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HOME DIALYSIS - WHAT IS THIS TREATMENT ALL ABOUT?
When kidneys fail and the decision is made to start dialysis there are many questions to be answered.
- Where and how should I do my dialysis?
- How will my lifestyle be affected?
- Will I be able to cope in a life with dialysis?
- How can I stay healthy and travel on dialysis?
We hope the information we provide will support you to make your treatment choice decision easier.
When do I need Home Dialysis?
What type of dialysis is right for me?
You may need Home Dialysis if your kidneys fail. Chronic kidney disease (CKD) is long-term permanent damage to the kidneys. Signs and symptoms usually start when the kidneys are working below 40%. Once they are working below 10%, dialysis or a transplant is needed to stay alive.
When kidneys fail and the decision is made to start dialysis there are many questions to be answered:
- which type of dialysis is right for me?
- how will my lifestyle be affected?
- what supports are available to me to help me cope in a life with dialysis?
- how can I stay healthy on dialysis?
If the most suitable option of dialysis is chosen, the impact of dialysis on your usual lifestyle will be less. If the dialysis program you choose is started in a timely manner, you are also supported by health professionals and outcomes will be better.
What is Home Dialysis?
Home dialysis includes both Peritoneal Dialysis (PD) and Home Haemodialysis (HDD). There are various lifestyle and health benefits associated with these options. You can choose to dialyse at home during the day or night. Almost all peritoneal dialysis is performed at home given the ease of the procedure and the need for ongoing exchanges several times every day or night.
IMPORTANT HOME DIALYSIS RESOURCE
An Introduction to Home Dialysis
This A5 booklet focuses on lifestyle aspect of choosing home dialysis.
It provides information on daily routine, work and leisure activities,
diet and fluids and associated health benefits.
Renal Resource Centre
Haemodialysis - a treatment option *Conservative care of Advanced Kidney Disease *Withdrawing from dialysis
Home Peritoneal Dialysis
Peritoneal Dialysis (PD) has been used at home since the 1970s. Currently in Australia nearly 25% of the people on dialysis are using PD at home. About 40% of new patients do PD early in their journey with end stage renal failure. In New Zealand 35% of people use PD.
PD is gentle and works 24 hours a day. The remaining kidney function is well preserved on PD. The remaining kidney function helps to keep individuals healthy. How to manage PD at home is easily learned by the majority of people. More than fifty patients aged 85 years old or more are on PD at home around Australia. Everything you need is provided to your home and the waste can be placed in your rubbish bin.
There are two types of Peritoneal Dialysis:
- Continuous Ambulatory Peritoneal Dialysis (CAPD)
- Automated Peritoneal Dialysis (APD) see photo
Useful link: Introduction to Peritoneal Dialysis Renal Resource Centre
(HHD) uses a machine which delivers your blood to a dialyser. The dialyser cleans your blood, and then the blood is returned to you. At minimum, it is 3 times a week for 4-5 hours. Vascular Access is required to access your blood.
HHD treatment schedules are decided by you in collaboration with your health care team. Ideally a minimum of fifteen hours a week is completed in regular sessions. This allows maximum flexibility for work, lifestyle activities and time to be spent with your family. Options are:
- dialysing in the day (daytime dialysis) or overnight (nocturnal dialysis)
- hours that range from 2 to 8 hours a session (long sessions overnight usually)
- sessions from 3 to 7 times a week
The machine for haemodialysis is free and is installed in your home. Most homes are suitable but sometimes a community centre is used when the home is unsuitable. The health care team can answer any queries about your home. Special plumbing will be installed in your house and the quality of your home water supply is tested. All supplies are delivered free of charge to your home.
The dialysis training is done by a nurse at your pace. It is given to you and your support person (if you choose to have one). Dialysis once you are trained is independent, but with on-call support at all times.
Choosing the right option for me
For some people a medical reason may indicate that a particular option is not available. For most however it is your life and your choice. Your doctor and the education nurses will support you in deciding. You may change your treatment choices later if your first choice does not work out.
You should be provided with education sessions for yourself and your family and friends. These may be individual sessions or by attending one of the treatment options sessions that many units hold. Ask your doctor or nurse where you can get more information and discuss your options with them. Some important questions to consider are:
- Do I like to be at home?
- Do I value flexibility and freedom?
- Do I like to control my own health-care?
- Do I have a home where I could complete dialysis?
- Would I like a diet without too many restrictions?
If you answered YES to the above questions - this indicates that you will prefer Home Dialysis.
- Would I prefer a gentle dialysis without needles?
- Would I prefer a treatment overnight?
- Can I operate a machine if I am taught how?
- How much time can I spare for training?
- What do my health professionals recommend to best suit my health needs?
- Would I like to travel easily?
Answering questions like these will determine whether PD or HHD suits your lifestyle.
Home Dialysis - On the Road booklet
A quick reference guide has been developed to help you if you are planning your dialysis ‘on the road’ which includes real-life stories and many practical tips. Download and print Home Dialysis - On the Road>
‘My Kidneys, My Choice’ Decision Aid
This tool may support you at the decision making stage of your education journey. If you would like to use the decision aid tool you can either:
Videos selected for our KidneyEd TV on YouTube playlist
to help you consider options for treatment
Home Dialysis playlist - KidneyEd TV on YouTube
INFORMATION FOR HEALTH PROFESSIONALS
The HOME Network is a national initiative to engage healthcare professionals in the field of home dialysis, empowering these individuals to develop solutions to overcome barriers that currently inhibit uptake of home therapies in Australia.
Home haemodialysis in Australia is used by approximately 10% of those on dialysis. Research is starting to determine that it is the best therapy for many with a good quality of life, improved life expectancy and less time spent in hospital.
Refer to our sister site: homedialysis.org.au at Home Dialysis - Health Professionals
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Newsletters - Home Dialysis site
Renal Update - September 2015 I Archived Home Dialysis Newsletters I Kidney Community News
Subscribe to Home Dialysis Newsletters for Health Professionals
Simply email Debbie Fortnum, our Home Dialysis Project Manager at email@example.com with your contact details, to organise your subscription or contribute to these interesting newsletters.
Page updated 24 September 2015. Disclaimer: Information provided is intended as an introduction to this topic and not meant to substitute for your doctor's or health professional's advice. All care is taken to ensure this information is relevant and applicable to each Australian state. Kidney Health Australia recognises each person's experience is individual and variations do occur in treatment and management due to personal circumstances. Consult a healthcare professional for specific treatment recommendations.