Since the 1960’s home dialysis has been an alternative for patients with end-stage renal disease (ESRD). Joe Cosgrove knows that both home hemodialysis (HHD) and Peritoneal dialysis (PD) have been available for decades to those who barely had the chance to go to the hospital because of their condition. However, the usage of home dialysis only became popular during recent years.
At first, home dialysis was quite uncomfortable for both patients and healthcare providers. It was an exhausting and expensive procedure that would need patients to use huge machines. Nowadays, technology has made it possible for ESRD patients to have access to home dialysis comfortably. This way, patients get the chance to have a better lifestyle while being treated.
Home Peritoneal Dialysis
Peritoneal dialysis is the most popular dialysis treatment that can take place at home. It is easy to handle and most patients who choose this type of procedure are able to take care of it on their own. People on Peritoneal dialysis are able to use the peritoneal membrane (which covers the intestine and other organs) in the abdominal cavity to filter any type of wastes from the blood.
This dialysis solution needs the patient to get a catheter installed in the abdominal cavity. This way they catheter will stay in the abdomen for several hours while toxins and fluids are filtered from the blood vessels through the peritoneal membrane and into a special solution called dialysate.
The reason why this procedure can be performed at home is that the dwell time is programmed and easy to handle. Once the patient got the waste filtered through the membrane and diluted in the dialysate, it will be drained out of the body and a new dose of dialysate will be introduced in the abdominal cavity so the cleaning process can start all over again.
This exchange process can be done with the assistance of a machine or manually. When the process is done manually by the patient at home, all the fluid held in the abdominal cavity will need to be removed before the new solution is injected. The patient will drain the solution thanks to the gravity force, placing the empty bag to receive the fluid onto the ground. Usually, the average amount of fluid that the patient will drain at home can reach the two liters and it can be drained within 10 to 20 minutes.
The most common peritoneal dialysis machine is called a cycler and it performs the exchange process automatically. Most patients at home choose to have this machine because it makes the dialysis process easier and faster, leaving enough free time to have a regular life. An ESRD patient will plug the catheter to the machine during the evening and the machine will work during its sleep, performing at least three exchanges.
Some patients choose to carry some dialysate in the abdominal cavity during the day and drain it out at night, once they are connected to the machine. Also, some patients need to perform one exchange during the day.
One of the most amazing things about this type of home dialysis is that the nurse and the doctor will need to teach the patient and its family how to use the machine and how to perform the dialysis manually. After three weeks, the patient will be able to take care of its condition on its own.
This type of home dialysis has been the least common. Nevertheless, there are two types of hemodialysis available for patients who want to have it performed at home. The first type is called short daily home hemodialysis and the second type is known as conventional home hemodialysis.
The conventional type of home hemodialysis usually takes place three times per week and each session takes at least 3 hours. The procedure takes places regularly, just as it does at a dialysis center. Patients who choose to have this type of home dialysis, tend to spend the dialysis time watching television, on the computer or chatting on the phone.
The other type of home hemodialysis, known as short daily home hemodialysis, need to take place at least six times every week. Each session will take just a few hours depending on the patient’s weight, health condition, lab results and other factors. Since the blood gets to be cleaned every day, patients have the chance to have a freer fluid intake and side effects such as cramps, migraine, waves of nausea and low blood pressure are controlled since they are not likely to appear.
Unlike peritoneal dialysis, home hemodialysis cannot be done manually. This means that the patient will always need to be assisted by a machine in its house. Also, for safety reasons, a partner will need to be present during the entire session so the patient can get some help. Both the patient and its partner will need to be trained on how to handle and clean the machine. The training process can take up to six weeks to be completed.