March is National Kidney Month. To help you understand therapies for kidney failure, Varun Agrawal, MD, nephrologist and assistant professor of medicine, explains home dialysis services that are offered by the University of Vermont Medical Center – and why it may be a great option for patients and families to consider.
What is dialysis? Is home dialysis something new?
Our kidneys work hard every day to get rid of waste products such as urea, water, acids, and potassium to keep us healthy. When the kidneys get so damaged from diabetes or high blood pressure that they cannot meet the needs of the body, people suffer from symptoms of kidney failure. At that time, a nephrologist (kidney doctor) evaluates the need for dialysis, whereby a machine helps get rid of toxins and waste products from the blood of the patient. In short, dialysis is a treatment to ‘clean the blood.’ While the concept of dialysis is not new, currently available machines and advanced technology now allow one to consider dialysis at home.
Who can have home dialysis?
Anyone with kidney failure who has been evaluated by a nephrologist (kidney doctor) to require chronic dialysis is eligible for home dialysis. If you have or are likely to develop kidney failure, ask your nephrologist if home dialysis would be a safe and effective option for you. Adequate home setting, support at home, water, and electricity supply at home are taken into account when considering home dialysis. Your doctor will help guide you in making the choice between various home dialysis options.
Why should I consider doing dialysis at home as compared to going to a dialysis unit where trained staff is available to do the treatments?
Though dialysis can be done in the hospital or a dialysis unit, I believe that home dialysis has more benefits and choices to offer. Many patients that I take care of have an active lifestyle and are working and thus don’t like the idea of traveling back and forth to a dialysis unit to ‘lose’ a major part of their day. Home dialysis allows the person to take ownership of their care and do the dialysis at their own schedule and a familiar environment. Home dialysis treatments are shorter and done more frequently than in-center dialysis, and thus are gentler and usually better tolerated.
I am afraid of doing any sort of medical treatment at home. Is it safe to do home dialysis?
Yes, it is safe to do dialysis at home, provided the safety precautions and guidelines are carefully followed. At the UVM Medical Center, comprehensive training and supervision by the home dialysis nurses, technicians and doctors ensure that every possible error or complication be addressed during the training. While this may sound overwhelming, we have made the training easy with simple to use checklists and troubleshooting guides. Training materials or electronic resources such as an electronic tablet are given to the patient to take home for easy reference. Doctors and nurses are available every day to answer any questions that arise. Home visits by nurses or technicians are also available to answer any questions or review the dialysis techniques.
Any closing thoughts?
In the end, choose the kind of dialysis that best fits your lifestyle. One does not need to be a ‘medical person’ to learn home dialysis. Besides medical benefits, home dialysis offers great flexibility in the person’s life at the comfort of their home. At the same time, one needs to work diligently with the home dialysis team to make this a safe and enjoyable experience. The home dialysis program at the UVM Medical Center is committed to work with you and your nephrologist in providing the benefit of home dialysis.
Varun Agrawal, MD, is a nephrologist at The University of Vermont Medical Center. He is also assistant professor of Medicine in the Division of Nephrology and Hypertension at the Larner College of Medicine at UVM.