A skeptic at first, 71-year-old Clara Tanner began her journey on dialysis treating in a center even though her son, who is her care partner and an experienced dialysis technician, continually tried to convince her to make the switch to home dialysis. After a year of going into a center for treatment, Tanner switched to treating in her home, and she's stayed with that treatment option for the past 10 years.
"He kept telling me I needed to come home, but I wasn't ready," Tanner said. "I didn't know what it was all about."
For many people on home dialysis, having more flexibility and freedom when it comes to their treatment schedule is important and can help prevent missed treatments. Missing a treatment has never been an issue for Tanner.
"Home dialysis allows people on dialysis to dialyze from the comfort of their home, giving them better control of their treatment schedules, more time for themselves, their families, their jobs and the activities they enjoyed before starting dialysis," said Dr. Martin Schreiber, chief medical officer of Home Modalities for DaVita Kidney Care.
There are two types of dialysis that can be done at home: peritoneal dialysis (PD) and home hemodialysis (HHD).
PD is a needle-free dialysis treatment that's most similar to a person's natural kidney function. Instead of cleaning the blood outside of the body, PD uses the person's peritoneum, which acts as a filter to remove toxins and fluid in place of the kidneys. It can be done during the day at home or work, at night during sleep — or potentially even on vacation.
HHD uses a machine with a filter to remove fluid and waste from the blood. HHD treatments can be done on a person's own schedule and in the privacy of their home.
A nephrologist, which is a physician who specializes in kidney care, guides people with kidney disease to help identify the best treatment option for them. While home dialysis treatments primarily take place in the home, people on PD and HHD still come into a center about once a month for support.
Tanner worked with her physician when considering switching to HHD treatments. Her physician also prescribed a treatment plan that works best for her condition and lifestyle to help her manage her treatment schedule.
That said, Tanner cautions that being on HHD doesn't give a person a license to slack off.
"You have to have discipline," Tanner said. "You've got to do what you're supposed to do and diet is so important."
Not only is each type of home dialysis treatment different, but every person on home dialysis is unique. Dietitians who specialize in helping people on dialysis with their diets take into consideration a person's lab results, access to food and food preparation, weight, malnutrition and other factors to help come up with diets that work best for the individual. For example, Tanner loves watermelon but, because it's high in potassium, she has a strategy to control her cravings.
"When I want watermelon, I cut out everything else that has potassium," Tanner said. "Everything should be done in moderation."
One piece of advice Tanner recommends: "Ask questions so you can be aware and don't assume you know."
To learn more, visit DaVita.com/Home.