Dr Brent Miller treats patients at 
Center for Advanced Medicine
Medicine Multispecialty Center
4921 Parkview Place, Suite c, 5th Floor
St. Louis, MO 63110
Phone: 314-362-7603 Fax: 314-286-0855
Medical Building Two
Barnes-Jewish West County Hospital
10 Barnes West Drive, Suite 200
Creve Coeur, MO 63141
Phone: 314-362-7603 Fax: 314-747-5213
Question: My 58-year old father has been told he needs kidney dialysis, but his doctor says he and my mom can manage it at home. Can you explain what is involved?
Answer: Treatment options for patients with kidney disease have dramatically expanded and improved over the last decade. Kidney transplantation remains the best choice for resumption of a normal lifestyle and its success rate has consistently improved with fewer complications. However, patients may face a three-to-five year waiting list. Almost 60% of patients with kidney failure are not healthy enough to receive a kidney transplant.
Dialysis treatments remove the hundreds of toxins the kidneys would normally eliminate. Similar to kidney transplantation, choices and successes of dialysis have improved in recent years.
First, patients should decide whether they want to undergo dialysis treatments at home or in an outpatient dialysis center. Patients who choose home dialysis will perform their own treatment, with the assistance of family members or partners if necessary. Those choosing an outpatient center will have dialysis nurses and technicians perform dialysis treatments for them.
Two general types of home dialysis are available: hemodialysis and peritoneal dialysis. Hemodialysis purifies the blood directly. One or two needles are placed in a vein and a machine purifies the blood and then returns it to the patient.
Peritoneal dialysis utilizes the small capillaries in the lining of the abdomen to purify the blood. A catheter is inserted into the abdomen underneath the muscle and fat once and left in place. Dialysis fluid is then instilled into this catheter, generally at night, and then removed several hours later after toxins are allowed to diffuse into the fluid.
The advantages of home dialysis are multiple: no need for travel to a dialysis center, flexible treatment schedules, the ability to travel away from home easily, more natural dialysis rather than only three times weekly, and control of one’s healthcare.
Other medical benefits may include better blood pressure control, more energy, better appetite, and less hospitalization. The training time for home hemodialysis is about three weeks and for peritoneal dialysis is about three half days.