Purpose of the Guide

Sophie Halldin, RN, Renal Unit in Haemodialysis Department, Danderyds Sjukhus AB, Stockholm Sweden

Dialysis is a life supporting treatment, which is very time consuming, requires a certain structure to everyday life and limits the ability to travel. The patient simply enters into an often life-long relationship with the dialysis. For success the relationship with dialysis should be based on acceptance and understanding, instead of constantly fighting it. It takes energy to live in disharmony with this life-sustaining treatment.

The healthcare professional team is responsible to ensure that a patient, in the pre-dialysis phase, chooses the treatment that is best suited by ensuring they are fully informed of the options available to them. However, how should the patient, after receiving information of the different options, choose?

Many start on In-Centre treatment for a while. This is an opportunity for 
the patient to discover that the entire health care team believes in the patient’s ability to manage dialysis treatment at home. Why not, really?

The choices made initially, will not be permanent but experience does 
show that it is easy to stay on the first choice. It is a big decision to be made by a patient, since it is a life changing choice. Is it our duty to steer the patient toward the choice that we know gives increased healthrelated quality of life? Possibly, but it is the patients choice. However according to numerous studies, many patients with chronic illness made completely different choices when they recieve the right information, in the right way from the beginning. For the future, we think it is important to provide information about HHD and its positive impact.

Many observational studies along with a limited number of randomized clinical trials suggest that frequent HD not only improves outcomes for uremic patients undergoing chronic dialysis but does so with a more favorable cost/benefit ratio compared with conventional HD. Because of this, there has been a rapid increase in the interest in HHD.

We hope you are inspired by this Guide to support your patients to do Home Haemodialysis.