American Renal Associates - Spotlight Archive
“Where Would You Like To Do Your Dialysis?”
I once heard a nephrologist ask a patient who was considering if the next chapter of his life would include dialysis, “where would you like to do your dialysis”? It’s such a softer starting point than “what modality do you want”? Would you like to do your dialysis at home or would you prefer to come into a dialysis center? This question is especially helpful to a renal patient, who is not yet on dialysis, as they progress through the stages of CKD, giving them the benefit of time and education along the way.
American Renal Associates is proud to support our nephrologist partners in providing great dialysis for patients, whether in-center or “home”. We do this in a variety of ways, beginning with experienced and passionate clinical staff, supporting patients in this important and personal decision. Building beautiful, comfortable and adequately sized home dialysis clinics is also important to success.
In our Dallas region, partnering with great nephrologists, we have developed three large clinics with a combined census of 500 patients, of which over 25% have chosen to dialyze at home. When asked about this success, our Regional Home Clinic Manager, Belinda (Bunny) Talton, said it was giving everyone a chance to be “home”. Nearly everyone has a yearning to be home in any given situation, so why not with dialysis? This is where our staff reaches out and educates patients, giving them a chance, as well as a choice, to help them reach their goals. By thinking “out of the box”, you help patients go “home” instead of checking them off a list.
Bunny shared a story about a patient who wanted home dialysis so he could travel independently during his retirement. After experiencing the freedom home hemodialysis (HHD) afforded him, he traveled the country in his RV educating others about home dialysis. Another patient wanted to keep his job as an aeronautical engineer, which kept him traveling, and peritoneal dialysis (PD) fit well with this lifestyle.
Earlier, I referred to patients that have been regularly seeing their nephrologists prior to starting dialysis. We all know there are many times when this is not the case. Can patients who “crash” into dialysis without the knowledge their kidneys have been failing do “home” dialysis? The answer is absolutely yes. Careful nephrology assessment can determine whether Urgent Start PD is an option. This is a procedure that happens in the dialysis clinic where small volume PD, with patients lying flat, is done daily while waiting on the catheter to heal. For HHD, it is also possible to train patients using a temporary catheter, while working to develop a permanent fistula.
Our observation over the years is that in-center clinics grow somewhat naturally, but it requires a lot of passion and work to educate and train for successful home dialysis programs. We are committed to continuing to “fight” for patients to have the knowledge to choose “home” if it best fits their life.
Stan Langhofer, RN
Regional Vice President
American Renal Associates