Why home hemodialysis?

Many people ask me why I choose to do home hemodialysis. To me the answer is quite simple. The main reason I do home hemodialysis is that it makes it easy for me to do daily nocturnal dialysis. This begs the question, why daily nocturnal?

I’m going to let you into a secret here. 

Many people do daily nocturnal hemodialysis because they say the outcomes rival those of a deceased donor transplant (cadaver transplant). They say the risks of organ stunning, damage to the heart and many other co-morbidities associated with long term kidney failure (and hence dialysis) are much lower with daily nocturnal hemodialysis than the regular thrice a week modality.

Honestly, for me all that does not matter much. I do daily nocturnal only for one reason - no diet and fluid restrictions. I eat and drink pretty much what I want and how much I want. I don’t stop to think whether something is high potassium or high phosphorous. I don’t stop to think how much I have drunk today before sipping on a cola. 

This freedom to eat and drink without any restriction is the main reason I do home hemo. 

That said, there are other things that are good about this modality:

- Flexibility to do dialysis when you want to. You can skip when you choose not to do dialysis. You can choose to do dialysis if you feel like it.

- Flexibility on the time of dialysis. I got late at a party? No problem. Dialysis will begin late and will be only 6 hours instead of the 7 1/2. 

- Full control over dialysis parameters. I can play around with the dialysate temperature and sodium level based on how I feel and what I have read helps.

All this is good. But the main reason is no diet and fluid restrictions. Period. 


Nachiket said…
I'm Nachiket. I am on HD since late 2015 post failed transplant. Before that did CAPD for year. My nephro also suggested home hemo for the very same reason what you have mentioned above. It is justifiable.
Would like to know the cost of Fresenius dialysis machine and recurring cost if you have those! Any related issues while handling the machine?
What are your views on using home HD (portable) used in the USA?
Thanks & regards.
Kamal D Shah said…
Hi Nachiket, I have responded to you by email separately. Thanks.
Unknown said…
Sir my mother is diagnosed with CKD 5THstage..we have started her hemodialysis...doctors have told thrice a week...but after reading your article..i want to know about the cost of home hemodialysis and from where can i buy it pls give me any contact details any distributors
Unknown said…
Hi ,My father has been diagonised with kidney failure and my mother is ready for organ donation as all the reports have matched ,is peritonial dialysis good or hemo dyalisis or orhan transplant .My father is a diabetic patient from past 17 years and Also had heart attack 1.5 years ago.
Shobhit said…
Hello Mr kamal, wishes for your long life first of all, can you send me the same detais on reetusingh2511@gmail.com
Thanks in anticipation!
Unknown said…
Hi my father has undergone a surgery for renal cancer He will be on dialysis for his life. Could you please forward me the details
Phone 9518792502
Kamal D Shah said…
What details are you requesting sir?
Prashant said…
Hi Kamal, Is there a difference in the machines for home haemodialysis vs nocturnal haemodialysis. One of my dads doctor mentioned they will schedule demos for home haemodialysis with 3 companies and on quizzing on nocturnal he said it’s a different technology and not available in India. Is it so, which I doubt since you have been doing this for a while now.
Kamal D Shah said…
In India, no. Same machines are used for hospital and home hemodialysis (whether 4 hour or nocturnal). I am using a Fresenius 4008s for the last 15 years for nocturnal home dialysis.

In countries such as the US, for home hemodialysis (whether short duration or nocturnal), they use a machine called the NxStage System One which is not available in India. But, by no means, can you not do nocturnal without that. Like you said, I have been doing Daily Nocturnal Home Hemodialysis for the last 15 years.
Prashant said…
Thanks a lot Kamal, this helps a lot
Prashant said…
Thanks a lot Kamal