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Author Topic: What are the requirements for nocturnal hemodialysis at home?  (Read 2970 times)
Dragonfly
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« on: June 13, 2011, 03:22:13 PM »

I am interested in doing nocturnal hemodialysis at home and I would like to know what is required to do so, can someone help me please?


Dragonfly
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Bill Peckham
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« Reply #1 on: June 13, 2011, 08:28:40 PM »

It really depends on what your dialysis provider requires. I think the number one requirement (maybe the only requirement) is your desire to do it, but I don't operate a dialysis center. You need to have the support of a center.


People on IHD have plenty of hard earned experience to share but the first question is who is your dialysis provider and what is their stance on nocturnal HHD?
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http://www.billpeckham.com  "Dialysis from the sharp end of the needle" tracking  industry news and trends - in advocacy, reimbursement, politics and the provision of dialysis
Incenter Hemodialysis: 1990 - 2001
Home Hemodialysis: 2001 - Present
NxStage System One Cycler 2007 - Present
        * 4 to 6 days a week 30 Liters (using PureFlow) @ ~250 Qb ~ 8 hour per treatment FF~28
tyefly
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« Reply #2 on: June 13, 2011, 10:02:08 PM »

I believe the first requirement is that you have a care partner to train with... most clinic require someone to know how the machine works along with you ...   Second... your clinic needs to support you on doing nocturnal and you need to want to do it.... My clinic was not doing nocturnal and I spend 8 months talking to them about it and what it would take to do it... like heparin pumps and how I would protect my self while I was sleeping.... It was easy .... and also my Doctor help me alot as he supported it and helped convince the clinic...  there maybe Nxstage clinics close to your clinic or maybe your clinic supports Nxstage... if they do then start feeling them out on nocturnal.... or  really the like to call it EXTENDED....... If you are in center now start cannulating your self and developing buttonholes..... I really like sleeping with doing D....  It free's  up my whole day.... and YES  I feel way better than I did doing short daily..... I am trying to do one on and one off right now....its working great....
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Bill Peckham
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« Reply #3 on: June 13, 2011, 10:08:39 PM »

 It's true that the majority of centers make the mistake of requiring a trained helper, but some don't. I've dialyzed at home, by myself, since 2002 ... it depends on the center.
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http://www.billpeckham.com  "Dialysis from the sharp end of the needle" tracking  industry news and trends - in advocacy, reimbursement, politics and the provision of dialysis
Incenter Hemodialysis: 1990 - 2001
Home Hemodialysis: 2001 - Present
NxStage System One Cycler 2007 - Present
        * 4 to 6 days a week 30 Liters (using PureFlow) @ ~250 Qb ~ 8 hour per treatment FF~28
tyefly
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« Reply #4 on: June 13, 2011, 10:28:13 PM »

I agree Bill.... I too only had a care partner to train with and she only came in a few times over the three weeks that I trained...  Right now I have been doing everything and feel very good with the care that I give my self.... its really pretty easy after you get past the newness of it all....  And Bill is the person to get alot of info from ....
   I did.....  and was much appreciated....
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IgA Nephropathy   April 2009
CKD    May 2009
AV Fistula  June 2009
In-Center Dialysis   Sept 2009
Nxstage    Feb 2010
Extended Nxstage March 2011

Transplant Sept 2, 2011

  Hello from the Oregon Coast.....

I am learning to live close to the lives of my friends without ever seeing them. No miles of any measurement can separate your soul from mine.
- John Muir

The clearest way into the Universe is through a forest wilderness.
- John Muir
Desert Dancer
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« Reply #5 on: June 16, 2011, 11:38:46 AM »

I am interested in doing nocturnal hemodialysis at home and I would like to know what is required to do so, can someone help me please?

Like Bill said, it all depends on what your center requires. Mine requires a trained partner, though I've just found out they can and will make exceptions to that rule.

Certainly you need room for the machine and its supplies. (I can post pictures of my set up for you if you like.) Depending on what machine you choose for nocturnal, you may need a dedicated electrical outlet and a dedicated water line (Fresenius) or not (NXstage).

I'd say you need to be organized - so things don't slip through the cracks - and vigilant about sterile technique, so you minimize any risk of infection.

The ability to cannulate yourself is most helpful, or at least a care partner who can do so.

Of course, the first thing you need is a center to support your decision.  Have you talked to yours?
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August 1980: Diagnosed with Familial Juvenile Hyperurecemic Nephropathy (FJHN)
8.22.10:   Began dialysis through central venous catheter
8.25.10:   AV fistula created
9.28.10:   Began training for Home Nocturnal Hemodialysis on a Fresenius Baby K
10.21.10: Began creating buttonholes with 15ga needles
11.13.10: Our first nocturnal home treatment!

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