When a patient is diagnosed with kidney failure and is told to undergo dialysis treatment in order to stay alive, it can be very difficult. He/she may have many doubts about the treatment regime and also feel anxious about his/her health condition. Kidney diseases affect several areas of a patient’s life, including diet, sleep, work and personal life. It is very important to talk to your nephrologist and decide the treatment option that is best for you.
Home dialysis includes both, peritoneal dialysis and hemodialysis.
Peritoneal dialysis is almost always done at home. In peritoneal dialysis, a sterile liquid, called the dialysate, full of minerals and glucose is infused into the peritoneal cavity in the abdomen and kept there for a few hours. During this time, the waste products and excess fluid from the blood passes into the dialysate through the semi-permeable peritoneal membrane. After the period, the dialysate is removed from the body and fresh dialysate is infused into the body.
The process of doing peritoneal dialysis is called an exchange and it can be done in two ways:
Continuous ambulatory peritoneal dialysis (CAPD): This is the most popular form of peritoneal dialysis. In this method, the dialysate is infused and stays in the peritoneal cavity for about 4 to 6 hours, during which time the patient can perform his daily activities such as work, cooking, gardening, exercise etc. After 6 hours, the solution is drained out and fresh dialysate is infused. The patient has to carry out the exchange for about 4 times a day.
Continuous cycling peritoneal dialysis (CCPD): During CCPD, a machine automatically fills and drains the dialysate from the peritoneal cavity. This takes about 10 to 12 hours, so CCPD may be done by patients at night, when they are asleep.
Mild back pain or abdominal cramps may occur during peritoneal dialysis.
Advantages of Peritoneal Dialysis
- There are fewer dietary restrictions for the patient.
- The patient doesn’t have to be immobile and has the freedom to stick to his/her daily routine.
- Peritoneal dialysis reduces the patients’ dependence on medications for hypertension.
Home hemodialysis is still not very popular in India. However, if you choose to do hemodialysis at home, you will have to invest in a hemodialysis machine, a reverse osmosis based water treatment plant and any additional electrical wiring or plumbing that may be required.
The patient or the caregiver has to be thoroughly trained to carry out the treatment at home. The patient may have a technician come home and help with the treatment for the first few days.
Home hemodialysis is the same as the dialysis that is carried out dialysis centres. The procedure uses a machine that delivers blood to the dialyser, which clears the blood of waste products and extra fluid and returns it back to the body. The treatment schedulescan be discussed with the nephrologist and the patient will have to choose from the following options:
- Dialyzing during the day or nocturnal dialysis
- Sessions ranging from 2 to 8 hours, longer sessions may be carried out during the nights
- 3 to 7 sessions a week
The advantages of home hemodialysis
- The patient has the advantage of taking treatment in the comfort of his/her home.
- If the doctor recommends, the patient can dialyse for longer hours or more frequently, which helps in overcoming nausea and cramping and the patient will have better energy.
- The patient can decide the time for his/her treatment with his/her doctor, so there’s flexibility and the patient’s daily work schedule or social life is not affected.
- The patient can cut back on travel costs of having to travel to the dialysis centre thrice or four times a week.
- If the doctor has prescribed more frequent dialysis treatments, the patient may go easy on his/her diet.