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The Pros and Cons of Home Dialysis

In July, the Trump Administration announced by Executive Order that the United States intends to change how patients with kidney disease are managed in the United States. Instead of receiving dialysis at an outpatient dialysis treatment center, patients will be moved to in-home dialysis treatment. Additionally, by 2025 the Trump Administration has set a goal that 80% of end-stage kidney disease patients should receive home dialysis. This initiative will affect older adults since half of the 125,000 People diagnosed with kidney failure each year are 65 and older.  


According to the National Kidney Foundation,

  • 10% of the population worldwide is affected by chronic kidney disease (CKD), and millions die each year because they do not have access to affordable treatment.
  • 726,000 people with end-stage kidney disease in the U.S.
  • Of those patients, 88% receive treatment at outpatient dialysis centers and 12% receive dialysis at home.


Benefits of home dialysis

People who receive home dialysis says it’s convenient, with a rapid recovery time, and an overall improvement to their quality of life. Dialysis at home however takes a great deal of discipline, skill, will, and support.


Disadvantages of home dialysis

Home dialysis is not for everyone. Individuals with dexterity issues or poor eyesight may not be able to administer home dialysis. Similarly, individuals who live alone without a care partner, may find home dialysis to be impossible to perform.


How home dialysis works

A fluid called dialysate (water, electrolytes, and salts) is flushed into a patient’s abdomen through a surgically implanted catheter. There it absorbs waste products and excess fluids over several hours before being drained away. There is an operation to implant the catheter. Once the catheter is in place, home treatment can begin and usually lasts 7 1/2 hours. Many at-home dialysis patients report they run the machine at night so as not to interrupt their partner’s day and improve the quality of their own life. Once a month the patient must undergo blood tests and see his or her nephrologist to monitor progress and progression of chronic illness.


To be cleared to perform in-home dialysis, a rigorous 2 months education and training program is required. The patient and his or her care partner have to learn things such as what to do if air gets into one of the lines, when to adjust the rate at which the patient’s blood is pumped and flowed through the machine, and the ordering and storing of supplies, such as fluids, filters, needles, syringes, and more.  


For more information about whether in home dialysis is right for you talk to your health care professional. 

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