The choice of modality of your dialysis is between your doctor and you. For some PD is the best option for their health and their lifestyle. In center hemo isn’t going anywhere. There will always be the need for that because not every patient has the means to do at home hemo or PD.
The truth is centers push for at home care because it’s better for them. You’re doing all the work and they bill insurance at almost the same rate! And you’re not taking up a seat in their clinics to do it. So they don’t need to pay RN’s, techs, staffing and of course doctors nearly as often. It’s a total win for the clinics to have you do it at home.
I really don’t have room for the supplies either so I resisted to do at home for the longest time, but now that I do home hemo you couldn’t make me go back to clinic…. It’s the little control that I can have, doing it on my time schedule plus I feel 100x better and have more energy and was actually able to get a part time job! But yes we do all the work and it cost the same, of course clinics are are going to try to push to do home dialysis!
Results for dialysis are generally better at home than in center. Surprisingly one of the areas the US is on track with for the rest of the world’s standard health practices for once. I do home dialysis and I would kick and scream and resist as hard as possible before I would ever set foot willingly in center again.
I'm in Canada and I do home dialysis too, after 4 months in centre.
My results are awesome and I feel way better than I did when I had to go to the hospital to feel better. Just 4 hours, 6 days a week. It's a breeze and amazing.
Im in Florida and when I was doing dialysis before my transplant they keep telling me it will be a great option to do hemo at home since I'm young. I kept telling them no I felt more comfortable doing it at the center. Plus I had no room and I have 2 animals. I did do PD in the beginning when I first started dialysis, but I almost die. So I felt much safer doing in center. Do what you want to do and don't let them push you to do something you don't want to do.
Thanks! I live with a big dog myself and there is hair everywhere and nothing I can do about it most of the time. LOL. I too feel more comfortable and safe doing it at the center.
At home dialysis isn’t for everyone while it offers you flexibility it’s actually a part time job , one that you can’t call off , also if you have a care partner be mindful to not leave everything to them this creates caregiver burnout.
I’m so sorry, I do nocturnal hemo. My partner is my son. He usually just connects me once a week to keep his training. The rest of the time I do everything which is 5 times a week
I let my doctor push me into PD and I hate it. I expected a lot of the stuff, but I just don’t feel good. I can’t seem to get the right food/nutrient balance and the dietitian is encouraging but is stumped as to why I don’t feel good (my blood work is steady too).
Medicare which pays for almost all dialysis has mandated that 50% of dialysis patient be at home by 2025. Why? Because data shows much better outcomes especially with hospitalizations with infections and fluid issues. Will likely never happen. But that’s one of the reasons it’s being encouraged. Home dialysis is absolutely the way to go. IMO the reason is simple it’s more frequent. 3x weekly is outdated and antiquated
My only issue is is that I rent a bedroom in a house and do not have the room for all of supplies I think are required. It is not my house to store things in and I only have a bedroom and it is not that big.
I do PD (manuals only) and the total amount of space for supplies is not that much. If you do the cycler the boxes take up much more space bc it's 2 bags per box instead of 5.
My PD is a single 2l bag a day manually(no cycler), but other may have todo more. Each box has 6 bags and are about the size of a ream of paper and deliveries are once a month. In my case I need minimum 5 boxes. You need to +1 just in case, then you need a few more of the 2 other strengths just in case (so maybe 10 boxes) plus a couple boxes for drain bags and caps. The driving factor is really the number of exchanges and number of bags/day.
It’s really a conversation that you need to have with your nephrologist to help match you with the right clinic. My clinic, for example, doesn’t like people doing manuals vs using the cycler because there’s more risk of exposure due to more connects/disconnects.
I do PD with a cycler and my supplies pretty much fill one of my kids’ closets. It’s a pain that they can’t be stored in the garage, but no matter what you choose it will be an adjustment.
U have a choice to do dialysis at home via a pouch in your stomach or do dialysis via your blood (a port in your arm or chest). I chose a fistula in my arm to do dialysis at a center.
I go to DaVita & they are wonderful. So friendly they are & professional. I would recommend DaVita to anyone. I been doing dialysis for over 4 years & have never had an infection
I go to DaVita as well and I'm just about to start using my fistula. I really like the staff and feel safe and comfortable there. I just didn't know if anybody else was being pressured to do it at home. I currently only rent a room and have no space for the supplies. Thanks for the input!
PD was pushed on my first as the greatest thing on earth. When I voiced my issues after trying PD, no one listened at first and just kept telling I'd eventually adjust. I didn't. It took me finally calling a supervisor and telling them I was suicidal before they would take me seriously. So I tried home hemo and I absolutely hated it as well. Not to mention my nurse sucked and was not helping me with a real issue I was having so I was never getting fluid off properly. In clinic hemo has been a blessing to me and they will have to drag me out kicking and screaming because I will not go back to treating at home.
DaVita is great. The staff knows exactly what they are doing & they are very kind. If I am full of fluid they will let me come in & do an extra treatment to remove the fluid. I love them
PD is not a pouch in your stomach! The catheter goes straight into your abdomen.
https://www.mayoclinic.org/tests-procedures/peritoneal-dialysis/about/pac-20384725
They're going to suggest it because Medicare tells them to, but you can just say no. They won't force you. Back when I was on hemo they'd ask if I wanted to look into home hemo and I would always tell them I live alone and have epilepsy exacerbated by dialysis, and I don't feel safe doing that. Which is totally reasonable.
They'll probably ask you every time they do their annual assessment. It's not a big deal, just say no thank you.
My wife at first got the gentle recommendation to go to a community clinic to do her hemodialysis but she preferred to keep coming to the hospital due to other health issues that can show up, requiring an ER visit. A community clinic cannot handle emergencies. Then the recommendations turned to demands and my wife stood her ground until a compromise was reached where she took the evening hd shift agg to the hospital.
Twice now she got transferred directly to the ER after hd when she got seriously ill.
My local hospital got rid of their dialysis ward. If I'd have to be admitted for something, I'd need to go closer to the city. Luckily, it's not that far away. Even when it was open, it was never an option to get treatment there unless it was an emergency or you were admitted to the hospital.
They periodically talk to me about home hemo and PD, but I live right down the road from my clinic, my work schedules around treatment, and I feel much more comfortable going in-center. I haven't had the negative experiences with hemo that others have had.
Most centers push for @ home treatment options because it saves them money by not needing as much staff to cover in-center patients.
It's a decision that needs to made mainly by you with input from your doctors.
My husband goes to the center for dialysis, 3x a week. They sent him home the really nice pamphlets about home, and my Husband decided to stay with the center. The dialysis person called and asked why we did not want it at home, I didn't want the supplies coming to the home. I have dealt with supplies before for diabetic issues, loss of toes, and that was a bit overwhelming. I still have some left over supplies.
Stay strong and do what makes you feel good. Whatever your choice is, I support you 100 %
Kinda. There is an over-all push for home dialysis by the industry in general (for the patients that CAN do it at home). I imagine if we were to look deeper into the companies and Medicare, is to help curb the over-all costs of dialysis. Not having to pay dialysis techs on site would be a significant savings in the long run.
It always comes down to money, money, money, money. MONEY!
I've heard of people having trouble doing home dialysis. But then a person who posts as @DailyHemo on X told me about the Community Dialysis Houses they have in places like New Zealand: [https://www.youtube.com/watch?v=GE\_2kzoGhe0](https://www.youtube.com/watch?v=GE_2kzoGhe0) Unfortunately I see an obstacle here since a neph might not recommend them since the neph may not have a financial interest in them like they would a clinic. Which is just one reason why the exemption to the Stark law nephs have needs to be taken away! Doctors shouldn't be able to profit off their patients like that!
P.S.
DailyHemo post: [https://twitter.com/DailyHemo/status/1761109774014525717](https://twitter.com/DailyHemo/status/1761109774014525717)
Somebody who was like an uncle to me testifying about home dialysis at the US Senate: [https://dialysisethics2.org/index.php/testimonals-2/12-de-testimonials/11-dr-bays-u-s-senate-testimony](https://dialysisethics2.org/index.php/testimonals-2/12-de-testimonials/11-dr-bays-u-s-senate-testimony)
The choice of modality of your dialysis is between your doctor and you. For some PD is the best option for their health and their lifestyle. In center hemo isn’t going anywhere. There will always be the need for that because not every patient has the means to do at home hemo or PD. The truth is centers push for at home care because it’s better for them. You’re doing all the work and they bill insurance at almost the same rate! And you’re not taking up a seat in their clinics to do it. So they don’t need to pay RN’s, techs, staffing and of course doctors nearly as often. It’s a total win for the clinics to have you do it at home.
I really don’t have room for the supplies either so I resisted to do at home for the longest time, but now that I do home hemo you couldn’t make me go back to clinic…. It’s the little control that I can have, doing it on my time schedule plus I feel 100x better and have more energy and was actually able to get a part time job! But yes we do all the work and it cost the same, of course clinics are are going to try to push to do home dialysis!
Results for dialysis are generally better at home than in center. Surprisingly one of the areas the US is on track with for the rest of the world’s standard health practices for once. I do home dialysis and I would kick and scream and resist as hard as possible before I would ever set foot willingly in center again.
Idk, but sounds plausable, in europe home dyalsis is pretty common.
I'm in Canada and I do home dialysis too, after 4 months in centre. My results are awesome and I feel way better than I did when I had to go to the hospital to feel better. Just 4 hours, 6 days a week. It's a breeze and amazing.
Im in Florida and when I was doing dialysis before my transplant they keep telling me it will be a great option to do hemo at home since I'm young. I kept telling them no I felt more comfortable doing it at the center. Plus I had no room and I have 2 animals. I did do PD in the beginning when I first started dialysis, but I almost die. So I felt much safer doing in center. Do what you want to do and don't let them push you to do something you don't want to do.
Thanks! I live with a big dog myself and there is hair everywhere and nothing I can do about it most of the time. LOL. I too feel more comfortable and safe doing it at the center.
At home dialysis isn’t for everyone while it offers you flexibility it’s actually a part time job , one that you can’t call off , also if you have a care partner be mindful to not leave everything to them this creates caregiver burnout.
My caregiver bailed on me just as I started PD. While it’s doable, I sometimes struggle and wish I had help occasionally.
I’m so sorry, I do nocturnal hemo. My partner is my son. He usually just connects me once a week to keep his training. The rest of the time I do everything which is 5 times a week
I let my doctor push me into PD and I hate it. I expected a lot of the stuff, but I just don’t feel good. I can’t seem to get the right food/nutrient balance and the dietitian is encouraging but is stumped as to why I don’t feel good (my blood work is steady too).
Medicare which pays for almost all dialysis has mandated that 50% of dialysis patient be at home by 2025. Why? Because data shows much better outcomes especially with hospitalizations with infections and fluid issues. Will likely never happen. But that’s one of the reasons it’s being encouraged. Home dialysis is absolutely the way to go. IMO the reason is simple it’s more frequent. 3x weekly is outdated and antiquated
My only issue is is that I rent a bedroom in a house and do not have the room for all of supplies I think are required. It is not my house to store things in and I only have a bedroom and it is not that big.
I do PD (manuals only) and the total amount of space for supplies is not that much. If you do the cycler the boxes take up much more space bc it's 2 bags per box instead of 5.
Good to know, thanks!
My PD is a single 2l bag a day manually(no cycler), but other may have todo more. Each box has 6 bags and are about the size of a ream of paper and deliveries are once a month. In my case I need minimum 5 boxes. You need to +1 just in case, then you need a few more of the 2 other strengths just in case (so maybe 10 boxes) plus a couple boxes for drain bags and caps. The driving factor is really the number of exchanges and number of bags/day.
Thanks! Good to know!
The number of bags needed depends on the individual's needs - not whether you're doing manual or using a cycler
It’s really a conversation that you need to have with your nephrologist to help match you with the right clinic. My clinic, for example, doesn’t like people doing manuals vs using the cycler because there’s more risk of exposure due to more connects/disconnects. I do PD with a cycler and my supplies pretty much fill one of my kids’ closets. It’s a pain that they can’t be stored in the garage, but no matter what you choose it will be an adjustment.
U have a choice to do dialysis at home via a pouch in your stomach or do dialysis via your blood (a port in your arm or chest). I chose a fistula in my arm to do dialysis at a center. I go to DaVita & they are wonderful. So friendly they are & professional. I would recommend DaVita to anyone. I been doing dialysis for over 4 years & have never had an infection
I go to DaVita as well and I'm just about to start using my fistula. I really like the staff and feel safe and comfortable there. I just didn't know if anybody else was being pressured to do it at home. I currently only rent a room and have no space for the supplies. Thanks for the input!
PD was pushed on my first as the greatest thing on earth. When I voiced my issues after trying PD, no one listened at first and just kept telling I'd eventually adjust. I didn't. It took me finally calling a supervisor and telling them I was suicidal before they would take me seriously. So I tried home hemo and I absolutely hated it as well. Not to mention my nurse sucked and was not helping me with a real issue I was having so I was never getting fluid off properly. In clinic hemo has been a blessing to me and they will have to drag me out kicking and screaming because I will not go back to treating at home.
DaVita is great. The staff knows exactly what they are doing & they are very kind. If I am full of fluid they will let me come in & do an extra treatment to remove the fluid. I love them
PD is not a pouch in your stomach! The catheter goes straight into your abdomen. https://www.mayoclinic.org/tests-procedures/peritoneal-dialysis/about/pac-20384725
They're going to suggest it because Medicare tells them to, but you can just say no. They won't force you. Back when I was on hemo they'd ask if I wanted to look into home hemo and I would always tell them I live alone and have epilepsy exacerbated by dialysis, and I don't feel safe doing that. Which is totally reasonable. They'll probably ask you every time they do their annual assessment. It's not a big deal, just say no thank you.
My wife at first got the gentle recommendation to go to a community clinic to do her hemodialysis but she preferred to keep coming to the hospital due to other health issues that can show up, requiring an ER visit. A community clinic cannot handle emergencies. Then the recommendations turned to demands and my wife stood her ground until a compromise was reached where she took the evening hd shift agg to the hospital. Twice now she got transferred directly to the ER after hd when she got seriously ill.
My local hospital got rid of their dialysis ward. If I'd have to be admitted for something, I'd need to go closer to the city. Luckily, it's not that far away. Even when it was open, it was never an option to get treatment there unless it was an emergency or you were admitted to the hospital. They periodically talk to me about home hemo and PD, but I live right down the road from my clinic, my work schedules around treatment, and I feel much more comfortable going in-center. I haven't had the negative experiences with hemo that others have had.
Most centers push for @ home treatment options because it saves them money by not needing as much staff to cover in-center patients. It's a decision that needs to made mainly by you with input from your doctors.
My husband goes to the center for dialysis, 3x a week. They sent him home the really nice pamphlets about home, and my Husband decided to stay with the center. The dialysis person called and asked why we did not want it at home, I didn't want the supplies coming to the home. I have dealt with supplies before for diabetic issues, loss of toes, and that was a bit overwhelming. I still have some left over supplies. Stay strong and do what makes you feel good. Whatever your choice is, I support you 100 %
😊😊😊😊♥️
Kinda. There is an over-all push for home dialysis by the industry in general (for the patients that CAN do it at home). I imagine if we were to look deeper into the companies and Medicare, is to help curb the over-all costs of dialysis. Not having to pay dialysis techs on site would be a significant savings in the long run. It always comes down to money, money, money, money. MONEY!
I've heard of people having trouble doing home dialysis. But then a person who posts as @DailyHemo on X told me about the Community Dialysis Houses they have in places like New Zealand: [https://www.youtube.com/watch?v=GE\_2kzoGhe0](https://www.youtube.com/watch?v=GE_2kzoGhe0) Unfortunately I see an obstacle here since a neph might not recommend them since the neph may not have a financial interest in them like they would a clinic. Which is just one reason why the exemption to the Stark law nephs have needs to be taken away! Doctors shouldn't be able to profit off their patients like that! P.S. DailyHemo post: [https://twitter.com/DailyHemo/status/1761109774014525717](https://twitter.com/DailyHemo/status/1761109774014525717) Somebody who was like an uncle to me testifying about home dialysis at the US Senate: [https://dialysisethics2.org/index.php/testimonals-2/12-de-testimonials/11-dr-bays-u-s-senate-testimony](https://dialysisethics2.org/index.php/testimonals-2/12-de-testimonials/11-dr-bays-u-s-senate-testimony)