ALL YOU NEED TO KNOW ABOUT HOME DIALYSIS
Quick links this section: Treatment options:- Early management I Unit-based Dialysis I Transplantation I Conservative care
Welcome to Australia’s comprehensive source of information about Home Dialysis. Please note this information will soon be transferred to a complete website that is currently under construction. We hope the information below will make your treatment choice decision making process easier and provide some positive support information and healthy lifestyle tips for those choosing Home Dialysis.
When do I need Home Dialysis?
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.
What type of dialysis is right for me?
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 and you are supported by health professionals, the outcomes will be better.
What is Home Dialysis?
Home dialysis includes both Peritoneal Dialysis and Home Haemodialysis. 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.
Useful weblinks:
Choosing whether to have treatment - Kidney Health Australia Fact Sheets - Organ & tissue donation & transplantation
Haemodialysis – a treatment option - Renal Resource Centre NSW
Conservative care of Advanced Kidney Disease - Renal Resource Centre
Withdrawing from dialysis - Renal Resource Centre NSW
Live Kidney Donation - KHA webpage
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 weblink: Introduction to Peritoneal Dialysis Renal Resource Centre NSW
Home Haemodialysis
Home Haemodialysis (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 during the day (daytime dialysis) or overnight (known as nocturnal dialysis)
- hours that range from 2 to 8 hours a session (long sessions are 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 the 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.
Useful weblink: Find out more about the new age of Home Dialysis which is being trialled in Australia now.
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.
Useful weblinks: You can compare Home Dialysis treatments here using information from Home Dialysis Central (USA)
This is one of our YouTube playlists - view selected videos on Home Dialysis
To progress to the next video, you hover your mouse over the second forward arrow on the bar
SUPPORT FROM HEALTH PROFESSIONALS
Support at home can be provided by a Home Dialysis nurse if you have an emergency or problem with your equipment or need help with your routine. A range of other health professional support is available to help you - your kidney specialist (nephrologist) a renal dietician and a social worker. Phone support is usually provided 24 hours a day for those on Home Dialysis.
Personal support
Various groups, both online and face to face events operate for those with kidney health conditions. Kidney Health Australia co-ordinates some Support Groups around Australia. A contact list of active groups can be found on our Families and Carers webpage.
Holidays and dialysis
With planning you can go on holiday. Peritoneal Dialysis affords the most freedom. Your clinic can help you to plan travel. Your doctor will have to agree that you can travel.
Useful weblinks: Dialysis and Travel and Dialysis Konnections KHA webpages
FINANCIAL SUPPORT - also see Finance this website
Carer's Pension
If a carer is supporting you, they may be eligible for a Carer's Pension.
Financial concessions and travel reimbursement
Patients on Home Dialysis treatment may be eligible for financial assistance for costs related to, but not exclusive to electricity and water. The HOME Network has put together Fact Sheets (see links below) providing a guide to concessions available in each State of Australia.
A comprehensive summary provides general information and links to relevant agencies - refer to Financial Support for Home Dialysis Patients in Australia (updated February 12)
Electrical costs
Check with Switchwise to access a comparison calculator, to provide you with information on the cheapest energy provider in your State. Using the information you find, it is possible in the larger States to obtain better deals for electricity prices, especially rural, by phoning around.
Australian Patient Assisted Travel Scheme (PATS) state information
Isolated Patient Travel and Accommodation Assistance Scheme (IPTAAS)
Patients travelling to the city for treatment may be eligible for a government scheme to provide financial assistance for travel and accommodation. Patients may be unaware of eligibility for this support.
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 the barriers that currently inhibit the 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.
Newsletters
- Home Updates - April 2012 see other issues below
- Pre-dialysis Education - April 2012 see other issues below
Important publications
Conferences
Tools
Useful weblinks
UPDATED 27 APRIL 2012