Hemodialysis from the comfort of home

How does home hemodialysis work?

Home hemodialysis uses a machine to clean your blood, but you don’t have to travel to a dialysis center to receive treatment. The machine uses a very fine filter called a dialyzer. This filter removes waste and excess water from your blood, while allowing necessary proteins to return to your body.

Studies show that people who receive hemodialysis at home have higher life expectancy than people who receive in-center dialysis.^1,2,3 It can be easier and more convenient to do longer, more frequent hemodialysis treatments at home. Talk to your doctor about how this could mean you may be able to take less medications, experience better sleep and enjoy more energy.

Hemodialysis at home requirements

Deciding on which route you want to take when it comes to dialysis is an important decision that takes careful planning. And when considering hemodialysis at home, you’ll need to ensure you have the following:

• About 15 square feet of clean space in your home. This area will be dedicated to housing your home dialysis machine, equipment and supplies. Your dialysis room should be a pet-free zone, but it’s OK to have pets elsewhere in your house.
• A reliable person to be your dialysis partner. You’ll need someone you feel comfortable with to assist you with each of your treatments.
• Time to dedicate to pre-dialysis training. Both you and your dialysis partner will need to complete a program to understand how home dialysis works. This includes how to use the equipment and how to log your treatments. The training is held in a dialysis center by a dialysis nurse over a number of weeks. 

Getting started

Before you can start home hemodialysis, you’ll also need a minor medical procedure to create what’s called vascular access. Vascular access creates a connection between your blood vessels and the tubes leading to the dialyzer. You and your doctor will decide what access is best for you. The three different types of vascular access are as follows:

• Fistula: The most common and preferred type of access. It lasts the longest and has the lowest potential for complications like infections and blood clots. To make a fistula, a surgeon will join an artery to a vein under your skin to make a bigger blood vessel. Healing time is approximately one to four months.
• Graft: If a fistula isn’t right for you, your surgeon may recommend a graft, where they’d use a piece of soft tube to join an artery and a vein in your arm. Healing time is approximately two weeks.
• Catheter: This type of vascular access is generally for temporary use, like if you needed to start dialysis and your fistula was still healing. Catheters have the highest risk of infection and the poorest function compared with other access types. They should only be used if a fistula or graft cannot be maintained. A catheter is made by inserting a soft tube into a large vein in your neck or chest.

Creating your schedule

Many people enjoy the benefits of hemodialysis at home, including more frequent treatments which lead to better health outcomes and improved quality of life.^1,2,3,4 Additionally, there is increased flexibility to choose when you want to have your sessions. There are a few scheduling options to consider:

• Conventional home dialysis: Three times a week for three to five hours per session. This option is most similar to the schedule you’d experience going to a dialysis center.
• Short daily home dialysis: Five to seven times a week for two to four hours per session. More frequent dialysis means less fluid needs to be removed each time.
• Nightly (nocturnal) home dialysis: Three to six nights a week for eight hours a session, while you sleep. Many people find that this option helps boost their overall energy level.

Learn more about home dialysis, including how it works and pros and cons to be aware of.