Care for patients carrying out dialysis therapy at home

The goal of home dialysis is to more successfully reintegrate dialysis patients with high activities in daily life (ADL) into society as compared to hemodialysis (HD), which is carried out at a dialysis facility. By achieving this goal, this therapy can prove to be more effective than renal plantation, which has been carried out only in a few cases in Japan. Since self-management forms the basis of home dialysis, dialysis complications can be reduced by arranging meals, fluid management and dialysis schedule according to the lifestyle of the patient himself. In addition, long-term survival rate with health conditions similar to that of a healthy person can be increased. On the other hand, the goal of home dialysis for dialysis patients with a lower ADL is to strengthen the family bond, and improve quality of life and life prognosis, since nursing and support from family members are essential to ensure a long-term survival rate and ADL. For safe operation of home dialysis, which can be more effective than HD carried out in dialysis facilities, it is important for doctors, nurses, clinical engineers, social workers and all other members of the dialysis staff to work together as a united team. The type of nursing varies depending on period (during conservative treatment of end-stage renal disease, during the introduction and maintenance of dialysis, and when changing to end-stage renal disease replacement therapy). It also varies depending on whether continuous ambulatory peritoneal dialysis or home hemodialysis is implemented. The important points of nursing in home dialysis for each treatment period, depending on whether by continuous ambulatory peritoneal dialysis and home hemodialysis, are summarized here.