Dialysis is a medical procedure where a patient’s blood is purified with the help of equipment. The kidneys are responsible for purifying the blood by filtering it from impurities and toxic substances for the body’s proper functioning. When the kidneys fail to function properly—which might occur due to certain medical conditions—the body suffers from an imbalance in fluids and electrolytes. That’s when dialysis comes into play.

What is the procedure for Home Dialysis?

Home dialysis refers to the process of performing dialysis treatments at home instead of a dialysis center. There are two main types of home dialysis: peritoneal dialysis (PD) and home hemodialysis (HHD). Here’s a general procedure for each:

Peritoneal Dialysis (PD):

    • Step 1: Training and Preparation
      • Consult with a nephrologist (kidney specialist) who will evaluate your suitability for PD and guide you through the process.
      • You’ll receive training from a healthcare professional on how to perform PD at home. This includes learning about the equipment, sterile techniques, and proper catheter care.
      • Your home will need to be prepared with a clean and dedicated space for performing PD exchanges.
    • Step 2: Catheter Placement
      • Under sterile conditions, a PD catheter will be surgically placed into your abdomen. The catheter serves as an access point for the dialysis solution.
      • The catheter insertion procedure is usually performed as an outpatient surgery.
    • Step 3: Initiation of PD
      • After the catheter placement, you’ll begin PD with the guidance of your healthcare team.
      • PD involves using a sterile dialysis solution called dialysate, which is infused into your abdomen through the catheter.
      • The dialysate remains in your abdomen for a prescribed dwell time, during which it removes waste products and excess fluid from your blood through the peritoneal membrane.
      • The used dialysate is then drained out, and a fresh solution is infused for the next cycle.
    • Step 4: Ongoing Home PD
      • You’ll perform PD exchanges at home according to your prescribed schedule, which typically involves several exchanges throughout the day or overnight.

Regular follow-up visits with your healthcare team will be scheduled to monitor your progress, adjust your treatment plan if necessary, and ensure your well-being

Home Hemodialysis (HHD):

        • Step 1: Assessment and Training
          • Consult with a nephrologist to determine your suitability for HHD.
          • You’ll undergo a thorough assessment, including evaluating your vascular access options (arteriovenous fistula, graft, or central venous catheter) and overall health.
        • Step 2: Vascular Access
          • If you don’t have suitable vascular access, a procedure will be performed to create one. This might involve surgical placement of an arteriovenous fistula or graft or the temporary use of a central venous catheter.
        • Step 3: Training and Education
          • You’ll receive comprehensive training on how to perform HHD, including machine setup, dialyzer preparation, and monitoring of vital signs.
          • Training sessions typically cover topics such as infection prevention, troubleshooting, and emergency procedures.
          • You’ll also learn about water quality requirements and the necessary supplies for HHD.
        • Step 4: Ongoing Home HHD
          • Once trained, you’ll perform hemodialysis treatments at home according to your prescribed schedule.
          • You’ll need to adhere to the recommended dialysis duration and frequency, typically several times a week.
          • Regular follow-up visits and lab tests will be scheduled to monitor your progress, adjust your treatment plan, and ensure your well-being.

It’s important to note that the specific procedures and protocols may vary depending on the healthcare provider, the type of home dialysis chosen, and individual patient needs.

Home Dialysis in older adults

With the treatment being possible to practice at home and an increasing number of dialysis among elderly people, people started to wonder if the process is effective at home permanently. Studies have put forward their findings, helping one find the answer to the much-asked question, “Is home hemodialysis a practical option?”

Is home dialysis better than a hospital?

Home dialysis for elderly people with ESRD makes them feel comfortable about the procedure, sparing them from the anxiety of being in a hospital. This also gives the patients the choice to select their dialysis schedule, and spend more time with family and friends. Recovery time would also reduce significantly in home dialysis. The usual recovery time is eight hours, but it is just one hour at home.

How difficult is home dialysis?

As much as the patient would find comfort and support in home dialysis among elderly patients, the entire process is difficult and any minor mistake would lead to consequences. Home dialysis requires utmost care and dedication from the patient and the person taking care of them. One of the patient’s family members or the person themselves had to hold responsibility for the procedure, from managing the equipment to placing the needles on the body.

Disadvantages of home dialysis

Despite the advantages and benefits of home dialysis among elderly patients, one should be aware of its cons. The lack or absence of a medical care person for assistance could complicate things, and could sometimes lead to problems like misplacing needles or infections. Infections during home dialysis occur due to improper handling of the needles or equipment, which could result in severe consequences. So it is important to follow the procedure properly.

Home dialysis among elderly patients is a balance of pros and cons. Make sure to have a thorough consultation with a specialized healthcare professional about the procedure and training. Also, discuss this with your family to confirm if everyone has a mutual understanding of the same..

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