← Back

Dialysis at Home: Options, Preparation and Safety

When the kidneys stop working properly, waste products and extra fluid build up in the body and can make a person very ill. Dialysis does part of the kidneys’ cleaning work. Some people need it for a short time while their kidneys recover; others need it long term, or until they can have a kidney transplant. Dialysis is often done in a hospital or dialysis centre, but for some patients it can be done at home. This guide explains the home options, how to prepare and what to watch for.

What Dialysis Does, and What It Does Not

Dialysis removes waste and extra fluid from the blood. It replaces part, but not all, of what healthy kidneys do. That is why patients on dialysis usually still need medicines, regular blood tests, and limits on some foods and fluids, as their kidney team advises.

The Two Types of Dialysis That Can Be Done at Home

Peritoneal dialysis (PD)

Peritoneal dialysis uses the inside lining of the abdomen (the peritoneum) as a natural filter. A soft tube, called a PD catheter, is placed in the abdomen in a small procedure some weeks before treatment starts. Dialysis fluid is run into the abdomen through this tube, collects waste and extra fluid, and is then drained out. Each fill and drain is called an exchange. PD is done every day, in one of two ways:

• Manual exchanges during the day (often called CAPD), done by hand without a machine.
• Automated PD (APD), where a machine does the exchanges overnight while the patient sleeps.

Home haemodialysis (home HD)

In haemodialysis, blood passes through a filter outside the body, called a dialyser, and is cleaned before it returns to the body. To reach the blood, the patient needs a vascular access. The preferred long-term access is an AV fistula, made by joining an artery and a vein, usually in the arm, well before dialysis begins, because it needs time to heal. Some patients have an AV graft instead, or a soft tube (catheter) in a vein in the neck, chest or leg. At home, a smaller dialysis machine is used, on a schedule set by the kidney team.

Who Can Have Dialysis at Home?

Home dialysis is not right for everyone. The choice depends on the patient’s medical condition, kidney function, lifestyle and home. The treating nephrologist (kidney specialist) and the kidney team decide whether it is suitable and which type fits best. They also check whether the home can be set up safely.

Patients and family members who will help are trained before starting. In some programmes, a trained nurse or technician helps with the treatment at home.

Preparing the Home

The kidney team will usually advise on the space you need. In general:

• A clean, dry, well-lit area for treatment, with easy access to a sink for hand washing.
• Storage for supplies in a cool, clean, dry place, away from damp and direct heat. Supplies can take up a lot of room, often about the size of a double wardrobe.
• Water and electricity: a home haemodialysis machine needs plug points nearby, and some machines need a water supply and drainage, which may mean small changes to the plumbing or wiring.
• A stock of supplies kept in reserve, in case a delivery is delayed.
• A plan for power or water cuts: keep a torch with working batteries near the machine, and ask the kidney team in advance what to do and whom to call if a session is interrupted.

Caring for the Access

The fistula or catheter is the patient’s lifeline for dialysis, so it needs gentle, daily care exactly as the dialysis team trained you:

• Wash your hands well every time before touching the catheter, the access or the dialysis equipment.
• PD catheter: clean the exit site, where the tube leaves the skin, as the team showed you.
• Fistula or graft: keep the area clean, and feel for the gentle buzz (the “thrill”) as you were taught. Do not scratch it or pick at scabs.
• Do not allow a blood pressure cuff, a blood test or a drip on the access arm unless the dialysis team says it is fine. Tell every doctor, nurse and sample collector which arm has the fistula.
• Avoid tight sleeves, watches and bangles over the fistula.
• Neck or chest catheter: keep the dressing clean and dry, and tell the team straight away if it gets wet, loose or dirty, or comes off.

Diet and Fluids

Many patients on dialysis need to limit salt, potassium, phosphorus and fluids, and some need more protein. The right amounts differ for each person, so follow only the plan your nephrologist or kidney dietitian gives you. A simple daily note of everything the patient drinks can help.

Warning Signs: When to Call the Kidney Team

Call the treating doctor or dialysis team promptly if you notice:

• Fever, chills, or feeling hot, cold or shivery
• Redness, swelling, pain, warmth or discharge around the fistula or the catheter
• The buzz over the fistula has stopped, feels weaker, or feels different from usual
• PD fluid that drains out cloudy, or with white flecks, or new tummy pain
• New swelling in the feet, ankles or face, or more breathlessness than usual
• A new lump or swelling in the tummy or groin
• Passing much less urine than usual, or a racing heartbeat

Call 112 straight away if the fistula bleeds and the bleeding does not stop with firm pressure, as the kidney team showed you, if the patient has severe difficulty breathing, chest pain or tightness, blue or grey lips or skin, or sudden confusion. Read more in our guide on a medical emergency at home.

How OSVI Healthcare Helps

OSVI Healthcare arranges dialysis at home, done by doctors and trained nurses, as planned with the patient’s treating nephrologist. Our care team is available 24×7, and a care manager is your one point of contact. We can also help with:

• Lab tests at home, with home sample collection and reports on WhatsApp and email. See how home sample collection works.
• Nursing care at home, with background-verified nurses and attendants.
• A doctor visit at home, day or night, and medicines delivered at home.

Frequently Asked Questions

What should we do if the power or water goes off?

Agree a plan with the kidney team before starting. Keep a torch near the machine, follow the steps you were taught, and contact the team if a session is interrupted or a long cut is expected, so they can arrange another session.

Which is better at home, peritoneal dialysis or haemodialysis?

Neither is better for everyone. The choice depends on the patient’s health, kidney function, lifestyle and home, and is made with the nephrologist.

Can we change the diet or fluid limits ourselves?

No. Follow the plan from the nephrologist or kidney dietitian, and ask them before making any change.

Are regular blood tests still needed?

Yes. Regular tests help the team check that the patient is getting enough dialysis. Samples can be collected at home; do not take blood from the fistula arm unless the dialysis team says it is fine.

This article is provided for general information and does not constitute medical advice, diagnosis or treatment. Every patient’s situation is different, so please consult a qualified doctor for guidance specific to you. In a medical emergency, call 112.