Transitioning from In-Center to Home Hemodialysis

Disclaimer: This article is for informational purposes only and is not intended to be a substitute for medical advice or diagnosis from a physician.

If you are thinking of switching from in-center hemodialysis to home hemodialysis (HHD), you may have some questions about the transition. How long will the transition take? Will you have a healthcare team to support you? What is the training process like? Is there a way to ease into this type of home dialysis slowly? What if you're not ready to do your own treatments when your training is completed? Read on to find out the answers to your questions about the transition process.

Assembling your home hemodialysis healthcare team

If you're worried about losing touch with your healthcare professionals when you transition to HHD, don't be. Choosing HHD does not mean you’ll need to say good-bye to your doctors and healthcare team. On the contrary, these individuals will continue to play an integral role in your home dialysis treatment and will be there to answer questions you have along the way. You will also be scheduled to have monthly in-center checkups to make sure everything is going according to plan.

When you begin training for HHD, you will be supported by a professional healthcare team which includes your nephrologist, a home training nurse, a renal dietitian and a social worker.

They are dedicated to and focused on your care. They will monitor your lab values (if you are a DaVita® patient, you can track your values on the DaVita Health Portal™.) to help you get the most out of your dialysis treatments, train you on all aspects of home dialysis, provide you with kidney diet tips and access to online diet tools and help with financial and insurance or Medicare questions you may have.

Training for home hemodialysis

Before you begin training for HHD, your training nurse will explain the process to you. Because training requires such a high level of commitment, both you and your nurse will sign a document declaring your dedication to the training process.

Depending on how fast you learn and the equipment you have chosen, HHD training can take anywhere from three to five weeks. Your training nurse will work with you and your care partner to devise a training schedule that will fit into your daily routine. Your care partner must come with you to all training sessions so that he or she can learn to assist you. The majority of HHD training is done in a dialysis center.

When you begin training, you will be given a customized educational binder with the information you need to know about your particular choice of equipment and how to set it up, your list of medicine and prescriptions to be filled and your personal medical needs. The binder will also include a list of emergency phone numbers and more.

During your first week of HHD training, your HHD training nurse will set up your dialysis equipment, explaining the process as he or she goes along. As you become familiar with the process, you will gradually begin assisting with the set-up of the home dialysis machine. When you are ready, you and/or your care partner will insert the needles needed for your treatment into your vascular access. Once you learn how everything works, you and your care partner will orchestrate the entire treatment process from set-up to clean-up while your training nurse stands by and observes.

When you, your care partner and training nurse feel that you are ready to take your machine home and begin your home dialysis treatments, your training will be complete. Your training nurse will come to your house to support you during your first home hemodialysis treatment.

Modifying your home for home hemodialysis

During the training process, you will need to create space in your home to store your dialysis supplies. A closet or large cabinet works well. You will also need to decide where you want to dialyze each time and make space for your dialysis machine on a table next to a comfortable chair or your bed. You may need to make some minor plumbing and electrical modifications to your home depending upon your equipment choice. Your healthcare team will go over the changes that need to be made to your home (if any) and can help you plan for these changes if you need assistance.

Make a successful transition to home hemodialysis

Transitioning from in-center hemodialysis to HHD can be a smooth process with the help of a supportive healthcare team and the willingness to learn how HHD works. Such key components can make the transition from in-center to home dialysis a success.