Improved Home Hemodialysis Offers Hope For Kidney Patients
Research and Innovations For sufferers of chronic kidney disease who are facing a future filled with triweekly, half-day visits to the hospital for treatment, it can often seem that the cure is as debilitating as the disease.
While home hemodialysis offers a solution to some patients, historically, the traditional dialysis machines that were used in the home were large and included confusing, laborious processes that left patients feeling more lost than liberated.
Not only did many patients find the machines confusing to operate, but the availability of high-quality water and dependable electricity —especially for people in more rural or northern areas — posed an insurmountable hurdle.
For other patients, it has been a fear of self-administering needles or the possibility of a significant spike in their electricity and water bills that presented a real barrier to adopting home treatment. Dr. Michael Copland, Vancouver General Hospital Nephrologist and Provincial Medical Director of Independent Hemodialysis, sums up the problem clearly.
“The old machines were big, imposing hospital devices that were meant for nurses not patients. They were intimidating and looked like the control panel of a 747 aircraft. There was a big scare factor.”
"Thanks to these new units, patients are dialyzing to live not living to dialyze."
The historical challenges with home dialysis were all the more disheartening given that it can be the most effective solution for people with chronic kidney disease. Pointing out that patients don’t have to do peritoneal dialysis first, Dr. Paul Komenda, Associate Professor, College of Medicine, University of Manitoba and Director of Research and Home Hemodialysis at Seven Oaks General Hospital, says the biggest advantage of home hemodialysis is that it’s easier to do treatments for longer periods of time.
“Patients who do hospital-based dialysis only do it for four hours, three times a week. But to really restore the closest-to normal physiology we need to lengthen the frequency of dialysis because the longer we do it, the more often we see clinical improvements.”
Innovations in home hemodialysis technology
Thankfully, recent breakthroughs in hemodialysis technology have led to the development of a much more user-friendly and energy efficient home system. This small and portable modern device means that home hemodialysis is now a viable option for patients, who would once have spent a lifetime tied to a hospital and now can benefit from the improved clinical outcomes of more frequent hemodialysis in their home without compromising safety.
The system offers more people a real chance to fit dialysis into their lives rather than making their lives fit around dialysis, notes Dr. Copland. “In the last few years innovation has included a home dialysis machine that has a much simpler interface and is patient-focused; finally, the machine is designed with the patient in mind rather than the hospital,” he explains.
Dr. Copland and Dr. Komenda both emphasize that patients on home hemodialysis show improved blood pressure, healthier heart muscles and can enjoy less diet and fluid restrictions. Both doctors also laud the psychological advantages of home treatment. “The biggest benefit for patients is just the independence of getting out of the hospital system and taking control and ownership of their own health,” explains Dr. Copland.
Making the switch to home dialysis
Despite the fact that over 300 publications of clinical observations spanning over four decades have shown much better metabolic and physiologic parameters, quality-of-life measures, and survival with frequent dialysis when compared with thrice-weekly hemodialysis, still less than 3 percent* of dialyzed patients are treated at home in Canada.
The commercial availability of this portable home hemodialysis machine opens the door to new patients—and improved access means improved outcomes for patients overall. To date, the machine has been used to perform over 12 million treatments for thousands of patients around the world.
“The latest innovations in home hemodialysis are real game changers,” says Dr. Komenda. “The small portable unit doesn’t require power or water modifications. It is compact and you can move it around your home—we have one man who went on vacation in a camper with it! It is simple to use and has fewer buttons. Thanks to these new units, patients are dialyzing to live not living to dialyze.”
*Source: Canadian Organ Replacement Register Annual Report – April 2015