Partners on Home Dialysis-Are They Necessary?

As a retired public safety professional, it does not seem that partners are needed for home nocturnal dialysis, as the pump is only moving at a speed of 300-360. The Head RN at Indiana University Home Dialysis with 38 years of experience agrees with me on this issue. Another way to get around the use of a partner is the various companies that provide immediate response, such as companies as “LifeAlert.” In most and the vastly majority of emergency situation, a phone is not available. When I worked at the retirement community, they had a system called “Protect Alert.” When the resident need an immediate response, they simply pushed the protect alert and security was notified thru the system.

Some physicians allow patients to dialyze without a partner. I’ve known patients who did that, including a patient who was on nocturnal home HD. Some facilities offer remote monitoring over the Internet. Rubin Dialysis in NY does this.

I’d read some time ago that remote monitoring was not finding serious problems. The linked journal article below states:
“Accidental disconnection of dialysis needles or lines can rapidly result in fatal exsanguination. Monitoring of arterial and venous line pressure, along with patients’ visual inspection, remain mainstays of safety measures. Nocturnal dialysis generates particular concern, and initial arrangements for home hemodialysis involved remote monitoring (via phone or internet). Since no safety benefit has been demonstrated, remote monitoring is less commonly used now. Multiple devices and techniques have been developed to secure blood lines and needles. Enuresis pads are sometimes used under accesses to detect excess moisture from a blood leak. A new device to detect blood leak, using a fiberoptic cable taped over the access and attached to a small monitoring device, is now available in some countries, though it is not yet approved in the United States.”

One fiber optic device is Redsense which is now FDA-approved in the US.