My mother (in her early 70s, petite, diabetic and hypertensive) just started in-clinic dialysis in January.
I am thinking of setting her up with home hemo dialysis because she is just so tired (mentally & physically) of going into the clinic 3x a week.
My father would be doing the set-up and breakdown of the dialysis machine for her & he is very, very mechanically inclined.
I’m hoping for thoughts about this (ie: type/brand of a friendly to use machine, positive or negative thoughts, etc.)
Hi Shirlgirl, and welcome to Home Dialysis Central! The question of how to get started with home dialysis is the one we get most often, so we’ve actually written a step-by-step article that may be a helpful way to give you some structure, and I’m sure that some folks here will have some ideas for you. You can read that article at:
http://www.homedialysis.org/v1/rotating/0205topicofthemonth.shtml
Besides this article, just reading back through the old threads can give you tons of information about people’s experiences with the various machines, and we have an equipment “catalog” on this site that will show you many of the machines (http://www.homedialysis.org/v1/equipment/hh_mach_01.shtml).
Good luck, and keep asking questions. 
Hi Shirlgirl, I use the baby K Fresenius machine. I do five hours every other day in the evenings. I was in unit for about 18 months before coming home and I got sick at every treatment. Headaches, stomach troubles, shakey feeling the whole enchilada. I don’t have any of these problems now that I do slow longer treatments. I feel much better overall. The downside of the baby K is you have the initial cost of getting your room plumbed and a special electrical outlet. Also, for me it takes about an hour to set up and about 30-45 minutes on the cleanup depending which day it is and what has to be done to the machine. I guess the main thing I would say is I would use any home machine as compared to going to a unit. There is simply no comparison in the quality of life. Good luck
I also use the Fresenius “Baby 2008K”, which is a popular “conventional” dialysis machine - the same model which is used in a lot of dialysis centres, but on a shorter platform so the machine isn’t as tall. There was a write-up in a local paper about a 70+ year old couple who trained the same place I did, on the same machine, and have been doing daily hemo for the better part of the past year. So, it certainly is possible. In that particular case, the husband is the patient, and the wife if the helper.
The concept of dialysis is similar no matter what the machine, and no machine delivers better dialysis than any other. Some machines are more flexible in what they can do, but other than that, the more simplified machines either eliminate most of the daily setup by reusing the same tubing and disinfecting it in place on the machine, or they use a cartridge-like system that greatly simplifies the daily setup. A machine like mine uses new tubing and a new dialyzer each treatment, plus a bicarbonate and and acid jug, both of which are only used for one treatment. Everything is simply thrown away after the treatment (the jugs go to the recycling bin. It’s not really that complicated though. It just takes a little longer to set it up each treatment.
Whatever the machine which is used locally, home hemodialysis is very feasible. All they can do is to try it, that is, start the training (they would probably get a presentation about it first anyway). If it’s too much, it will quickly be apparent. Many people start the 6 week training and decide after the first week or two that it’s not for them, and nobody will force them to continue. Plus, once they are doing it, there’s no law which says they have to continue if it becomes too much at some point. So, no harm in trying.
Other than the machine, you also need to consider where the supplies will go. There are a lot of supplies for one month’s worth of treatment, plus, if it was me, I would also look at how far they would be from the paramedic ambulance should they need assistance - not that it’s any more dangerous at home than in a dialysis centre, but, things can happen.
For the person doing the home dialysis, it does help to have reasonably good dexterity (for handling the needles, syringes and connections), and you need to pay attention to what you’re doing. But, it’s not rocket science. You just follow the instructions or check-list, and learn a few procedures should some things go wrong, like taking yourself off manually when there’s a power failure, what to do in case of a fire, how to infuse saline if the blood pressure drops below a certain level, etc.
Even though this is a forum which advocates home dialysis, before you have them make that move, another possibility is that the current dialysis prescription is not optimal, leaving your mother drained and exhausted after a treatment. It’s kind of normal to be tired after a treatment of thrice-weekly hemodialysis, but there are things in the dialysis prescription which can be changed, but which may not necessarily be changed unless questions are asked. Dry weight can be changed, potassium concentration can be changed, bicarbonate can be changed, etc. Blood pressure medications are a major contributor to fatigue, in my opinion, and doctors are often reluctant to change these without some perseverant prodding. Sometimes these things can help.
Pierre
I am 33 years old and am on HomeHemo with the Aksys PHD system, I love it, it is simple and easy to use with minimal monthly supplies. It’s easy to learn to use and simple to operate. I dialize two hours a day six days a week, I am off all bloodpressure meds as well as off all epo since I started a year and a half ago. The daily dialysis makes me feel better than I have on all the others I have tried, I have no fluid restrictions and can eat whatever. I wouldn’t give it up for anything, it is simply the best there is out there at this time.
John L
Hi John,
Thanks for joining our discussion, and for sharing your positive experiences! It’s always great to hear of someone who is feeling so well on dialysis and finding the treatments so easy to do. Which other treatments have you tried, and how did you find your way to home dialysis? Are you working? I’d love to know more…
Yes I am working, part time as an electronic tech at a company that builds environmental and biological research instruments. I was diagnosed with FSGS in Nov 1989, I was 18 years old. I Started on PD in 1994, had a transplant in 1995, went back on PD until 1997 then switched to Hemo, I got another transplant in 1998 and went back on hemo in 1999, in November of 2003 I was sick and tired of in center hemo and found the Aksys PHD system just by chance while searching the internet for better options. I love it, it has been the best decision I have ever made. I feel the same every day now, no more bad mondays, it is simple to use and the supplies are minimal compared to PD. I am off all blood pressure meds and epo since I switched. I no longer have to watch my fluid intake or my diet. I feel better than I have in years and I feel like I have taken control of my life back. I work dialysis around my schedule rather than schedule my life around dialysis.
John L
Hi John,
It’s great to have you on our message board. It looks like you have a long history with kidney failure and have used a number of different treatments over the last 11 years. I’m happy to read that you feel so good on daily dialysis. I’ve been impressed by what patients on daily dialysis have to say about how well they feel.
One of my hot buttons is employment. Have you worked the whole time since you were 18 or did you stop working and return to work since you developed kidney failure? What barriers have you faced and overcome? What encouragement, if any, did you get from your doctor and renal team (dialysis or transplant) to work? Did you get any help from Vocational Rehabilitation or did you do it on your own? Working part-time, do you get any health benefits from your company? What would you say to someone who wanted to know about working on dialysis?
I have one of the best NON PROFIT centers in the US backing my support, The Dialysis Center of Lincoln in Lincoln Nebraska. If I had my way ALL centers would be NON PROFIT, it makes a huge difference in patient care. I’ve been in both non profit and for profit centers and you can tell by how they are run which is which. I started working at my present location in 1990, after I knew about the kidney disease, but before dialysis. I worked at a service station before that full time. In May of 1996 I quit because of health reason (was on PD at that time) and went back there part time in April of 1999. I have no benefits for health insurance through them, I have a supplemental insurance through the state of Nebraska offered only to people who can’t get insurance any other way. It still cost me $380 a month out of pocket. Since I didn’t switch careers I did not go through vocational rehab. I would tell others that if you feel good enough to work, work, don’t let dialysis stop you. I have had problems with coronary artery disease and have had two bypasses and 10, yes 10 stents. I also managed to tear both the left and right patellar tendons in my knees within three months of each other, I guess maybe I was feeling to good. LOL Over the years I have had over twenty surgeries, plus many, many “procedures”.
John L
Azgloria,
How do 5 hour txs done every other day compare with short daily txs? Why did you select these hours, days? How long have you been doing these hours and is your diet/energy equivalent to a nocturnal patient or more like a short daily patient?