Vascular Access at Home

The benefits of home hemodialysis on patient mortality, overall functional and nutritional status, and quality of life have become apparent overtime, and home hemodialysis as a modality is expected to increase in the coming future. Initiating an end-stage kidney treatment plan early can benefit patients in making decisions on modality and access type, and giving them adequate time for training and familiarization of equipment, cannulation techniques, and recognition of complications. Access type should be individualized for each patient with a shared decision-making approach with patient and family, and use of transitional care units with individualized attention and support groups that can facilitate the training process and assuage fears surrounding access cannulation. Furthermore, patients should be plugged into a vascular access team for maintenance of their dialysis access so that patients can have successful intermittent hemodialysis at home.