Hemodialysis

Hemodialysis is a procedure done with a particular machine with a special filter called an artificial kidney or dialyzer. Doctors create an access/entrance into your blood vessels with a minor surgery. This entrance is usually a graft located into your arm that allows access by two needles.

Dialyzers/artificial kidney have two main parts.

  1. A tube that takes small amounts of blood at a time to go through the machine/cycler. 
  2. The machine has a small membrane that separates the washing fluid known as dialysate. 
  • Blood cells, proteins, and other important things needed in blood are not able to pass through the membrane. 
  • Urea, creatine, potassium, and extra fluids can pass through the membrane and are washed away with the dialysate. 

This type of dialysis is usually done at a hospital or dialysis center. It is possible to do this treatment at home, however, it can be a long process to be certified for at-home care. You and your care partner will have to go through a few weeks to months worth of training, it does vary based on the method chosen for you. The more knowledge you have on your dialysis the easier it will be to move to at-home treatment. 

Treatment at a center or hospital is done on average 3 times a week in 3-to-4-hour prescheduled sessions. 

At-home treatment is commonly done 4-7 times a week with the session time decreasing each time. 

You and your doctor can discuss what method works best for you and how much treatment is needed for you to feel as normal as possible. The amount of dialysis is incredibly important. The correct amount of Dialysis can decrease the amount of hospital stays, improve your overall health, and may enable you to live a longer life. 

Correct dosage to look out for 

  • Urea reduction ratio (URR) 65%
  • Kt/V at least a 1.2 

This information is not a medical diagnosis or used for medical purposes but only for education purposes.

Types of at home hemodialysis

Conventional Home Dialysis

  • 3 time a week with 3-4 hours a session
  • Training with you and a care partner is required for a few weeks to a few months.

 Short Daily Home Hemodialysis 

  • 5-7 times a week (new machines) with 2 hours sessions
  • Less fluid generally needs to be removed over time.
  • Fewer symptoms (i.e. headaches, nausea, cramping, and feeling worn out after treatment) 
  • Training with you and a care partner is required for several weeks. 

Nocturnal Home Hemodialysis

  • Long slow treatment done at night while you sleep, 6 times a week or every other night depending on what the Doctor recommends for 6-8 hours a night. 
  • Some centers can receive information through the telephone or the internet from your machine. 
  • Since you spend more hours attached to the machine, more waste removal is done during that time. 
  • You can combine daily hemodialysis and nocturnal dialysis.
  • Training with you and a care partner is required for several weeks.

Short Daily and Nocturnal Hemodialysis Benefits

  • Less medication is needed in order to control high blood pressure and anemia.
  • Less medication is needed to keep phosphorous under control to help prevent bone disease.
  • Less neuropathy (nerve damage) and restless leg syndrome.
  • Feeling better before and after treatment.
  • Higher energy throughout the day.
  • Better sleep.
  • Less and shorter hospitalization.
  • Better quality of life.
  • Live a longer and fuller life.

However, it may take a while to learn all the information in order to do at-home care. You and your care partner must pass the training before you can begin any of the at-home treatments listed above. Discuss with your doctor what you believe might be the best course of action for you.