Home Dialysis

Home dialysis is an option for many CKD Stage 5 patients who require dialysis.  It offers flexibility of time and convenience of remaining in your home for treatment.  There are multiple options for home dialysis:

  • CAPD
  • CCPD
  • Conventional Hemodialysis
  • Daily Hemodialysis
  • Nocturnal Hemodialysis
     

How Peritoneal Dialysis Works

Continuous ambulatory peritoneal dialysis (CAPD) and continuous cycling peritoneal dialysis (CCPD) replaces some of your kidney function by using the lining of your abdomen, called your peritoneum, to filter wastes and fluid out of your blood.

To do PD, you'll need to have a soft plastic tube (called a catheter) surgically placed in your abdomen. You'll be trained to use the catheter to fill your peritoneum with 2 liters or so of a special fluid called dialysate. Wastes and extra fluid in the blood flow through the tiny blood vessels in your peritoneum into the dialysate.

After a few hours of "dwell" time wastes and fluid will flow into the dialysate. With CAPD, you drain out the fluid and replace with clean dialysate.  With CCPD, the cycler automatically drains and refills the dialysate while you sleep.  This process is called an exchange.  Peritoneal dialysis is done every day and may allow for a more liberal diet and fluid restriction.  A partner is not required for peritoneal dialysis.  You should discuss with your nephrologist the advantages and disadvantages of peritoneal dialysis. 
 

How Home Hemodialysis Works

Hemodialysis (HD) replaces your kidney function by using a dialyzer—a plastic tube filled with hollow fibers—to filter your blood and remove wastes and excess fluid. One needle carries your blood through tubing to the dialyzer, and another needle returns your cleaned blood to your body. The dialysis machine pushes your blood through the system and monitors time, temperature, and pressure.

Home hemodialysis can be conducted in several manners.  Conventional home hemodialysis is done three times a week for 3-4 hours based on your physician’s order.  Daily home hemodialysis is done at least 5-7 times per week for a time determined by your physician.  Nocturnal home hemodialysis is done 3-7 times per week for longer periods of time while you are sleeping.  Each type of home hemodialysis allows you the flexibility to determine when during the day you and your partner are available for treatment.  You must have a partner for home hemodialysis and train at a home training dialysis center prior to beginning treatments at home.

A vascular access is required for hemodialysis.  A fistula is considered the optimal form of vascular access for hemodialysis and can be placed in your arm in preparation for the initiation of dialysis.  You will then avoid the placement of an emergency catheter.  A graft is another form of vascular access that involves the placement of a small plastic tube connecting the vein and the artery.  This type of access is preferable to a catheter, however, it is not considered the optimal type of vascular access.  Patients should discuss what form of vascular access will be best for them with their nephrologist and vascular surgeon. 
 

More InformationFor Information about Home Dialysis, note the Web site of Home Dialysis Central.