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Haemodialysis at Home

Home patients play an active role in their dialysis treatment

Haemodialysis can be performed at home, in a self-care / limited-care unit or in a dialysis centre. Home Haemodialysis (HHD) is a good choice for patients who would like to continue working and prefer an independent and flexible lifestyle.

Four different home haemodialysis treatment modalities exist:  

  • Conventional haemodialysis treatments last about four hours and are performed three times per week. Conventional haemodialysis is the most common dialysis modality which is also offered in the dialysis centre. 
  • Short daily haemodialysis is performed for two to three hours per day, about five to seven times per week.
  • Nocturnal haemodialysis is performed at night while you sleep. Nocturnal haemodialysis lasts about eight to ten hours. You will dialyse three or seven nights per week. 
  • Every-other-day haemodialysis treatment sessions are performed every second day. The length of the treatment sessions is usually four hours, but may vary according to your doctor’s prescription.

In fact, every combination of time and frequency is possible, which makes HHD such a flexible treatment.
 

What you need to perform Home Haemodialysis

For home haemodialysis you need the same dialysis machine and disposals as for in-centre treatments. But additionally, you need to have a water treatment system installed at your home. 

During each standard home haemodialysis treatment around 120-150 l of dialysate flow through the dialyser. Calculated over the period of a year this is an enormous amount of water the patient’s blood is in contact with. Chemicals, minerals and sometimes bacteria can be found in common tap water. They normally cause no harm when the water is used as drinking water. But for dialysis it is very important to use highly purified water. The water treatment system consists of special filters, charcoal tanks, bacteria-catching devices and a reverse osmosis system (RO).

You will have a miniature water treatment system installed at your home. Tap water flows through special plumbing and filters to your RO before reaching your dialysis machine. This system is the size of a small cabinet. You will learn how to operate the water treatment system during your training.
 

Support & service

Support & service

You will be asked to come for a visit to your dialysis centre every 4-12 weeks. During the visit, a blood sample is taken to determine if any changes have developed since the last visit and if your treatment needs to be adjusted. Together with you, your doctor will review these laboratory results, your medication sheet and your diet. Your records from home will also be reviewed to check your vital signs such as blood pressure, pulse, temperature and weight. Your blood access will be examined.

Please be prepared for the questions your doctor will ask you about your general well-being, appetite, etc. The dietician and social worker may join this visit. HHD is teamwork. Your input is just as important as the input of the professionals. Therefore, prepare yourself well for each visit. 

In a lot of ways, learning to do home haemodialysis is like learning to drive a car. There is so much to learn that it takes a few weeks to pick it all up. It can be scary and new at first—but then you get used to it, and it will seem like you’ve always done it. Of course, you’ll have a 24-hour phone line to call if you have questions or need help once you’re home. Remember, even when you are having treatments at home, you will be supported by a team that includes medical professionals, dieticians and social workers. They will help you every step of the way. 

Dialysis supplies

Your dialysis prescription is specific to your needs. Your doctor and your nurse complete and sign a prescription list with your supplies and the amounts necessary for your treatment. Please remember: Changes to your prescription must always be made by your doctor! 

Your initial order will be handled by your nurse. He or she will contact your future customer service representative and order all the supplies that you will need to get started. These will include the dialysers, concentrates, bloodlines, fistula needles, syringes etc. and any other items you may need such as a blood pressure cuff (if not already integrated in your dialysis machine), stethoscope and scales. Your customer service representative will then contact you to discuss your delivery schedule.

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