What is Home Haemodialysis ?
Home Haemodialysis (HHD), is the provision of Haemodialysis in the home of people with stage 5 chronic kidney disease. As early as 1962 or 1963, the first HHD patient in India, and who was also probably the first HHD patient in the world went to Seattle with his doctor for training to do HHD and returned to Madras and lived for a year or more on HHD.
Home haemodialysis was the most common method of renal replacement therapy in the early 1970s before the introduction of peritoneal dialysis (in the late 1970s), at which point it went into decline. Nocturnal Haemodialysis was the brainchild of Dr. Robert Uldall in Canada in 1994 and was rigourously pursued by Dr. Andreas Pierratos in 1998 in Toronto, Canada. This concept was implemented by Dr. John Agar in 2001 in Geelong, Australia. In 2002 HHD began a resurgence in the United States with the introduction of machines designed solely for home use.
Patients on Home Haemodialysis are followed by a nephrologist who writes the dialysis prescription and they rely on the support of a dialysis unit for back-up treatments and case management. Studies show that HHD improves patients' sense of well-being. The more they know about and control their own treatment the better they are likely to do on dialysis.
- The greatest reward of HHD is the gaining of ‘Freedom’ for the patient in life style. It removes the ‘shackles’ and releases the patient to enjoy new lease of life.
- Adequate advance counselling should be done to the patient and the family in all aspects of Home Hemodialysis.
- HHD can be done either by the patient as Self-Hemodialysis or Partner Assisted Hemodialysis or by employing a ‘Dialysis Nurse/Technician’, depending on the individual needs and circumstances.
Home Hemodialysis is a worthy alternative and deserves more awareness in the dialysis and renal community.