As an end-stage kidney disease (ESKD) patient, are you familiar with all your dialysis options? Many patients are educated on in-center hemodialysis and self-care dialysis at home, but are rarely informed about self-care in-center hemodialysis. While it’s not available at all centers, it is a treatment option that you deserve to know about. Learn more about self-care in-center dialysis here.* 

What is self-care in-center dialysis?

According to the Centers for Medicare and Medicaid (CMS), self-care in-center hemodialysis is “Dialysis performed by an end-stage kidney disease (ESKD) patient in-facility with the expectation that the patient performs their dialysis treatment with little or no professional assistance.” Patients who choose this dialysis will receive extensive training from a registered nurse (RN) on how to perform and manage their dialysis treatment. 

Once you’re trained and ready to act on your own, your self-care in-center dialysis clinic routine will include:

• Checking and recording your vital signs, including weight, blood pressure and temperature 
• Receiving and inspecting your disposable supplies 
• Setting up and testing the dialysis machine before you use it
• Preparing your arm through washing and cannulation
• Monitoring your numbers, such as time left, blood flow rate, arterial pressures, and more (you can make your own adjustments for speed and comfort)
• Tear-down, including removing the needle, bandaging your arm, and cleaning up the space
• Debriefing with your medical team, to discuss your numbers and make adjustments for next time

What are the benefits of self-care in-center dialysis?

Some patients may think self-care in-center dialysis is just more work, but research studies show numerous benefits for patients. When compared to traditional in-center dialysis, research finds self-care in-center patients to have: 

• Higher self-confidence and self-esteem
• Fewer hospitalizations 
• Fewer deaths 
• Fewer missed treatments 

Where is self-care in-center dialysis offered?

In 2019, only 522 of approximately 500,000 dialysis patients in the United States performed self-care in-center dialysis. This type of dialysis is extremely underutilized and many dialysis clinics may not initially offer it to patients. 

Dialysis clinics do not need a separate certification to offer self-care in-center dialysis, however they do need to be certified to provide home hemodialysis (HD) training. If you are interested in self-care in-center dialysis, speak to an administrator at your facility. If your clinic does not provide home HD, you may be able to discuss the option with another clinic nearby. 

Witten, B. (2020, November 12). The End Stage Renal Disease Treatment Choices Model Includes In-center Self Care. Home Dialysis Central. https://homedialysis.org/news-and-research/blog/387-the-end-stage-renal-disease-treatment-choices-model-includes-in-center-self-care