condition.
The benefits of home hemodialysis
The benefits of home hemodialysis are many and are outlined below.
*. Home dialysis improves the quality of life of the patient.
*. The patient can adopt a more flexible treatment schedule.
*. There is more privacy for the patient while undergoing home dialysis.
*. The patient has enough spare time to spend with the family or go about his/ her daily chores.
*. The patient experiences a sense of freedom and confidence as he/she is able to manage his/her own health condition.
*. If a patient is on a more intense therapy combining daily and nocturnal hemodialysis, there is a better clearance of toxins and a better prognosis in terms of survival and the risk of falling sick.
*. Home dialysis has shown to improve a patient’s energy levels and life expectancy.
*. Last but not the least, home hemodialysis is cost-effective as it saves the patient the travel expense to and from a dialysis centre three days a week.
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