Patients and Families
Your Life. Your Treatment.
Only you, together with your doctor, can decide if home hemodialysis and the 2008K@home™ machine is right for you. On the 2008K@home machine, you, the patient, have the flexibility, based on your physician’s prescriptions, to perform a variety of therapy options.
Patients and Families
The 2008K@home machine offers greater treatment flexibility, which gives you the freedom to dialyze on your schedule. With a committed care partner, you can dialyze at home and achieve results that stand to improve your lifestyle.
Frequently Asked Questions
Chronic kidney disease (CKD) and acute renal failure cause the kidneys to lose their ability to filter and remove waste and extra fluid from the body. Hemodialysis uses a machine to pump blood through a filter (called a dialyzer) that takes out water and waste products.
Hemodialysis is often done in a dialysis center; however, there are many patients who do dialysis at home. In the dialysis center, nurses and technicians usually perform the patient’s hemodialysis treatment multiple times a week, but when done at home, the patient and their selected care partner will set up and perform the treatments using equipment like the 2008K@home machine.
Patients, along with their physician, can determine the therapy options and treatment schedule that best fits their lifestyle. With conventional home hemodialysis, patients may be able to achieve adequate dialysis in as few as three treatments per week.1 Flexibility in treatment days each week may allow for more freedom and independence.
Home hemodialysis, or HHD, is currently one of the fastest growing renal therapy treatments available.2 With HHD, the patient and their care partner perform dialysis at home after completing a few weeks of HHD training in the dialysis home training center.
To find out if HHD is right for you, talk with your physician.
The data reported here have been supplied by the United States Renal Data System (USRDS). The interpretation and reporting of these data are the responsibility of the author(s) and in no way should be seen as an official policy or interpretation of the U.S. government.
- Sands, J.J., Lacson, Jr. E., et al. Home hemodialysis: A comparison of in-center and home hemodialysis therapy in a cohort of successful home hemodialysis patients. ASAIO J 2009;55(4):361-8.
- U.S. Renal Data System, USRDS 2013 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2013.
Who is eligible for home hemodialysis?
Many patients may believe that hemodialysis at home is not an option or may not even know the option exists. Often, patients find out that they are eligible for at-home treatment. You must consult with your dialysis medical team to determine if home hemodialysis is the right treatment option for you.
You may be the right fit for home hemodialysis if you want:
- More independence and control of your healthcare
- To spend more time with family/friends
- To have more time to return to work, school or other personal activities
- To choose your own care partner
You may prefer in-clinic treatment if you:
- Want to spend more time with others on dialysis
- Do not have room at home for equipment and supplies
- Want to avoid inserting your own needles into your arm
- Do not mind the clinic schedule
Nephrologists and dialysis staff identify and assess patients who may be candidates for home therapies. Ask your doctor if home hemodialysis will work for you.
What are the steps to transitioning to home hemodialysis?
- Consultation with medical team — If you are interested in learning more about home hemodialysis please consult with your medical team.
- Decision to transition — In addition to approval from the medical team, you should review the benefits and risks of home hemodialysis carefully, talk with your family about their desire to transition and ultimately decide if home hemodialysis is the right choice for you and for them.
- Access Site — There are three types of blood access used in hemodialysis:
Any of these access types could be used to perform hemodialysis at home. During the instruction period, the home training nurse will teach you and your care partner how to access your blood.
- Home assessment and setup — In preparation for equipment setup, a qualified person from the home hemodialysis team performs a home assessment that includes water quality testing and volume, space requirements and electrical supply. During the inspection, the team member will review:
- The treatment area and care partner accommodations
- The water source
- Storage spaces
- Delivery logistics
- Plumbing and electrical needs
- Telephone/Internet connectivity
- General condition of the home
The clinic staff will help you complete the assessment and set-up; however, there may be some additional costs including any direct changes to the home, like plumbing or wiring.
- Training — You and your chosen care partner will undergo several weeks of training in a dialysis center on the 2008K@home machine. A home hemodialysis training nurse will instruct you and your care partner on the following:
- Setting up a treatment area
- How to take care of the access site and needles
- Setting up and performing the hemodialysis treatment on the 2008K@home machine
- How much fluid to remove
- Following diet and fluid limits
- Taking blood pressure
- Keeping treatment logs
- Recognizing and reporting any problems
- How-to care for the 2008K@home machine
- Storing and ordering supplies
The dedicated home training nurse will help you and your care partner feel comfortable handing all aspects listed above to perform home hemodialysis successfully. The nurse may visit your home to observe the first few home treatments and to answer any questions. Once the nurse and home care team determine you are ready, you and your care partner can begin treatments on your own.
- Monthly visits — You will typically be expected to return to the clinic monthly to meet with physicians, the home training nurse, and any other members of the healthcare team. In order to maintain the best level of health, it is vital to follow your medical team’s advice, attend clinic visits as scheduled, share concerns or issues openly, and manage your diet based on team input and lab values.
- Home care assistance — The home training nurse is available to assist you and your care partner by phone between clinic visits. If you or your care partner ever have questions or concerns, the nurse is available by phone. In the case of an emergency, you should follow the instructions provided during training. Find out if HHD is right for you – speak with your medical team to learn more.
How will home hemodialysis be different from my in-clinic treatment?
Home hemodialysis requires commitment from you and your designated care partner. This includes setting up for, performing, and completing the dialysis treatment, learning how to insert needles into the blood access site, testing the machine and water system, responding to any machine alarms or emergencies that may occur, ordering supplies, and communicating on a regular basis with the home dialysis team.
You will need to follow all instructions that are given by the home dialysis team, such as using aseptic technique, monitoring blood pressure, documenting treatments, and following up with the home training staff on a regular basis and as needed.
- Machine — The dialysis clinic will provide a 2008K@home hemodialysis machine for use in the home. Many patients who commit to home hemodialysis find that they quickly become familiar with the procedures and the machine since many patients have been treated in the clinic on a similar 2008® series machine. You or your care partner will need to monitor the following:
- Setting up the machine
- Testing alarms
- Setting fluid removal goals
- Checking tubing connections
- Running saline through tubing
- Starting and stopping machine
- Recording and monitoring values during treatment
- Support — In addition to self-support and care partner support, technical and clinical support is available from the clinic staff.
- Treatment log — You or your care partner are responsible for checking weight, temperature, blood pressure and pulse on a regular basis and need to keep a manual or electronic log recording each item.
- Supplies — The physician will prescribe, and the home training nurse will order, the first set of supplies; however, you will need to monitor and store supplies at all times. You will be responsible for gathering and using supplies during treatment and for re-ordering supplies as needed according to how you are trained by your home therapy nurse. Our friendly Customer Service team ensures that this process is simple.
- Needles — If you have a graft or fistula, you or your care partner will need to insert needles into the access site to bring blood through the bloodlines to the dialyzer and back to your access site during treatment. You will also need to clean your access site, connect tubing and care for your access. They also need to clean, tape, and connect tubing and needles to your access.
- After treatment — You and your care partner need to rinse the blood circuit with saline, disconnect from the hemodialysis machine and tubing, remove the needles, and clean and disinfect the machine as taught by your home training nurse.
- Mood and energy levels
- Pain, swelling and breathing
- Amount of fluid removed after each treatment
- Blood pressure throughout treatment and as needed
- Weight — before and after each treatment
- Blood tests (potassium, phosphorous, etc.) that will be reviewed during monthly clinic visits
- Access site — daily
- Other items that your care team may suggest or require
Home Dialysis: How often is home hemodialysis performed?
Performing hemodialysis at home, as opposed to in a dialysis center, provides flexibility in the scheduling of treatments. The appropriate treatment schedule will be determined by your physician in consultation with you in order to determine what will meet your medical needs, while also considering your lifestyle needs. Below are a few of the available treatment options:
- Thrice Weekly — Also known as conventional home hemodialysis, three- or four-hour treatments, three times per week
- Every Other Day — Every other day home hemodialysis, similar to conventional, but no long weekend periods without dialysis
- Short daily — Short two- or three-hour treatments, five to six days per week
- Extended — six- to eight-hour treatments, five to six days per week
There are risks to hemodialysis, whether performed in-center or at home. Here are some things to consider:
Hemodialysis treatment sometimes causes loss of blood, high or low blood pressure, increased amount of fluid, fever, headaches or itching. It may make you feel sick to your stomach, cause cramping or other aches and pains, confusion, nervousness, or may make you feel hot or cold. Convulsions, seizures or other problems associated with the brain are also potential risks.
Other more serious problems such as too much bleeding, air in your veins, or damaged red blood cells can cause serious injury or death. Venous needle dislodgement (VND) is also a risk and this should be assessed before beginning treatment. The most important precaution you can take against VND is to monitor the access site, keeping it visible at all times during dialysis. Follow your doctor’s prescription and instructions to reduce the risk of these problems.
If you choose to perform HHD, you will not have a nurse present in the home to assist with emergencies, so adequate and appropriate training must be provided to ensure you and your care partner can respond to emergencies or call 911.
For a more comprehensive list of safety and warnings: Indications, Safety and Warnings
Extra Comforts for Home
While all efforts are made to ensure a safe and successful treatment, hemodialysis in the home environment can encounter challenges. The team at Fresenius Renal Technologies has developed products designed to monitor your dialysis treatment even when we can’t be there.
WetAlert Wireless Wetness Detector
The WetAlert wireless wetness detector is a disposable device that, when placed at your venous need access site, can sense leaks and sound an alarm. During the treatment, the WetAlert device transmits radio signals to the 2008K@home hemodialysis machine and will alert the machine if the device detects a blood leak. During a wetness alarm, the 2008K@home hemodialysis machine will automatically stop the blood pump, close the venous clamp, and signal an audible and visual alarm.
Physicians have relied on the 2008® hemodialysis (HD) machine and disposables from Fresenius Renal Technologies for over thirty years. And now they can provide the same level of customization for the home patient as well. Unlike other home hemodialysis (HHD) systems that rely on standardized products to deliver simplified solutions to the home patient, Fresenius Renal Technologies allows your doctor to select from a wider variety of products to specialize your dialysis treatment at home. These products include HHD bloodlines, Optiflux dialyzers, and concentrates.
Get technical training, plus on-site and phone support to maximize your investment.
Caution: Federal (US) law restricts these devices to sale by or on the order of a physician.
Note: Read the Instructions for Use for safe and proper use of these devices. For a complete description of hazards, contraindications, side effects and precautions, see full package labeling available at www.fmcna.com.
© 2015, 2018, Fresenius Medical Care, All Rights Reserved. Fresenius Medical Care, the triangle logo, Fresenius Renal Technologies, 2008, 2008K@home, success@home, the @home logo, DIASAFE, Dialysis without Boundaries, WetAlert, Optiflux, CombiSet, TruBlu Logistics, Fresenius Polysulfone, and bibag are trademarks of Fresenius Medical Care Holdings, Inc. or its affiliated companies. All other trademarks are the property of their respective owners. P/N 102337-01 Rev C 09/2018