Home hemodialysis for a child

By SickKids staff

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Learn what is involved in performing home hemodialysis and how it can benefit your child.

Key points

Home hemodialysis can be done in your child's bedroom during the day or while your child is sleeping at night.
Home hemodialysis has a number of benefits, including more independence and flexibility in caring for your child, the need for fewer medications and less absence from school.
Your child should weigh more than 20 kg and have a working central venous line before they start home hemodialysis.
You must be physically able to operate the equipment and commit time to training, performing the dialysis properly for at least a year and solving any problems that might occur at home.

Introduction

Home hemodialysis can be done in your child's bedroom as either:

short daily hemodialysis (SDHD) - during the day while your child is awake
nocturnal hemodialysis (NHD) - at night while your child is sleeping.

You will perform the treatment with your child and have support and guidance from the home dialysis team. The treatment is monitored remotely and you can access on-call nursing support overnight if you have any questions.

More information

Benefits of home hemodialysis

Home hemodialysis is slower and gentler than in-hospital dialysis, but it is very efficient.

Home hemodialysis:

offers independence and control over your child's health care, as you perform the therapy
allows more flexibility to work around your child's daily routine and any hobbies or family time - it can even be performed while your child is sleeping
requires fewer trips to the hospital, so minimizing travel time and any transportation costs
requires your child to take fewer medications than if they were on peritoneal dialysis or in-hospital hemodialysis
makes it easier to control your child's blood pressure
allows your child to eat and drink a wider range of food than with in-hospital hemodialysis
allows your child to attend school more often than if they were receiving in-hospital hemodialysis
helps your child feel more secure during treatment and have more energy

In general, patients usually feel better on this type of dialysis. Managing your child's care with close guidance from the home dialysis team is also very rewarding.

Preparing for the treatment

Are all homes suitable for hemodialysis?

Before you can start dialysis at home, someone will visit you to check if your home is suitable for storing and using the equipment and supplies. If it is suitable, the hospital will arrange some home renovations, including electrical and plumbing changes. An experienced technician will need to install a hemodialysis machine and a reverse osmosis (RO) system to treat the water that will be used during dialysis.

All the supplies you need will be delivered to your home. Your provincial health plan will cover the costs.

Treatment

Things to consider when deciding on home hemodialysis

Learning to perform home hemodialysis is exciting, but it can be overwhelming. It requires both commitment and confidence.

To help you decide if this type of treatment is suitable for your child, please consider the following points.

Your child's suitability for home hemodialysis

Your child should weigh more than 20 kg (about 44 lbs).
Your child must have a working central venous line for the tubing from the dialysis machine.

Your ability and time to perform home hemodialysis

As a caregiver, you must be able to understand and read English.
You must be physically able to perform the therapy. This includes having the fine motor skills (for example being able to control the small muscles in your hands) to safely operate the equipment and handle the tubing.
You and your child (if they are old enough) will need time to attend and complete training.
Dialysis can take several hours. You and your family must commit to the time involved in performing each dialysis.
You must commit to home hemodialysis for at least a year.
You will need to be actively involved in decisions about your child's health and able to solve problems at home as they happen.
You will need to have a reliable back-up person to help with dialysis if you are not available.

Your home's suitability for home hemodialysis

Your home must have a suitable space to store and operate the equipment and supplies.
Your family should be able to tolerate possible night disturbances from the alarms on the dialysis machine.

Costs of home hemodialysis

Your provincial health plan will not cover the running costs of hemodialysis at home. Your domestic bills (for example for water or electricity) may increase once you start using the equipment.

At SickKids

If you need more information or are interested in pursuing home hemodialysis, please contact the Home Dialysis Program at 416-813-5895. The program would be happy to answer any questions or meet you to discuss if it is the best option for your child.

Last updated: July 30th 2014