This is how home hemodialysis works (HHD)

You may have already read this in the previous chapter, but hemodialysis is a well-established routine procedure. Home hemodialysis (HHD) means, as the name implies, doing your dialysis treatment at home. With home hemodialysis, you yourself are responsible for a large part of the treatment. Supported of your nephrologist and the center's dialysis team, you are doing the dialysis at home.

Do many people do home HD?

In some countries, up to 10% or more do home hemodialysis. In other countries, such as Germany, only very few people do it. Variations are in large parts due to several structural reasons of the healthcare systems in different countries.

With HHD, you work with your nephrologist to determine how often and how long you will do your dialysis treatment. This allows you to dialyze for a shorter period of time each day and keeps your body status at healthier blood levels. Shorter, daily dialysis treatments are often easier to integrate into your daily routine, are easier on your body, and usually lead to an improved sense of well-being.

What are the basic requirements for HHD?

When doing HHD, you must be able to take responsibility for your own dialysis treatment. This means that you must be able to dialyze at home, without any medical assistance. It's not rocket science, but it does require some training. You can be supported in doing HHD by a partner of your own choice partner (usually your life partner) and you will both be trained at the dialysis center. Nowadays, it is also possible to even do dialysis without a partner. However, this is only possible under certain conditions and must be discussed with your nephrologist.

What do I need for dialysis at home?

The space at home is an important element for being able to do HHD. Your dialysis team will advise and support you in setting up your home hemodialysis station properly. This entails the necessary preparations, such as water installation, electrical connection and water treatment. All necessary materials (dialysis machine, osmosis, dialysis table, dialysis material) are provided by your center.

What is the biggest challenge of home hemodialysis?

The biggest emotional hurdle of home hemodialysis is often the puncturing of your dialysis access by your partner or by yourself. If you are capable of doing this, HHD is often recommended for many reasons.

Advantages of HHD

• Dialysis can be better integrated into your daily life, work and family time, as it has a more flexible treatment schedule.

• Treatment is carried out at home, in your familiar surroundings. You avoid regular trips to the dialysis center.

• You have greater personal responsibility and better control over your personal needs, as you can have more individualized dialysis treatments.

• You have the option of longer, gentler dialysis treatments to improve your vitality and reduce physical side effects.

• The flexible treatment plan and your improved diet can reduce the amount of medication you need to take.

If you can make home hemodialysis a viable treatment option, it usually leads to a higher quality of life and well-being for most people.