Overcoming challenges with home dialysis

Once you decide to do home dialysis, you and your care partner will take training classes to learn the process step by step. Your dialysis care team will guide you through how to set up and use the equipment, follow safety procedures, and manage treatments at home. They will also teach you how to handle any potential issues, such as troubleshooting alarms or recognizing signs of infection.

Beyond formal training, ongoing support is available. You can ask your care team questions at any time, attend refresher sessions if needed, and connect with other home dialysis patients through support groups. Many dialysis centers also provide educational materials, online resources, and videos to help reinforce what you’ve learned.

Dialysis supplies are usually delivered to your home. You will store your dialysis supplies in an indoor clean, dry space. You need to protect your supplies from animals, insects, sunlight, and chemicals. Your supplies do not need to get too hot or too cold. You will always need at least 6 weeks of supplies at home.

These supplies can take up a lot of space. To save space you can:

• Stack supplies that are in sturdy boxes
• Remove supplies from boxes to store in baskets, drawers, or shelves (do not remove supplies from any sterile, sealed packaging)

If your supplies run low, tell your dialysis nurse as soon as possible. It may take time for new supplies to arrive. Your dialysis center may have supplies to help get you through until your supplies arrive.

Yes, you can have pets while you are on home dialysis. However, keep your pets separate from your treatment and storage spaces. This is to help keep your treatment space clean of dirt, dust, dander, and pet hair. These allergens could cause allergic reactions or infections. Protect your supplies, access and dialysis lines from pets’ teeth, nails, and beaks because scratches and breaks can lead to infection. 

Here are some tips to prevent infection if you have pets:

• Keep a pet-free zone: Keep pets separate from the space where you do dialysis and store your supplies. Keep litter boxes and bird cages outside the rooms you use for treatments and supplies. If possible, have someone else clean these to avoid exposure to bacteria.
• Dust, vacuum, and disinfect surfaces to keep your treatment and storage space clean.
• Wash your hands after handling pets and before touching dialysis supplies.
• Keep pet nails, beaks, and other sharp edges short and filed to avoid scratches. Protect your access and all treatment lines from any sharp edges.
• Keep your pets healthy. 

Infections are tiny organisms like bacteria and viruses that can enter our bodies and multiply causing sickness. People on dialysis are more likely to get infections. These can be in your blood, but most infections happen at your dialysis access site. This site is where you connect to the dialysis machine:

•  if you do hemodialysis, this may be a catheter, fistula or a graft
• if you do peritoneal dialysis this is the catheter (tube) in your belly 

Here are some tips to keep your access site, treatment space, and supplies clean to avoid infections:

Keep your access site clean:

• Wash your hands before every treatment or any time you change your catheter dressing.
• If you have fistula or graft, wash this area each time before you use it.
• Keep the dialysis access area and bandages clean and dry.
• Always wear a mask over your nose and mouth. This is important when the access needle or catheter is open and also when you change your access dressing.
• Keep the caps and clamps on your catheter (tube) closed when not in use
• Keep pets away from your access site.
• If you have a peritoneal dialysis catheter, avoid sitting or swimming in untreated water. This includes bathtubs, lakes, rivers, and oceans. You can swim in a pool with treated water but cover your exit site with a waterproof dressing. Clean and dry the site any time it gets wet.
• If you have a hemodialysis catheter, do not swim or submerge this catheter in any water.

Keep your treatment space clean:

• Keep your treatment space clean and dry
• Dust, vacuum, and clean surfaces with disinfectants before and after each treatment

Keep your supplies clean:

• Keep supplies in a clean, dry area
• Protect them from animals, insects, sunlight and chemicals. Do not let them get too hot or too cold.
• Only open supplies when you are ready to use them (do not remove supplies from any sterile, sealed packaging before you are ready to use them).
• Do not use supplies that are not completely sealed, have wet packaging, or are damaged
• Do not use expired supplies. 

If you think you might have an infection, contact your dialysis care team right away. Signs of an infection include:

• A fever, or high body temperature (higher than 99 degrees F)
• Chills or sweats
• Muscle aches
• Redness, swelling, warmth, or pus (drainage) at your access site

During home dialysis, you may experience occasional challenges such as low blood pressure, muscle cramps, or irritation at the access site. Your care team will guide you on how to manage these situations and when to seek additional support. Below are some common issues and ways to address them.

Your dialysis team is here to help. If you have any worries or need answers about your treatment, don’t hesitate to ask. Whether it’s about your dialysis routine, equipment, or how you’re feeling, your care team can give you the support you need.

Contact them right away if you:

• Have unusual bleeding
• Feel unwell, have a fever, stomach pain, or trouble breathing
• See changes in your blood pressures or heart rate, higher or lower
• Have problems with or notice changes to your dialysis access site
• Have problems with your dialysis machine or supplies
• Have new or changed prescriptions or over-the-counter medicines
• Miss or can’t complete a treatment
• Have a new care partner who needs training
• Are hospitalized for any reason

• What should I do if I might have an infection?
• How often will I see my dialysis care team in person and where?
• Who can I talk to if I’m feeling anxious or overwhelmed?
• What if I need help from my dialysis nurse after hours?
• Where can I learn about more treatment options for my kidney disease?
• When should I be referred for kidney transplant evaluation?