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at home has offered her not only a marked improvement in her health but also

the freedom to take off for the weekend with her husband at a moment’s notice.

Her USA holiday report is on the next page. Amy’s consultant, Dr Natalie

Borman tells Kidney Life how and why the Wessex Kidney Centre is offering home

haemodialysis to every one of its dialysis patients – with great success.

A large number of patients who develop end stage facilitate this and try to remove as many barriers as we

can. All patients receive a home visit prior to training to
renal failure will receive haemodialysis at some
discuss therapy in their own environment, and meet the
point during their lifetime. Historically, this was
largely performed at home. Over the years home consultant to discuss treatment options and expectations.
haemodialysis (home HD) has dramatically We ensure that our patients understand that this therapy
reduced with only around 4% of the UK dialysis population is an available option but also that if it does not suit
haemodialysing at home. There are many benefits to home them we will support their transfer to an alternative.
HD with reports of improved quality of life, more flexibility Additionally, we are able to offer our patients ‘experience
of therapy and a significantly reduced recovery time after the difference’ sessions to try dialysing more frequently
dialysis sessions. Many patients see an improvement in with our home machines and see if it suits them.
blood pressure control, a reduction in pill burden and the
Once patients are ready for home training they visit
ability to eat and drink more freely. Most importantly it
our training facility and learn how to use the machine,
gives patients more freedom to fit dialysis around their
cannulate their access and deal with any problems.
lives, giving them back the control which standard dialysis
We have excellent success with our training and have
takes away. With the development of newer and more
an average training time of nine sessions to become
compact machines home adaptions are now minimal; a
independent at home with the final two sessions taking
home based HD machine will require only a small amount
place at home. We extend that training time a little for
of space. And as a result of these improvements in dialysis
those who are from pre-dialysis but the final duration
machine technology worldwide travel has become a reality
depends entirely on how the individual progresses.
for HD renal patients.
We have recently developed a pre-home training pack
Wessex Kidney Centre re-established a home HD which can be used for patients already on HD to learn
programme in 2009 following a decade with no service some of the basics and cannulation technique prior to
at all. It now has a large and rapidly growing home HD commencing home training. This is not essential but
programme training 150 patients for home HD to date does help to build patient confidence.
and currently supporting 84 patients at home, including a
Once home our patients are supported by a dedicated
nocturnal therapy programme. This has all been achieved
team who provide home visits and support, vascular
with minimal financial investment and the programme
access monitoring, monthly blood monitoring as well as
is now sustainable with a dedicated home HD team.
clinical and prescription reviews. Home HD means we can
The clinical and quality of life outcomes have been very
work with the patients to find a dialysis regimen that can
good and we hope in the near future to have research
provide good dialysis and suit their individual needs. This
outcomes to evidence impact on both health and survival.
prescription can be changed and adapted as required to
Home HD should be an option for all patients who wish mirror changes in the patient’s life.
to do it, and it is paramount that we all work towards
It is essential that we work
this. Home HD allows patients to engage with their
together to break down
therapy and to be in control, which is essential given
the barriers to providing
kidney disease will always be a major part of their lives.
haemodialysis at home to
At the Wessex Kidney Centre we offer this modality to
allow all patients this choice.
all patients in the pre-dialysis clinics and to any patient
As our own programme
already on dialysis who wishes to switch modality. We
has demonstrated there
do not have any exclusion criteria and have had great
are no limits to what can
success with patients of all ages, many with significant
be achieved and the most
co-morbidities and all types of vascular access. If
rewarding outcome is to see
patients want to do home HD we do whatever we can to
our patients thrive.
this method of dialysis. Quanta is another company providing home
haemodialysis solutions and Kidney Life will be exploring their service in Dr Natalie Borman,
Consultant Nephrologist,
the next issue. Wessex Kidney Centre
HELPLINE 0845 601 02 09 www.kidney.org.uk Autumn 2016 11