Most frequently asked questions (FAQ) (common to patient, RN, MD and health plan)
Both the short daily and slow Nocturnal Home Hemodialysis offer the highest quality of hemodialysis to you with a significant improvement in your quality of life.
Canada has had an active daily home hemodialysis program for the last twelve years. Patients have been dialyzing at home on either short daily or slow nocturnal hemodialysis. The Canadian experience and our own over the past two and a half years has shown that daily home hemodialysis performed 5 to 6 times week have a marked improvement in the quality of our patient’s life.
Your partner may be involved with your dialysis treatment at home, so be sure to discuss your wishes with your partner.
Why do Daily Home Hemodialysis?
Home Hemodialysis Means:
- Improved quality of life
- More energy & better sense of "well" being
- Improved quality of sleep (sleep Apnea)
- Improved and reversal of dialysis related complications as BP control, phosphate removal, bone density,
- Better nutritional status
- Less medication
- Independence and flexibility
- Reduction in Left Ventricular Hypertrophy
- Enhanced professional and social life
Who should consider Daily Home Hemodialysis?
The main selection criteria for training for daily home hemodialysis are the ability and willingness to learn, to have a support person at home and to have adequate space for the equipment and related supplies.
In general:
- Patients who are willing to take the time and effort to learn the procedures
- Patients who want more independence and control of their treatment
- Patients who want more flexibility in scheduling of dialysis treatments
- Patients who are required to travel long distances to a dialysis unit
Doing your dialysis at home allows you flexibility to work or engage in social activities. You can choose the dialysis days and times that best suit your lifestyle.
Learning more about your dialysis treatments also allows you to personalize your treatments. You are often the best judge of how you are feeling, and once you have the necessary knowledge you can control your treatment to meet your personal needs.
Once you have decided to do daily home hemodialysis you will be busy learning and getting ready to go home. It may seem like a lot of work at first, but the independence and well-being you gain will be worth the effort.
Do I need to change my physician?
NO. You will be able to maintain and continue to receive care from your physician. Our program is open to all qualified nephrologists.
Will there be medication changes with Daily Home hemodialysis?
Prescriptions may require adjustment for patients on daily hemodialysis. Some of the changes may be more significant depending on the chosen home modality. Slow daily nocturnal hemodialysis has demonstrated to offer the best clinical results in dialysis therapy.
Home dialysis patients can self administer EPOGEN or ARANESP. As a result of more frequent dialysis, other medication reduction or elimination such as blood pressure medication and phosphate binders may be required.
You mentioned Slow Nocturnal Hemodialysis. What are some of the other benefits with this type of modality?
Probably one of the most welcome changes is the lifting of almost all dietary restrictions. Removal of phosphate has been so much better that many patients stop taking calcium pills and are in fact encouraged to eat more phosphate in their food.
Restrictions on dairy products are lifted. Since nocturnal hemodialysis is done at night while sleeping, there is no limit to the amount of water patients can drink or even the amount of salt they can take. Most patients see their blood pressure medication reduces or completely eliminated.
Is there back-up for patients whose dialysis at home is compromised due to short term problems?
YES. Home Dialysis Centers in Conjunction with Glendale Kidney center will guarantee an opening for all home hemodialysis patients.
What about dialysis vascular access?
While any access can be used for daily home hemodialysis, a Fistula offers the better access choice.
What about cannulation (sticking) pain, especially since dialysis is virtually performed most days?
You will be taught the “Buttonhole” cannulation technique which involves inserting the needle or cannula through exactly the same hole every time. This makes success of the cannulation predictable and after a few insertions, due to the formations of scar tissue around the inserted site no pain or very little pain is felt. There is
some evidence to suggest that buttonhole technique involving insertion in the same hole/site prolongs the life of the Fistula.
Will Daily Home Hemodialysis help me get back to work?
Many home hemodialysis patients have returned to work Full Time. Not only they fell better but had more energy for family and other social activies.
How long is the training program?
Training will vary from patient to patient and the type of equipment you will be trained on. However, it is our experience that most patients will be able to successfully complete their training within 3 to 5 weeks.
Are Diabetics Candidates for Daily Home Hemodialysis?
YES. In fact diabetic patients can benefit even more from daily home hemodialysis.
Can patients with heart disease go on the Daily Home Hemodialysis?
YES. In fact the more severe the disease the more patients benefit from daily home hemodialysis therapy in particular with slow nocturnal hemodialysis.
Studies have shown a 30% reduction in echocardiographic left ventricular mass index, an indicator of left ventricular hypotrophy.
How is Home Hemodialysis funded? Will I have to pay “out of pocket” for the treatments an services provided to me?
Medicare and Medical fun for Home Hemodialysis services. It is important to note that at the present time Medicare does not reimburse dialysis facilities for the cost of daily home hemodialysis. Medicare and Medical will allow for some reimbursement on additional treatments provided adequate medical justification is made available to them. Most HMOs and commercial plans do allow for daily home hemodialysis services.
Why don’t more people choose Daily Home Hemodialysis?
Many people never get educated from their doctors about the full range of treatments available to patients on CKD. Most dialysis centers are either not licensed/certified to offer home dialysis or simply do not have the expertise to offer these modalities.
I am afraid to put needle in my Fistula or Graft. How do I learn to do this and over come my fears?
It is normal to have concerns and fears when starting a home hemodialysis program. However, you will be trained by some of the best experts in the field with several years experience in training and proving daily home hemodialysis therapies. You will be taught on how to cannulate yourself and learn not only your equipment but also how to troubleshoot your machine and how to take care of your access site. You will also learn about dialysis and will NOT go home until you are fully trained and comfortable with needle insertion and your dialysis treatment.
