Overcoming Obstacles: A Guide to Starting Home Hemodialysis

February 14, 2024


Transitioning to home hemodialysis can be a life-changing decision, but it also comes with its challenges. In our third article, we provide an informative guide for patients and their families on how to start home hemodialysis. We discuss the necessary equipment, training, and support needed to ensure a smooth transition. Discover the steps to embark on this journey towards greater independence in kidney care.

Home hemodialysis offers a paradigm shift in kidney disease management, providing patients with the flexibility and comfort of undergoing dialysis in the familiar environment of their homes. However, making the transition requires careful planning and preparation. Here’s a guide to starting home hemodialysis:

  1. Assessment and Eligibility:

Before starting home hemodialysis, patients undergo a thorough assessment to determine eligibility. Factors such as overall health, home environment, and the patient’s ability to manage the treatment independently or with the help of a caregiver are considered. A collaborative decision-making process involving the healthcare team, patient, and family is crucial.

  1. Training:

Training is a pivotal aspect of successfully starting home hemodialysis. Patients and their caregivers receive comprehensive training on operating the hemodialysis machine, managing supplies, and adhering to infection control protocols. This training typically takes place in a clinical setting, ensuring that individuals are well-prepared for home-based treatment.

  1. Equipment Setup:

Setting up the necessary equipment at home is the next step. This includes the hemodialysis machine and storage for supplies. Creating a dedicated and clean space for treatment is essential. The healthcare team assists in ensuring that the home environment meets the specific requirements for safe and effective dialysis. Today’s home hemodialysis systems would also require installation of a water treatment system in the homes. This is not needed with the Neokidney hemodilaysis device.

  1. Caregiver Support:

Many individuals undergoing home hemodialysis benefit from the support of a caregiver. This could be a family member or a trained professional. Caregivers play a crucial role in assisting with treatment, providing emotional support, and being prepared to respond to any emergencies. Open communication and shared responsibilities are key components of a successful caregiver-patient partnership.

  1. Routine Maintenance:

Regular maintenance of the hemodialysis machine and water treatment system is vital for the ongoing safety and efficacy of current home-based treatment. As Neokidney does not depend on a water treatment system. Therefore the cost and inconvenience of scheduling regular water treatment maintenance is avoided. Patients and caregivers receive training on routine maintenance tasks, ensuring that the equipment functions optimally. A maintenance schedule is established, and access to technical support is provided as needed.

  1. Monitoring and Reporting:

Patients must actively monitor their health and report any unusual symptoms or issues to their healthcare team. Regular check-ins with the care team are scheduled to assess treatment progress, adjust settings if necessary, and address any concerns. Remote monitoring systems may also be employed to enhance real-time communication between patients and healthcare providers.

  1. Medication Management:

Alongside the technical aspects of home hemodialysis, patients are educated on medication management. This includes understanding and adhering to prescribed medications related to kidney disease and other coexisting conditions. Maintaining a consistent medication routine is crucial for overall treatment success.

  1. Emergency Preparedness:

Having a comprehensive plan for emergencies is a fundamental aspect of home hemodialysis. Patients and caregivers are educated on potential emergency scenarios, such as power outages or equipment malfunctions, and how to respond effectively. Access to emergency services and clear communication protocols are established to ensure a rapid response when needed.

Starting home hemodialysis requires dedication, education, and a collaborative effort between patients, caregivers, and the healthcare team. This transition not only empowers individuals to take control of their treatment but also opens the door to a more flexible and fulfilling life. As patients embark on this journey, ongoing support and education remain crucial for long-term success in managing kidney disease at home.



  1. National Kidney Foundation. (n.d.). Home Hemodialysis. Retrieved from https://www.kidney.org/atoz/content/homehemo
  2. Mehrotra, R., & Agarwal, A. K. (2016). Choice of Dialysis Modality. Retrieved from https://www.kidney.org/atoz/content/homehemo
  3. Marshall, M. R., & Hawley, C. M. (2017). Home hemodialysis: Benefits and risks. UpToDate. Retrieved from https://www.uptodate.com/contents/home-hemodialysis-benefits-and-risks
  4. MacNeill, S. J., & Ford, J. A. (2015). The challenges of home haemodialysis: a narrative review. BMC Nephrology, 16(1), 172. https://doi.org/10.1186/s12882-015-0166-5
  5. Perl, J., & Dember, L. M. (2020). Hemodialysis Adequacy. UpToDate. Retrieved from https://www.uptodate.com/contents/hemodialysis-adequacy
  6. Wong, B. (2019). Home Hemodialysis: A Patient’s Guide. American Association of Kidney Patients. Retrieved from https://aakp.org/wp-content/uploads/2019/12/AAKP-Patient-Guide-to-Home-Hemodialysis.pdf
Author: Gaëtan Pannetier