Home peritoneal dialysis (PD) can be a good option for individuals on dialysis. Home PD can offer more flexibility and minimized side effects compared to other treatment options such as in center hemodialysis. In order to perform home PD, both you and your care partner (if applicable) must be trained by a home dialysis nurse, and you may have to make some adjustments at your home to ensure you’re safely performing PD treatments.
How to prepare your home for PD
As PD treatments are performed daily, you will need to make sure you have plenty of storage space for the dialysis solution. Your home dialysis nurse or nephrologist will discuss with you the PD options (ambulatory or cycler) available to you and the solution requirements. A nurse from your dialysis clinic may perform a pre-training home visit prior to PD training. This is a great time to ask the nurse for advice on where you can store your supplies and the appropriate area in your home to perform PD treatments.
Look for a space in your home that has the following features:
Good lighting
Minimal/no dust and clutter
No live plants
No pets
An area that can be closed off
Adequate space to store the dialysis solutions
What to expect during PD Training
During the first week of training at your dialysis center, you’ll receive detailed instructions on how to safely perform PD treatments at home. Read all the information thoroughly and write down any questions you have during and after the trainings. Your home dialysis nurse is there to help answer your questions so do not hesitate to ask a question. It is also important to discuss any feelings of uncertainty or anxiety, asking questions and receiving answers can help increase your confidence in performing home dialysis, so take advantage of your time with your nurse.
Your home dialysis nurse will teach you about the following:
How to log your treatment information, including your vital signs (blood pressure, weight, etc.), dialysis solution strength (1.5%, 2.5%, 4.25%), and the amount of drained fluid.
How to check your vital signs.
How to know which dialysis solution strength to use.
How to determine the amount of fluid that was drained.
How to avoid contamination and what to do if you accidentally contaminate your PD catheter or supplies.
Your home dialysis nurse will give you and/or your care partner (if applicable) the opportunity to perform PD treatments in the dialysis clinic. Your home dialysis nurse will observe you to make sure you’re comfortable with the process before you start performing PD treatments on your own in your home.
When you are performing treatments in the dialysis center, make sure you write down questions as they come up, and the associated answers that you receive from the dialysis nurse. It’s important to get all the information you need to feel comfortable before independently performing your first PD treatment at home.
Your first time performing a PD treatment at home
Depending on your dialysis center’s procedures, your home dialysis nurse may travel to your home and watch you perform your first home PD treatment or they may send you home to complete your first PD treatment independently. If you’re concerned about performing your first PD treatment alone in your home, discuss your concerns with your home dialysis nurse. Ask for additional training and observation time if needed.
Also , it’s common to have questions after starting home dialysis, so reach out to your home dialysis nurse or clinic to get answers to any additional questions you have.
Tips to help you remember the information you are given & get help when you need it
1. Ask your nurse for a handout of the steps to perform PD treatments.
2. Add notes to the handout of information that you have trouble remembering and hang this in an easy to view location for your reference.
3. Keep the on-call nurse phone number and dialysis clinic phone number in an easy to see location for you and your care partners reference.
Scheduling your PD treatment times
1. Create a calendar with hours for each day and add in your current must do daily activities. If your care partner is helping you add in their regular activities as well.
2. Add in time on the calendar to do things you enjoy.
3. Consider the time you need for PD based on the training you were provided and your home dialysis nurse recommendations.
4. Identify the largest gaps in time on the calendar for you and your care partner if they will be helping you, and determine your best options.
5. Create a schedule based on when you are the most alert and also when your care partner is available if they will be supporting you.
If needed, ask your home dialysis nurse to help you plan your dialysis treatments according to your current routine and adjust as needed. Remember, your dialysis treatments are critically important, and you should perform your dialysis treatments as prescribed by your nephrologist.
Support after training
Once you’ve completed training in the clinic and start PD treatments at home, there will be someone available for assistance via telephone if needed. Obtain contact information such as the number for the on-call nurse and the number to the home dialysis clinic, prior to performing treatments at home. It’s important to understand what to report and when to contact the home dialysis nurse. For example, you will be taught how to safely handle dialysis equipment and supplies. If you contaminate your supplies, it can lead to an infection, therefore, your home dialysis nurse may instruct you to contact them if you contaminate your PD catheter or supplies.
Remember you are not alone! You can ask questions at any time during this process, before, during and after training, and when you are regularly performing PD you might have additional questions that is ok and normal. Reach out to your dialysis center support team to get the answers you need!
Resources:
Peritoneal Dialysis Overview. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Peritoneal dialysis review (includes comparison table of two PD types). American Kidney Fund.
Home Dialysis Basics. Peritoneal Dialysis. Home Dialysis Central.
Pets and peritoneal dialysis. American Kidney Fund.
