At DCI, we believe in empowering patients to take control of their kidney health. When deciding on a treatment option for chronic kidney disease, we encourage patients to choose an option that works best for them. Most patients receive in-center hemodialysis and are not aware of the home hemodialysis and peritoneal options that offer schedule flexibility and treatments in the comfort of home.

DCI’s home dialysis training program has experienced staff who will take you through each step of the process to prepare you for in-home dialysis treatments. The training lasts about six weeks, after which, you can enjoy all of the benefits of home dialysis.

Benefits of Home Dialysis

  1. Convenience- Do your treatments according to a schedule that fits your lifestyle
  2. Comfort- Do your treatments from the comfort of your home, without having to make several visits to a clinic each week
  3. Independence- Your flexible treatment schedule will allow you to travel more easily, have minimal interruptions to your employment, and take control of your own health

Understanding the Move from In-Center to Home Dialysis

  1. The patient has the right to choose the treatment that works best for them
    • Patients will learn about the advantages and disadvantages of each treatment option before beginning treatment so they can make the best decision possible for their health
  2. Home nurses will visit the patient’s residence prior to home dialysis training to ensure that each patient learns to do their treatments in a safe environment tailored to their specific needs
  3. Patients will be taught basic self-care such as weighing themselves, documenting treatments, inserting needles, and checking blood pressure prior to formal home dialysis training
  4. Patients should understand that surgery may be required for a new access
  5. Patients and their caretaker will be fully trained before transitioning to home dialysis treatments
    • Training takes several weeks, and after the patient and caretaker are fully trained, home nurses are available 24/7 to address questions or concerns and provide assistance
  6. Home dialysis patients will still be regularly monitored to ensure treatment is going well
    • Home dialysis patients will have a monthly clinic visit to check their lab work and see how they are managing their home treatments

Peritoneal Dialysis

Peritoneal Dialysis (PD) is an alternative to hemodialysis and can be performed at home. The peritoneal membrane (lining of the abdomen) is used as a dialysis filter. A catheter is surgically placed through the abdominal wall. 2-3 liters of dialysis solution (dialysate) stays there for several hours, then waste products and extra water are removed through the peritoneal membrane.

Types of PD

  • Continuous Ambulatory Peritoneal Dialysis (CAPD)
    • Seven days a week, four exchanges (treatments) per day
    • Each exchange has three steps
      • Drain - removes old dialysate
      • Fill - replaces old dialysate with new solution
      • Dwell - solution remains in peritoneal cavity
    • There are three daytime exchanges (dwell time 4-6 hours each)
    • One nighttime exchange (dwell time 8-10 hours)
  • Continuous Cycling Peritoneal Dialysis (CCPD)
    • Exchanges performed by a machine (cycler) while patient sleeps
    • Exchanges are performed seven days a week, approximately 10 hours per night

Advantages of PD

  • Patient is involved with their care
  • No needles
  • Patient can control their schedule
  • Less restricted diet
  • Less clinic visits (one routine visit per month)
  • Better control of blood pressure

Disadvantages of PD

  • The PD treatment schedule requires four exchanges per day (CAPD) or that the patient be connected to a cycler each night (CCPD)
  • Permanent catheter
  • Potential weight gain
  • Some risk of infection
  • Storage space needed for supplies in the patient’s home
  • If you are a diabetic, you will have to monitor your blood sugar levels carefully due to the sugar in dialysate. A slight increase in your blood sugar levels may occur, which will require an insulin adjustment.

The Ideal PD Candidate

  • Able to perform self-care
  • Desires independence
  • Motivated
  • Has had few abdominal surgeries