Home Dialysis Unit
As in the previous talk about haemodialysis, patients go to the hospital to dialyse 3 times a week for 3 to 5 hours. The day and the time are chosen for the patient and there is less flexibility whereas with dialysing at home the patient can choose the days and also the time that suits them. Home haemodialysis has become popular all over the world and also in New Zealand. It is very flexible and suits most people especially patients whom have work and other commitments. Hospital haemodialysis has become very busy and less flexible, whilst in home haemodialysis you can halve the inflexibility and do more hours so that blood is effectively cleaned from waste products and extra fluids that the body is unable to eliminate. Patients need to have a vascular access where the fistula is created in the arm. This is safer than having a temporary line.
The Home Haemodialysis Unit in Auckland started in 2008 and a lot of people have been trained and are now having their haemodialysis at home.
A new Home Haemodialysis Unit was built in 2011 where there are machines for training and a team of 2 nursing staff and a technician train the patient. There is also other support staff and the patient gets reviewed from time to time by one of the kidney doctors. The first step to get into home haemodialysis is to be reviewed by a kidney specialist to see whether the patient is medically stable, after which they are assessed again by a team from the Home Haemodialysis Unit for suitability. The facility at home is checked regarding space for the machine and other accessories. A member of the family, friend or caretaker may also be trained and a lot of people who choose home haemodialysis encourage them to do so.
The new Home Haemodialysis Unit facility is shared with the Peritoneal Dialysis Unit and is based at Greenlane Hospital and it is called Home Dialysis Unit. The home haemodialysis patient is trained on their own or with their caregiver, friend or family member. Training takes 4-6 weeks; setting up the machine and putting in of needles is taught. There is a flat where the patient can come later, independently to do dialysis, including after hours. After training has taken place the patient is assessed regarding suitability of doing haemodialysis independently and staff then do home visits to assess the machine and also to see how the dialysis is going. The team carries a cell phone for emergencies and the patient is reviewed regularly by the kidney specialist. A lot of patients now are choosing to have home haemodialysis whereby they can go to work and then dialyse themselves at home in the evening, overnight or during the day. They choose the days that suit them, especially Sundays where there is no dialysis in the hospital except for emergencies. A lot of studies now are encouraging people to do home haemodialysis. Whilst on dialysis at home you can choose to have the machine in the bedroom or the family room, you can watch television, work from home, eat have a nap or sleep. Every now and then the patient is reviewed and also re-trained back in the hospital Home Dialysis Unit.
The Home Dialysis Unit in Greenlane Clinical Centre accommodates 2 teams; the Auckland Team and the Waitemata Team. The Auckland Team consists of 2 kidney doctors (Renal Physicians) and 2 nursing staff plus 1 technician. Also attached is a social worker, dietitian and a representative of the company that manufactures the dialysis machines.