Facing the need for dialysis can be both physically and emotionally overwhelming. It often brings frequent hospital visits, disrupted routines, and a sense of losing control over daily life. For those who require regular dialysis, the option to get it done at home can make a meaningful difference. It allows patients to stay in a familiar environment, maintain greater control over their schedule, and feel more connected to everyday life. But managing dialysis at home isn’t always easy. To help get an idea of the process, this guide explores all about home dialysis, what to expect, and how patients and caregivers can prepare and manage it step by step.
Understanding Home Dialysis
Dialysis is a life-sustaining treatment used when the kidneys are no longer able to effectively remove waste, toxins, and excess fluids from the body. While many associate dialysis with hospitals or specialised centres, a common question is whether dialysis can be done at home – and the answer is yes, with proper medical guidance and preparation.
Home dialysis is not a different kind of treatment but a different setting in which treatment is delivered. There are two primary forms of dialysis that can be done at home:
Peritoneal Dialysis (PD)
Peritoneal dialysis uses the body’s own peritoneal membrane – the lining of the abdomen – as a natural filter. A soft catheter is placed into the abdomen, through which a special dialysis fluid is introduced. This fluid stays in the abdominal cavity for a prescribed period, allowing waste and excess fluid to pass from the blood into the solution. The used fluid is then drained and replaced with fresh solution. This method can be done manually several times a day (Continuous Ambulatory Peritoneal Dialysis or CAPD) or automatically with a machine at night (Automated Peritoneal Dialysis or APD).
Home Hemodialysis (HHD)
Home hemodialysis involves circulating the patient’s blood through a dialysis machine where it is filtered through an artificial kidney, or dialyzer. The cleaned blood is then returned to the body. This procedure requires access to the bloodstream, typically through a fistula or catheter, and must be done using specialised equipment in a clean and prepared area of the home. Depending on medical advice, home hemodialysis may be performed several times a week during the day or overnight sessions.
Note: The choice between peritoneal dialysis and home hemodialysis depends on several factors, including medical condition, lifestyle, available support, and doctor recommendations. Peritoneal dialysis is often suggested for those who prefer a needle-free option and have a healthy abdominal lining that can filter waste properly. Home hemodialysis may be better suited for individuals who require more intensive blood filtration or have specific clinical needs that make PD less suitable, often requiring access to specialised medical equipment at home.
Preparing Your Home for Dialysis
A well-prepared home environment plays a vital role in ensuring dialysis is performed safely and comfortably. Whether the treatment involves peritoneal dialysis or home hemodialysis, certain things are important to be arranged in advance. Here are a few tips that will help ensure your home is set for dialysis:
- Choose a clean, quiet, and private area that can be dedicated to dialysis
- Ensure good lighting and ventilation in the chosen space
- Maintain easy access to a handwashing area or sanitising station to reduce infection risk
- Keep the area clutter-free and organised to safely manage supplies and equipment
- Arrange for adequate storage for essential dialysis equipment such as dialysate bags, tubing, disinfectants, gloves, masks, and other necessary supplies
- Ensure reliable electrical outlets for equipment such as a cycler or dialysis machine
- If required, provide access to a water source or drainage point (especially for hemodialysis setups)
- Use a flat surface or table for preparing supplies during treatment
- Include a comfortable chair or bed where the patient can sit or lie down during sessions
- Follow guidance from the healthcare team regarding any specific technical needs or modifications
Step-by-Step: How Is Dialysis Done at Home?
The way dialysis is carried out at home depends on the specific method prescribed. Below is a dialysis procedure step by step, offering a general overview of how both peritoneal dialysis and home hemodialysis are typically performed in a home setting, following medical guidance:
Peritoneal Dialysis (PD)
- Wash hands thoroughly and clean the work area to maintain hygiene
- Gather supplies: dialysate bags, tubing, mask, and clamps
- Inspect the catheter site and ensure it’s clean and dry
- Connect the catheter to the tubing set using sterile technique
- Warm the dialysate bag to body temperature if required
- Infuse the fresh dialysate into the abdominal cavity
- Allow the solution to dwell inside the abdomen for the prescribed duration
- After dwell time, drain the used fluid into the drainage bag
- Repeat exchanges as prescribed (manually for CAPD or via a machine for APD)
- Clean and cap the catheter after completing the session
Home Hemodialysis (HHD)
- Wash hands and clean the dialysis space before beginning
- Prepare the dialysis machine and dialyzer according to specific instructions
- Ensure all connections, filters, and fluids are in place
- Record pre-treatment vitals such as blood pressure and weight
- Clean the vascular access site (fistula, graft, or catheter)
- Insert needles into the access site with sterile technique
- Start the blood flow through the dialyzer via the machine
- Monitor for alarms, pressure readings, and any unusual symptoms during the session
- Once completed, stop the machine and return the blood safely to the body
- Remove needles, apply pressure, and dress the access site
- Record post-treatment vitals and note any concerns
- Clean the machine and discard all used materials appropriately
Practical Tips for Caregivers and Patients to Make Home Dialysis Easier
Starting dialysis at home often involves learning new routines, becoming familiar with medical equipment, and understanding how to respond to changes during treatment. The process may seem overwhelming at first, but overtime, it becomes more manageable for both patients and caregivers. Following are some tips that can help patients and caregivers during the transition process:
- Start with simple guidance materials: Most dialysis providers offer printed manuals, visual guides, or videos that explain the procedure step by step. These resources are designed to be patient-friendly and can be referred to at any time.
- Learn by watching nurses or dialysis technicians: In the early days, a nurse, dialysis technician, or trained family member often supports the process. With regular practice, handling tasks such as connecting tubing, preparing equipment, or checking vitals becomes more manageable.
- Ask questions and stay involved: Open communication with the healthcare team helps everyone stay on the same page. Asking questions and taking notes can help clear any confusion and build confidence.
- Take it one task at a time: It’s okay to start with help and gradually take on more responsibility. Many families begin by observing, then move to shared responsibility before managing the process independently.
- Consider professional in-home support if needed: If regular assistance is required, considering having healthcare attendants at home or a doctor visit at home can provide additional peace of mind. These professionals are trained to assist with daily medical needs and can offer support when needed.
Advantages of Choosing Dialysis at Home
Choosing to do dialysis at home can make the treatment feel more manageable and less disruptive to daily life. It can also bring meaningful improvements to overall wellbeing. From emotional comfort to better health outcomes, home dialysis supports a more balanced approach to long-term care. Apart from that, following are the advantages of opting for home dialysis:
- Greater sense of control over daily life: Being able to manage treatment at a preferred time and pace often helps individuals feel more involved in their care and daily life.
- Comfort of a familiar setting: Staying in a home environment can ease anxiety, reduce stress, and make the experience feel less clinical.
- Flexibility in routine: Home dialysis allows more freedom to plan around meals, rest, work, or personal commitments, which may not always be possible with fixed centre-based schedules.
- Reduced travel and waiting times: Avoiding frequent hospital trips saves time and energy, especially for those who live far from dialysis centres or have mobility challenges.
Looking After Emotional Wellbeing and Daily Dialysis Needs
Living with dialysis isn’t just a physical adjustment, it can also take an emotional toll. At-home care helps ease some of that burden by creating a more familiar, relaxed environment and offering greater flexibility. Still, regular attention to emotional health and day-to-day dialysis routine remains essential. Here are some ways patients and caregivers can support both mental health and daily dialysis care at home:
- Create a calm, supportive space: A peaceful setting with comforting elements like natural light, music, or familiar surroundings can help ease stress during treatment.
- Build a consistent care routine: Simple daily habits, from checking vitals to organising supplies, help maintain safety and reduce uncertainty.
- Address feelings openly: It’s normal to experience frustration, sadness, or anxiety. Speaking with a counsellor, joining support groups, or simply sharing thoughts with family can be valuable.
- Balance rest with light activity: Gentle movement, as advised by a doctor, can boost mood and energy without overexertion.
- Celebrate small progress: Acknowledging steady routines, improved comfort, or successful sessions can help maintain motivation over time.
- Stay connected with the care team: Emotional changes, sleep issues, or a sense of burnout should be shared with healthcare professionals, who can provide support or adjust care plans if needed.
Conclusion
Dialysis is a life-altering journey, but choosing to manage it at home can offer a renewed sense of balance and control. With the right preparation, ongoing guidance, and a supportive care network, home dialysis becomes more than just a medical need, it becomes a way to live with greater comfort and flexibility. If you’re considering this shift, speak to a trusted at-home dialysis provider to understand how the process works and what support is available to help you get started safely and confidently.