Home dialysis: Does it require a nurse? Or is it not necessary?

Dialysis nurses are very important pillars in helping, educating and caring for the patient.

But what if the treatment is no longer done in the clinic but at home, can it be done without the help of a nurse?

Certainly, yes. Although… Every patient is different and there may be some exceptions.

This article will explain in detail how to do it in an effective and uncomplicated way by using proper safety techniques.

What kind of care does home dialysis require?

In the United States, 88% of people with kidney disease receive dialysis in treatment centers, while 12% receive it at home. However, it is expected that by the year 2025, 80% of patients will be receiving home dialysis.

Since, without a doubt, it can be quite advantageous for the patient to do it in the comfort of his or her home. And that is where the role of the training nurse comes in.

Since this treatment requires prior training by the patient and a companion (family member or friend) to learn safety techniques.

The home training nurse

The training nurse is in charge of making both the patient and the person accompanying him/her feel safe at the time of treatment. Usually, the nurse accompanies them on their first treatment at home, so that from then on they can do it properly.

In this training, the patient is taught the proper use of the hemodialysis machines, which remain at home. Since they are small enough to be placed on a table.

But the best part is that this training can last anywhere from 3 to 8 weeks. By dedicating approximately 4 to 6 hours and 5 days a week, you will be able to prepare very well. Although, if you already know how to place the needles in the access, the training can take less time.

In addition, 24-hour assistance will be provided if the patient or companion has any problems or questions, which is quite beneficial because you will not be totally alone when performing your treatment!

What kind of care will they learn?

During the training, the patient and caregiver will learn how to:

  • Take preventive measures to avoid infection.
  • Keep track of supplies used and order new ones.
  • Set up the machine.
  • Clean the machine.
  • Place the needle properly in the vascular access.
  • Check weight, temperature and blood pressure.
  • Record any details of the treatment so that the medical center is aware of them.
  • Dispose of used supplies safely.
  • Respond to any machine alarms.

What are the advantages and disadvantages of home dialysis?

Dialysis can undoubtedly become quite difficult for patients with kidney disease. But, the option of doing it at home can be quite helpful in order to have as normal a life as possible.

Since you can receive the treatment while you sleep, this is incredible! Because it does not take away the patient’s ability to do his daily activities.

In addition, other advantages could be highlighted:

  • It is convenient.
  • The therapy is personalized and more followed.
  • The recovery time is shorter.
  • It tends to have a better quality of life.

On the other hand, the disadvantages of not having the help of a nurse would be:

  • Air can get into the tubes.
  • You may inappropriately adjust the speed of the extraction.
  • Not knowing where to store supplies (filters, fluids, injectors, needles, and more) in an appropriate place.

Who can do home dialysis?

Home dialysis is not for everyone, as there are many types of patients, for example, some have vision problems, depression or cognitive impairment and usually cannot manage the treatment on their own.

Therefore, both the patient and the patient’s companion should make sure whether it is convenient to do the dialysis at home or whether it would be better to do it in the clinical center.

In addition, 80% of dialysis patients have pathological manifestations of anxiety, depression, anger and frustration. Then, it would become a titanic task to do the treatment at home and much more if you do not have a companion. Since many of the patients are over 65 years of age and are alone.

However, there is the possibility of having a companion come to the patient’s home at 7 p.m. to help them bathe and start dialysis. Then, at 5 a.m., the companion arrives again to switch off dialysis, clean up and prepare breakfast.

In this sense, nursing becomes a very important emotional support. And even for older adults with diseases such as arthritis, diabetes and heart disorders, they also require significant help at home.


Although home dialysis is a challenge, it also has great benefits. Even more so if you want to have as normal a life as possible, despite this kidney disease.

Although it may seem like a very difficult task, generally, by properly performing the indications made by the training nurse little by little it will no longer be as overwhelming as it was at the beginning. And in the least expected time both the patient and his companion will be able to do every activity without the help of a nurse.

Therefore, it is advisable to follow each safety technique in detail, to go to the doctor once a month, to have contact with the nurse, a dietician and a social worker.  And in turn, taking an active role in decisions about your care will help you notice the changes.

Marlene J. Shockley

My name is Marlene J. Shockley, and I am a Registered Nurse (RN). I have always been interested in helping people and Nursing seemed like the perfect career for me. After completing my Nursing Degree, I worked in a variety of settings, including hospitals, clinics, and home health care. I have also had the opportunity to work as a Travelling Nurse, which has allowed me to see different parts of the country and meet new people. No matter where I am working, I enjoy getting to know my patients and their families and helping them through whatever medical challenges they may be facing.