I came across this article today about the benefits of home hemodialysis. My father has been on dialysis for nearly 7 years, since a rare autoimmune disease destroyed his kidneys in the summer of 2001. He was on hemodialysis for a while, and then switched to peritoneal dialysis. That worked for a couple years until he got peritonitis that resulted in too much scar tissue for the peritoneal dialysis to work properly. So he was back to hemodialysis that involved going to a clinic three times a week to be hooked to a dialysis machine for four hours. He would be exhausted after a treatment, and was nauseous most of the time. He needed blood pressure medication because of the fluid buildup that would occur between dialysis days, even though he was meticulous about watching how much fluid he consumed. All in all, it was better than dying, but pretty rough.
In January of 2007, my parents were able to join a pilot program at the University of Colorado Hospital that was working to get patients set up on a home hemodialysis system. They took a three week training course where they learned all the ins and outs of the machine and my mother learned how to insert the needles and prepare for possible problems that could arise during treatment. They plumbed the dialysis machine into their house, and have been using it six days a week for the last 13 months. My father has felt better in the last year than he ever felt in the previous six years. His blood pressure is normal again. He hasn’t vomited since last May (before switching to home dialysis, it wasn’t uncommon for him to vomit daily). He and my mother are remodeling an old house they bought last summer, and he has the energy to work on it several days each week. When I’m around him now, I often forget that he’s sick, whereas before he started the daily home dialysis, it was pretty hard to miss.
Once a month my parents go to the University of Colorado Hospital for testing to make sure that my father’s treatment is working. The doctors also run additional tests for the study that my father is part of, to determine whether daily home dialysis results in better patient outcome than trice-weekly clinic dialysis. Medicare is the primary health insurance for the vast majority of dialysis patients, and they are very interested in large-scale studies to determine whether daily home dialysis should be the recommended treatment for more patients.
From my family’s experience, we would absolutely say that the daily dialysis is dramatically superior. But it does require a caregiver – in this case my mother – who can operate the system and assist with the dialysis process. So it might not work for everyone. But for the majority of patients with kidney failure, daily dialysis can make life seem much more normal than the standard protocol of going to a clinic three times a week and then riding the roller coaster of peaks and troughs in toxin and fluid levels that accumulate over two days. I’m very thankful that my parents were able to enroll in the University of Colorado Hospital program, and that the home dialysis is working so well for my father. I hope that this option will become available for more kidney patients, and will be reimbursed by Medicare for anyone who wants to participate.
