Kevin: Hello, my name is Kevin. I'm one of the renal dialysis matrons here at the Borough Kidney Treatment Centre, where some of our patients attend for regular dialysis.
Haemodialysis takes over the function of the kidney, which helps remove toxins and waste from the body, and excess fluid.
Blood is taken from the body, through the dialysis machine, through the artificial kidney, and then the fresh, clean blood is returned back into the body.
Dialysis normally takes place within one of our dialysis centres.
Some patients may wish to do some or part of their dialysis themselves, and we will train you to do that, and this is normally performed in the dialysis centre.
We also have the option of home dialysis, where patients would like to be trained to go home independently and perform their own dialysis.
This is under the care and support of the home dialysis team, so the choice is yours.
Adisa attends the dialysis centre three times a week to perform his own dialysis.
This is what we call self-care. He is fully independent with his care, but we supply nursing support should he need it.
Adisa: My name is Adisa. I'm a regular patient here at the Borough Lane centre. I dialyse three times a week, generally Monday, Wednesday, Friday, to fit around my university studies.
I've been dialysing now for about five years - just over five years.
The great thing about self-care: it allows me to pretty much pick and choose what time of the day I can dialyse.
I can look after my parents if they require any assistance. I'm going to be getting married soon, so I'm here to spend more time with my lovely wife when she comes, and my university studies.
The learning process for doing self-care isn't very long, and it's not very difficult really.
We receive our training whilst we're dialysing, so it takes a while, but the whole process is pretty straightforward.
I chose self-care because I found it to be quite empowering, where you can determine and decide your own healthcare.
Kevin: Enoch has chosen to dialyse at home. This is what we class as home dialysis. The hospital supplies most of the equipment, including the dialysis machine and chair, which is maintained by the hospital.
Enoch: Hi, I'm Enoch and I've chosen to have home haemodialysis.
Last year my consultant decided I have to start dialysis. From there I was introduced to the home dialysis unit, where they had a seminar, and I went, and I saw how home dialysis makes people's lives much easier.
I dialyse four times a week, depending on when it suits me.
Home dialysis also helps me fit around my family; for instance, if I had family functions, or I had to go somewhere, I dialyse so that it doesn't disrupt my movement.
The learning of the machine took approximately a month.
The home dialysis unit do take absolutely good care of me.
I don't see dialysis as a hindrance, I don't know whether because it's home dialysis I'm doing now, because it fits around my life perfectly.
I do whatever I want to do, at any time I want to do it, based on how often I want to dialyse. I would encourage anybody who wants to go on home dialysis to do it, because it gives you enough freedom.
Kevin: Amaka chose to do peritoneal dialysis at home. This involves having a small tube placed in your tummy. This allows fluid to be drained in and drained out. This allows toxins to be removed from the body including excess fluid. This is usually performed overnight with a small machine.
Amaka: My name is Amaka and I chose to go on to peritoneal dialysis because it fitted in with my lifestyle.
The type of dialysis I am on is called peritoneal dialysis. It required a small operation to feed a catheter into my abdomen and I hook myself up to a similar machine at home.
My treatment runs over a course of eight hours every night while I'm sleeping, and when I wake I disconnect from the machine and carry on with my day.
Training consisted of a week's worth of training. In the beginning, it was very daunting at first thinking about how I was going to set up the machine, but after two days I was confident and able to set up my machine no trouble, and it was actually really easy.
I have to do my treatment every day but it's also a gentler form of dialysis.
It's helped me remain active, I'm able to still look after my niece and run around and not think too much about what I need to be aware of in a week because my treatment runs at night.
I've also been on holiday with my dialysis machine. I'll just pack everything up in the car. Baxter will provide you with the supplies you need for that period of time and you're good to go.
Sarah:Hello, I'm Sarah. I'm one of the supportive care nurses who work as part of the supportive care team at Guy's and Thomas'.
There are some patients who decide not to have dialysis. This may be because of great age, frailty, or because of other illnesses.
If you do decide not to have dialysis or a transplant, we would anticipate that your kidney function would continue to deteriorate over time.
When you're managed supportively for your kidney failure, you'll be looked after by the kidney team, by the community palliative care team, your GP and community nurses.
The aim of supportive care is to ensure that we meet your needs, and that of your family and loved ones.