When the kidneys can no longer clean toxins from the body, dialysis becomes a life saver. Half a million Americans need dialysis, which can cost more than $50,000 each year and hours each week at a dialysis center. There are about 7,000 dialysis centers across the country.
The traditional dialysis routine in a clinic setting is hard on patients, who feel poorly for hours after the treatment. It is even harder as the patients get older. Dr. Robert LaClair, a nephrologist in Montana, prescribes home dialysis to 40% of his patients compared to the national rate of only 10%.
LaClair’s male patient uses a home dialysis machine every night while sleeping. More frequent dialysis means less recovery time, and patients can do it on their own schedule. It is also portable, so the machine can be taken on a vacation.
The peritoneal dialysis machine has a recording that talks the patient through how to connect the tubes properly. One tube plugs into a premixed bag of sugar solution, and the other connects to a permanent catheter near the navel. The machine pumps the fluid into the abdomen, allows it to circulate and absorb bodily wastes through blood vessels in the abdominal lining. It then draws the fluid back out through the same tube, with the other tube carrying the waste fluid into a bathroom toilet. Peritoneal dialysis is less common than hemodialysis, which filters the blood itself.
Setting up the home dialysis machine requires much up-front training. Medicare wants to more than double the payment it offers dialysis providers to teach patients how to use it. It is a personal choice, and no one is being pressured to change from using a dialysis center. Patients who switch to home dialysis rarely want to go back to a center.
LaClair believes that patients do better when they are active participants in their own care. Those who dialyze more frequently feel better and are hospitalized less. The goal is to improve patients’ experience while improving their health and lowering medical costs. Maintaining home dialysis costs less long term.
Whitney, Eric. “Dialysis At Home? Medicare Wants More Patients To Try It.” News. Kaiser Health News, 6 Oct 2016. Web. 6 Oct 2016.