HHD Basics
I am a good candidate?
Access
Training and follow up
Benefits of HHD
100

What is the typical frequency and duration of HHD treatments?

What is: 4-6 days per week and 2-3 hrs per treatment

100

A 50 year old male who is habitually late to treatment or misses due to demanding work schedule/family life

Yes, Patients seeking independence and more control over their treatment may actually do better and be more motivated at home.

100

What type of access is needed for HHD?

HHD can be performed using a CVC, AVF or AVG.

100

True or False:   An HHD patient or care partner needs to have a medical background.

False: The clinic will train you and a partner (if you require one). No medical background is needed.   

100

True or False: One of the benefits of HHD at home is that I can eat and drink whatever I want.

False:  Usually potassium and fluid intake are less restricted. While there are fewer dietary restrictions there are still some limitations on your diet. 

200

What type of utilities are required to perform HHD?

What are: standard electrical outlets and drain (sink or floor drain).

200

A recently retired 70yr male who lives with with his wife and would like spend his retirement years traveling and spending time with his grandchildren

Yes! :  Portable machines allow for road trips and vacations without having to book in-center slots elsewhere. Flexible schedule can make it easier to attend family functions.


200

Do all HHD patient's use Buttonhole technique?

No, Buttonhole cannulation is only used on AV Fistulas. Grafts require rope and ladder technique.

200

How long is the average HHD training?

HHD training is typically of 4-5 days a week, for approximately 4-6 weeks.

200

How does post dialysis recovery time differ from ICHD?

Home hemodialysis (HHD) is associated with a significantly shorter recovery time compared to in-center hemodialysis (ICHD).

300

True or False:

With HHD, you need to follow a strict treatment schedule

False:

Treatments can be done at varying times and days.

300

A known IV drug abuser with unstable housing with no care partner

Probably not at this time

300

What accesses are used for HHD?

HHD can be done with CVC, AVF or AVG

300

What does a typical HHD Training entail?

Includes both didactic and hands on training and covers:

  • Set up, breakdown, monitoring, alarms, complications, access care, cannulation, lab draws and much more
300

What are some Quality of life benefits of HHD?

Flexible schedule, comfort of home, transportation, travel, more time to work, spend with family or do hobbies

400

What can be done if a patient does not want to commit to HHD training?

We can offer Experience the Difference, which allows ICHD patients to dialyze more frequently with the Nx Stage machine on the in center treatment floor. Typically for two weeks to get an idea of what's involved and experience the benefits of more frequent dialysis.

400

A current PD patient  who is not meeting adequacy despite Rx changes and is exhibiting signs of membrane failure. 

Yes, PD ➡️HHD could be a great option.

400

Can patients learn to self cannulate prior to starting HHD training?

Yes! Patients can learn to self cannulate in-center by any expert cannulator, often cutting down HHD training time.

400

What is required for Patient to do nocturnal or Solo HHD?

MD Order and Red-sense monitoring

400

HHD has been proven to decrease blood pressure fluctuations, decreasing the chance of hypotension, cramping, nausea, vomiting and post dialysis fatigue. Why is that?

HHD is done more frequently and gentler and requires lower UFR than ICHD, decreasing the chance of hypotension, cramping, nausea, vomiting and post dialysis fatigue.

500

What are some things to consider regarding home environment ?

HHD requires a space for machine, comfortable chair and clean, well- lit space. As well as adequate space for supplies.

500

A 25 yr old female s/p failed transplant, Lives alone and has no care partner.

Yes,with a doctors order and added safety equipment like Red-sense some patients can dialyze solo.

500

What is buttonhole cannulation?


Constant site (Buttonhole) cannulation refers to inserting the needle into the same site using the same, angle, depth, and direction to create a tunnel-tract, similar to a pierces ear. Once the tract is established blunt - tip are used.

500

What are some safety mechanisms in place for HHD?

  • 3 air detectors, leak detectors 
  • ETR, telhealth
  • 24 hr on call RN support
  • 24 hr on call tech support
  • Notification sent to EMS, water company and electric company
  • Redsense:  a blood leak detector that alarms if the needle dislodges. ( Used for Solo and nocturnalHHD)
M
e
n
u