Is a partner required for nocturnal?

I’m currently in India on daily nocturnal where I have an expert who comes and does my cannulation and starts off the dialysis, sleeps in the same room and in the morning closes it.

I might need to shift to San Jose, California in the next few months. In that case, I will not have anyone staying with me.

I was wondering if it was possible and safe to do nocturnal dialysis without anyone to assist.

Assuming I do the cannulation myself, I had the following other concerns:

  1. Putting the tape on the needles after sticking
  2. Removing the needles after treatment
  3. Handling a blood leak, ooze etc.
  4. Any other emergency like cramps, low blood pressure etc. (I understand the risk is minimal on nocturnal with the low pump speed etc. but was wondering in case it happened, can the situation be handled alone)

Any inputs would be greatly appreciated.


Hi there well I got to say I dont really advise it on regular h.d. it really matters what machine as well . Myself I would do it 1st choice since your a daily treatment nxstage would do the job look at some of Bill Peckmans post and stories. My fiance and I do nocturnal using the fresinius home k . I love this machine but its really not good for your case we only dialize 3-4 times 10 hrs as for what I ve beentold the nx stage is really a must do every day type of machine at least 6 treatments. If my fiance had a newer fistula not 13 years old it would be a good change. Nx stag machine is also kid of portable Bill Peckman drags the thing all over the place with only minimal problems that what i gather from his posts. Well good luck

I think it is safe if the individual doing it thinks the risk is acceptable.

You need to differentiate between self-dialysis and dialyzing alone. Different units have different lines which are always changing but I think it is common for units to allow accompanied self-dialysis.

I will be dialysing alone. No one else at home. Is this unsafe?

It’s a hard question to answer as I don’t know as anyone could imagine all the different scenarios. I think it’s like Bill said there are some risks you have to decide if you want to take them. Only you know if your BP is stable most of the time. If you tend to be hypotensive it may not be a good idea.


I think it depends on the technology. For example, currently we’re using dialysis machines that pump a bit of blood around and around and they require monitoring…now if the machines were alot smaller like beeing able to carry around your wrist or arm then maybe most likely we don’t need a partner…just put it on and go to sleep.

However, this is a medical device and it is suggested to assistance in using it. Like a teenager requires an adult when they drive we patients require a partner to assist us. Its all safety… I think it would be a dream to do it alone but I think technology is not ready yet. I do dream we’re headed that way where no partner will be needed at all.


As my name states HemoHelper…
I personally think that you would need someone there if you are doing it at home… There are things that can go wrong and if there is any type of emergency!!! help is available. Anyway I don’t think any clinic in the USA would take the responsibility of having a patient home alone. When you transfer to San Jose, Calif what clinic are you going to go to? Have you contacted any and checked if they will let you do it by yourself? We live in the San Jose area… You might contact Wellbound. Check their web site. What machine are you presently using? If it is the Fresenius you might be out of luck… Wellbound has switched to NxStage System One’s… I know NxStage is not available where you are… Where are you planning on living?
When we first started on Home Hemo Dialysis (Nocturnal) we had to have a special electrical circuit dedicated for dialysis installed and also plumbing set-up for the water system that is needed… So you see when you say you might be going to California… You need to take care of these things before you come over here… Think your Doctor needs to contact the clinic and let them know that he is planning to have you come over here…If your stay here is for a week or two its a different story… You need to contact a clinic and make arrangements to have dialysis there, usually three times a week.
Don’t mean to discourage you but…
other questions???
Who is going to pay the bills?
Are you a US citizen?
Don’t know if any clinic will take you on as a patient because of your immigration status. Know there are other needs that is also important that needs to be answered; We have not been to any foreign country to have dialysis.
Please have these questions answered before you get your tickets…


Thanks for your response Hemohelper!

I will be moving in about 6-8 months so I have time to sort all these things out. I use the Fresenius currently but will be using the NxStage in San Jose.

I contacted Wellbound and currently plan to go with their services.

My company has a group insurance policy and I will be covered even with a pre existing condition but might need to pay out of pocket for the first 6 months. We are trying to see if anything can be done on this.


There are some clinics in the U.S. that do permit patients to self-dialyze–even at night–either because they started out the process without a helper, or because the helper they did have did not work out for some reason over time. At the Northwest Kidney Centers, they require anyone who is dialyzing without a partner to use a “Lifeline” device (a sort of button you can wear around your neck to call 911 or someone close by that you designate). This seems like a good precaution to me.

If you are fortunate enough to have a partner (or to be able to pay someone), it’s always better to have someone on hand to help–and in some cases it is the partner who is doing the bulk of the treatment for a dialyzor who is too ill or frail to do it him or herself. But an adult who is in the possession of all of his or her faculties may decide that it is less risky in the short and long-term to dialyze alone if the clinic will support it than to go in-center and get only 9-12 hours of treatment per week (with a 2-day gap).

For nocturnal, whether or not you have a partner, I would strongly urge folks to use a bedwetting alarm pad under the fistula arm and under the dialyzer. This way, if even a drop of blood falls onto the pad, the alarm will sound and wake you up immediately.

We just started on PD. So far, so good. I have seen the words “nx” what does that stand for??

NxStage. Having worked in public safety for a number of years, if the patient is in good health for a kidney patient, not frail or weak, I think the LifeLine is enough to insure safety. Also, you have to consider how far the public safety unit is from your location. I am lucky, my fire department is just a few blocks down the street from me. I also think Nocturnal treatments are safe alone at night, with the bedwetting alarm under the access and someone monitoring the treatment by internet connection. In addition, you could be monitored by web cam on Yahoo from anywhere in the world, easy for the monitor to call the fire department. It blows my mind that internet monitoring is not used here, it has been used in Canada for years.