Dialysis at Home
Since 1964, thousands of our patients have used self-dialysis safely and successfully at home. If you are able to and wish to dialyze at home, we’'ll support you every step of the way.
Types of home dialysis
With home hemodialysis, a small, more portable machine is kept in your home to clean your blood. Your blood flows from two needles connected to tubing (like IV lines), usually in your arm, to a machine that removes wastes and fluid. The clean blood is then returned to your body.
In peritoneal dialysis, a cleansing fluid goes into your abdomen through a small tube called a PD access. The fluid stays inside you for several hours, removing waste and water from the blood vessels of the peritoneum (lining of your abdomen). The fluid is then drained out and replaced with clean fluid. PD can work by gravity or with a machine.
We provide two types of peritoneal dialysis treatments: continuous ambulatory peritoneal dialysis (CAPD) and automated peritoneal dialysis (APD).
Before you begin hemodialysis treatments at home, you’ll need to:
• Get a hemodialysis access. The best type of access is a fistula.The fistula makes it possible for us to connect you to a dialysis machine to clean your blood. To get a fistula, you’ll have surgery as an outpatient where a surgeon will join a vein and an artery together inside your arm. After six to eight weeks, the fistula will be big enough to start being used for dialysis.
• Receive training. We will train you in one of our centers before you start dialyzing at home. Training is usually four weeks to make sure you are ready and comfortable doing home hemodialysis on your own or with a helper.
Before you begin peritoneal dialysis treatments at home, you’ll need to:
• Get a PD access. A surgeon will implant a PD access (a thin, soft tube that carries dialysis fluid into your abdomen for treatment) near your belly button. Your PD access stays in place permanently but is not visible under clothing.
• Receive training. We’ll train you in one of our centers on proper procedures and safeguards before you start PD at home. Training is individual and usually takes about a week.
What to expect
Your routine will vary, depending on which home hemodialysis schedule you choose. Here’s what you can expect for each:
• Frequent home hemodialysis. You’ll connect to your dialysis machine five to six days per week for about three to three and a half hours each time. The equipment for home hemodialysis is compact and portable, making it easy to take along with you if you travel.
• Nocturnal home hemodialysis. Five to six days per week, you’ll connect to your dialysis machine before bed and dialyze overnight for six to eight hours.
Peritoneal dialysis (CAPD)
A typical continuous ambulatory peritoneal dialysis treatment, called an exchange, takes about 40 minutes and will go like this:
• Connect your PD access to a disposable exchange set.
• Drain out used dialysis fluid (dialysate) into a bag.
• Fill from the bag of fresh solution.
• Disconnect, discard bags and tubing. The dialysate stays in you until the next exchange.
• CAPD takes place four times around the time of breakfast, at lunch time, dinner and bed time.
Peritoneal dialysis (APD)
A typical automated peritoneal dialysis treatment, will go like this:
• Begin the process before bed. Connect yourself to a machine called an automated cycler that will fill your abdomen with dialysis fluid while you sleep. You’ll remain connected to the machine for around eight to 10 hours overnight.
• Dialyze throughout the night. The automated cycler will fill, drain, and then refill your abdomen with dialysis fluid three to five times as you sleep.
• Do a single daytime exchange. Many people do one more exchange by hand during the day.
We also offer hemodialysis services at 15 centers located across the Puget Sound region. In our centers, trained nurses and dialysis technicians provide care.
Depending on your schedule, health needs and general preferences, you might rather receive treatment in a local center than at home. It’s useful to read about both home and in-center dialysis before you make a decision. Or take our free Choices class, which explains your options. Sign up by phoning 206-292-2771, ext. 1082.
In-center dialysis patient Patricia Smith.