Being at home
Together with your renal care center, B. Braun offers you the option of carrying out hemodialysis independently in your own home. Your attending renal care center will continue to be your advisor and dedicated contact person for all health matters.
What is Home Hemodialysis?
With home hemodialysis, patients carry out dialysis treatments at home instead of needing to travel to a renal care center. They get responsibility of performing their treatments based on prescribed treatment regime on their own or with a dialysis care partner. The attending physician remains responsible for prescription and medication, and will see patients at regular intervals in the center. A fully equipped dialysis station is set up at home in a most suitable room and maintained regularly. The supplies needed for treatments are delivered at defined schedules into patients homes.
Requirements for Home Hemodialysis
Who is suitable for home hemodialysis?
Thanks to technical advances, home dialysis is suitable for a growing numbers of patients. Many patients meet the prerequisites for home dialysis: patients need to be in a stable state of health, with a well-functioning vascular access, and must have the dexterity and technical skills to carry out the procedure safely. In addition to meeting the medical criteria, there needs to be adequate space for a fully equipped treatment station and storage space for the necessary disposables.
How your home dialysis place is created
Training before first treatment
Before home hemodialysis starts, individual training courses prepare the patient and the care partner for the treatment: This includes how to operate the dialysis machine, document the procedure, and also cannulate the vascular access. The training intensity and duration can be individually adapted to the personal needs of each patient until they feel "ready-to-go-home".
Benefits of Home Hemodialysis
Low space requirement
Dialysis at home does not take up very much space. Only 4 – 5 m2 of space is required for the setup of the dialysis station, including the storage of consumables. B. Braun will support you with the necessary adaptations and installation of the equipment.
Effect on diet and fluid restrictions
Because of the flexibility to either increase the frequency of dialysis to more than three times a week or extend the treatment time to more than four hours, dietary or fluid intake restrictions are usually less strict – as toxins and fluids are removed more often or for longer periods of time.
- Self-determined dialysis times, even at nights or on weekends
- Increased possibility of flexible treatment options in coordination with the attending renal care center, for better treatment outcomes and better well-being
- No time-consuming transportation or long waiting times
- Better balancing of treatment schedules regarding private and professional plans and appointments
- More independence and autonomy: personal responsibility instead of externally determined therapy
- Treatment in familiar surroundings without alternating nursing staff
- Reduced need for medication1
- Hospitalization rates and length of hospital stays are shorter in HHD patients compared to in center HD patients2
- Nutrition status of patients on HHD can be better than in patients with in-center dialysis3
- Improved blood pressure control4
- More than 20% better survival rates compared to in-center dialysis patients5
Cannulation at home
Most home hemodialysis patients gain great expertise in cannulating their own fistula in a short period of time and become much more familiar with their fistula than a dialysis nurse ever can be. Patients who carry out dialysis at home gradually become more relaxed and comfortable about the cannulation procedure.
What patients think about dialysis at home
1 Parker K, Nikam M, Jayanti A, Mitra S. Medication burden in CKD-5D: Impact of dialysis modality and setting. Clin Kidney J. 2014 Dec; 7(6):557–61. doi: 10.1093/ckj/sfu091. Epub 2014 Sep 11. PMID: 25859372.
2 Weinhandl ED, Gilbertson DT, Collins AJ. Mortality, hospitalization, and technique failure in daily home hemodialysis and matched peritoneal dialysis patients: A matched cohort study. Am J Kidney Dis 2016 Jan;67(1):98–110. doi: 10.1053/j.ajkd.2015.07.014.
3 Aparicio M, Cano N, Chauveau P, Azar R, Canaud B, Flory A, Laville M, Leverve X. Nutritional status of haemodialysis patients: A French national cooperative study. French Study Group for Nutrition in Dialysis, Nephrol Dial Transplant. 1999 Jul;14(7):1679–86
4 The FHN Trial Group, the Frequent Hemodialysis Network. In-clinic hemodialysis six times per week versus three times per week. N Engl J Med 2010; 363:2287–2300. Clin Kidney J 2014; 7:557–561; doi: 10.1093/ckj/sfu0912.
5 Kjellstrand CM, Buoncristiani U, Ting G, Traeger J, Piccoli GB, Sibai-Galland R, Young BA, Blagg CR. Short daily haemodialysis: Survival in 415 patients treated for 1006 patient-years. Nephrol Dial Transplant. 2008 Oct;23(10):3283–9. doi: 10.1093/ndt/gfn210.
6 Karkar A, Hegbrant J, Strippoli G. Benefits and implementation of home hemodialysis: A narrative review. Saudi J Kidney Dis Transpl 2015;26(6):1095-1107