Dialysis at home not for everyone

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Dialysis at home not for everyone

By Deborah Austin
HealthyRockford.com
Posted Jul 02, 2008 @ 10:00 AM

ROCKFORD —

The at-home hemodialysis option chosen by Ronald Lindsey and at-home peritoneal dialysis aren’t for everyone.

“It can be very overwhelming, for new patients or any patients,” Rockford DaVita Regional Operations Director Mary Anderson said. “When they come into the dialysis center where they have a nurse and technician to help, they feel safe and secure.”

At-home dialysis patients must have good manual dexterity and considerable storage space for supplies such as bags of solution, disposable filters, syringes, gauze and needles, she said. And people with extensive abdominal scarring from past surgeries may not be good candidates for peritoneal dialysis.

Dr. John C. Maynard, senior partner with Rockford Nephrology Associates and medical director for DaVita’s local dialysis centers, said both forms of at-home dialysis carry risks such as infection and hemodialysis has additional risks such as fluctuating blood pressure or air embolisms.

At-home hemodialysis also requires a partner there to help you, Maynard said.

“But whether in-center or at-home, hemodialysis or peritoneal dialysis, I think the risks are about the same regarding infection,” Maynard said, adding that fluctuating blood pressure might actually be less of a risk with at-home hemodialysis because of the shorter dialysis times.

As for the risk of air embolisms, Maynard said, “I think it’s quite low, and I don’t think it should be a consideration as to the modality to use.”

Centers offering at-home dialysis are available to patients around-the-clock via telephone or pager in case of need or emergency, Anderson said.

Medicare, Medicaid and private insurance companies don’t differentiate between in-center and at-home dialysis when it comes to reimbursement, Anderson said.
Supplies are included in the cost of in-home treatment.

Anderson said she did not have access to per-treatment costs of dialysis.

Medicare in Illinois usually reimburses at about $205 per treatment but that covers only part of the cost, she said, and many patients have secondary insurance plans to cover the remainder.

Social workers at the dialysis centers can help patients with such needs, she said.

HealthyRockford.com staff writer Deborah Austin may be reached at 815-987-1352 or at daustin@rrstar.com

http://www.rrstar.com/archive/x1743985951/Dialysis-at-home-not-for-everyone