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Dialysis takes over the function of the kidneys. You might go into hospital for your dialysis, or you might be able to have your dialysis at home. This information explains home dialysis, and the different types of dialysis you might have. 

 

Home dialysis

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Dialysis

During dialysis, blood flows out of your body, round a dialysis machine, and through an artificial kidney (dialyser).

This cleans the blood, and removes the excess fluid that your body does not need. The blood is then returned to your body.

Only a small amount of your blood is out of your body at any one time. 

Having home dialysis

Having dialysis at home allows you to be flexible with your treatment plan, and to dialyse for longer. Our home dialysis team will talk to you about this in more detail.

If you are interested in doing home dialysis, you need to be willing and able to learn how to do your own treatment. Some people have support from family, friends or carers, and some people manage on their own. The most important thing is to work with the home dialysis team to find the best option for you.

You will need to have enough space at home to carry out the dialysis, and store the supplies. The home dialysis nurse will arrange to visit you at home with a technician to make sure that your accommodation is suitable. 

The home dialysis machine will be smaller than the ones you will have seen in the hospital. 

Some changes will need to be made to your home for the equipment. The home dialysis nurse and technician will explain more about this when they visit. Guy’s and St Thomas’ will fund this work, and it usually takes 1 to 4 days. 

We will give you the dialysis machine and most of the equipment. You might need to provide small items, such as a table.

Types of home dialysis

The types of dialysis are:

Home haemodialysis (HD)

The dialysis supplies will be delivered to your home every 2 to 8 weeks, depending on how much storage space you have. Someone needs to be there to sign for the delivery. If you are not at home during the day, please let us know so that we can make arrangements for the delivery.

When dialysing at home, you should choose a treatment plan that meets your needs, and fits around your work and social activities. Here are some examples:

  • dialysis 4 days a week for 4 hours
  • dialysis 5 days a week for 3 hours
  • dialysis 6 days a week for 8 hours overnight (nocturnal home HD)

You will notice that you should dialyse more often than you would in the hospital. Research shows that doing more dialysis can result in you feeling better, having better blood pressure control, and having less dietary and fluid restrictions.

We have 2 pathways for learning how to do your own home haemodialysis (HD).

  1. We can arrange for you to have your dialysis and start your learning in the home training area. The teaching will be done at your own pace by the home dialysis nurses. This usually takes 4 to 12 weeks. 
  2. You can learn how to do home dialysis in a Dialysis Unit first, before moving to the home training area. The teaching will be done at your own pace by the nurses in your local Dialysis Unit.
  • Home training area

     

    The home training area is at 2 locations. These are:

    Borough Kidney Treatment Centre, 46 Long Lane, London SE1 4AU

    or

    The Tunbridge Wells Kidney Treatment Centre

    7-15 St John’s Road, Tunbridge Wells, Kent, TN4 9TF

Peritoneal dialysis (PD)

There are two types of PD: 

  • CAPD is the exchanging of fluid 4 times a day, by hand. It takes about 20 to 30 minutes. CAPD stands for continuous ambulatory peritoneal dialysis, which means you are able to do your everyday activities between dialysis. 
  • APD is the exchanging of fluid during the night, using a machine. It takes about 8 hours. APD stands for automated peritoneal dialysis, which means a machine performs the dialysis overnight while you are asleep.

Some people cannot have PD. For example, it might not be possible if you have had major surgery on your tummy (abdomen), or have bowel disease (such as diverticulitis or colitis), or if you are very overweight or malnourished. Please talk to the home dialysis team for more information.

To have CAPD or APD at home, you will need to have enough space to carry out the dialysis and store the supplies. The home dialysis nurse can discuss the space requirements with you. 

We will give you the dialysis machine for APD, and most of the equipment. You might need to provide small items such as a table.

The dialysis fluids and other supplies will be delivered to your home every 2 to 4 weeks, depending on how much storage space is available.

We can arrange for you to learn how to do your own PD in the home training area. The teaching will be done at your own pace by the home dialysis nurses. This usually takes 4 to 5 days.

  • Home training area

     

    The home training area is at:

    Borough Kidney Treatment Centre, 46 Long Lane, London, SE1 4AU

    In the future we hope to be able to offer PD training at The Tunbridge Wells Kidney Treatment Centre.

Benefits of home dialysis

  • You will not need to travel to the hospital for dialysis.
  • You can be more independent.
  • You will have more flexibility to fit dialysis around work, family and leisure time.
  • You can do dialysis for longer, or more often. This will benefit your health, and give you more flexibility in what you can eat and drink.

Support if you have home dialysis

There are people you can contact if you need more support when doing home dialysis.  

  • You will be able to contact technical and nursing staff if you have any questions about your dialysis. You will get more information during your training period.
  • The home dialysis teams also visit to provide support and check your condition on a regular basis.
  • You will have consultant clinic reviews every 3 months, at one of our Kidney Treatment Centres.

Going on holiday if you have home dialysis

You need to check with your kidney care team to make sure that you are well enough to travel. Please talk to the home dialysis team before booking a holiday. You should do this about 3 months before you plan to go away.

Going on holiday if you have HD

If you are going on holiday in the UK, find out where the nearest Dialysis Unit is and contact them. Ask them for dialysis on your preferred dates.

  • At an NHS Dialysis Unit, you can have an dialysis sessions free of charge.

  • In a private (non-NHS) unit, you might be able to have dialysis sessions free of charge, as long as the private unit has an agreement with NHS England. You should check this before booking treatment with them.

If you are going on holiday outside of the UK, you will need to check if the country has a 'reciprocal healthcare agreement' with the UK. If they do not, you will have to pay for the total cost of your treatment yourself.

If you are going on a cruise ship, and the cruise is within the boundaries of, or the majority of the ports of call are to a country which the UK has a reciprocal healthcare agreement, you can be reimbursed up to the cost of an NHS treatment.

It is sometimes possible to take a small transportable HD machine away for use on holiday, if you have had training. Please ask the home dialysis team for more information.

For more information please ask a member of staff for a copy of our Dialysis away from base leaflet. Please note that the NHS England policy on dialysis away from base is subject to regular review.

Going on holiday if you have PD

If you are having CAPD, you can usually go for days out and on holiday. An exchange can be done in any clean environment with a sink. If you are planning a holiday we can make arrangements for your fluid to be sent to where you are staying in the UK. It is also possible to holiday abroad, but there are some countries where the fluid cannot be easily supplied.

If you are having APD, you can take the machine on holiday with you. We can arrange for the fluid to be delivered. Or, you can swap onto CAPD for your holiday. 

More information

There is more information about dialysis at home and self-care in our series of kidney care films, available online at www.mykidney.org.uk

 

 

Ref number: 3019/VER4

Date published: September 2020 | Review date: September 2023

A list of sources is available on request


Where next?

 Contact us

For more information about home dialysis, please contact the Home Dialysis Team.

Phone: 020 7188 5191 or 020 7188 5133

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