# Home Dialysis - Indications and Contra-Indications **URL:** \ **Category:** In My Humble Opinion\ **Created:** [September 26, 2014, 2:52am UTC](https://boards.straightdope.com/t/home-dialysis-indications-and-contra-indications/699589 "2014-09-26T02:52:03Z")\ **Posts on this page:** 10\ **Page:** 1
**Author:** ![usedtobe](https://avatars.discourse-cdn.com/v4/letter/u/ec9cab/32.png) [@usedtobe](https://boards.straightdope.com/u/usedtobe)\ **Post date:** [September 26, 2014, 2:52am UTC](https://boards.straightdope.com/t/home-dialysis-indications-and-contra-indications/699589/1 "2014-09-26T02:52:03Z")
I will eventually fall from Stage IV into the Hell-hole known as Stage V CKD (“Kidney Failure”). I was rather hoping I would be a candidate for home dialysis (hey, if it was good enough that Osama could live in a cave…). There is another thread running about a relative who was in denial for so long that the medicos aren’t messing around - going for a tired-and-true approach. Assuming I’m a good boy and do as I’m told, what are the chances I’ll be ably to use a home unit? Yes, I can Google, but am not up for more Medispeak - I have a lumbar MRI and a chat with a nephrologist (who still hasn’t had the foresight to order blood work before the 8/1 appt.). She will again call in the Department head who will ask 4 questions (only two of which are accusatory), then issue the standing order for blood work, ---
**Author:** ![jtur88](https://avatars.discourse-cdn.com/v4/letter/j/e9c0ed/32.png) [@jtur88](https://boards.straightdope.com/u/jtur88)\ **Post date:** [September 26, 2014, 3:51am UTC](https://boards.straightdope.com/t/home-dialysis-indications-and-contra-indications/699589/2 "2014-09-26T03:51:49Z")
I have a friend in Quebec who is on home dialysis. He has learned to live with it quite smoothly, and is able to work his day to day schedule around daily dialysis, about 8 hours a day plugged into the machine. The rest of the time, he is free for his daiy’s activities, and gets a lot of his sleep while on dialysis. All the fluids are delivered to his home, the machine works well, and there is excellent immediate access to a customer service if anything happens. There are several different systems, and difficult to switch from one to the other, the surgically implanted input valves are not compatible. In Canada, if you choose home dialysis, the provincial insurance covers it, no questions asked. He’s on the wait list for a kidney transplant – was called once and reported to the hospital for prep, but the kidney that arrived was unusable. ---
**Author:** ![usedtobe](https://avatars.discourse-cdn.com/v4/letter/u/ec9cab/32.png) [@usedtobe](https://boards.straightdope.com/u/usedtobe)\ **Post date:** [September 26, 2014, 4:31am UTC](https://boards.straightdope.com/t/home-dialysis-indications-and-contra-indications/699589/3 "2014-09-26T04:31:05Z")
Yeah, it’s the prospect of a transplant which scares me - I do wish i had something other than good old O± make China have to frame a famous person in order to harvest a compatible organ.Or maybe do the ethical thing once in a while. ---
**Author:** ![Colibri](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/colibri/32/1841_2.png) [@Colibri](https://boards.straightdope.com/u/Colibri)\ **Post date:** [September 26, 2014, 4:35am UTC](https://boards.straightdope.com/t/home-dialysis-indications-and-contra-indications/699589/4 "2014-09-26T04:35:45Z")
Medical advice is best suited to IMHO. Colibri General Questions Moderator ---
**Author:** ![grude](https://avatars.discourse-cdn.com/v4/letter/g/e47774/32.png) [@grude](https://boards.straightdope.com/u/grude)\ **Post date:** [September 26, 2014, 5:03am UTC](https://boards.straightdope.com/t/home-dialysis-indications-and-contra-indications/699589/5 "2014-09-26T05:03:41Z")
This has no bearing either way, but I’ve always been stunned with how primitive the discovery of dialysis was. > **[Dialysis](https://en.wikipedia.org/wiki/Dialysis)** > > Dialysis may refer to: > [@](#): > > A Dutch physician, constructed the first working dialyzer in 1943 during the Nazi occupation of the Netherlands.[5] Due to the scarcity of available resources, Kolff had to improvise and build the initial machine using sausage casings, beverage cans, a washing machine, and various other items that were available at the time. Over the following two years,[1943-1945] Kolff used his machine to treat 16 patients suffering from acute kidney failure, but the results were unsuccessful. Then, in 1945, a 67-year-old comatose woman regained consciousness following 11 hours of hemodialysis with the dialyzer, and lived for another seven years before dying from an unrelated condition. She was the first-ever patient successfully treated with dialysis.[5] Dr. Nils Alwall modified a similar construction to the Kolff kidney by enclosing it inside a stainless steel canister. This allowed the removal of fluids, by applying a negative pressure to the outside canister, thus making it the first truly practical device for hemodialysis. Alwall treated his first patient in acute renal failure on the September 3, 1946. ---
**Author:** ![usedtobe](https://avatars.discourse-cdn.com/v4/letter/u/ec9cab/32.png) [@usedtobe](https://boards.straightdope.com/u/usedtobe)\ **Post date:** [September 26, 2014, 6:18am UTC](https://boards.straightdope.com/t/home-dialysis-indications-and-contra-indications/699589/6 "2014-09-26T06:18:00Z")
Perhaps they were looking for a cure instead of a stop-gap? The reason kidney failure is a big deal is erythropoiesis - the process by which the bone marrow is triggered to create red blood cells - it is done by a chemical released by (healthy) kidneys. That trick wasn’t done until Genentech came along in the mid ‘80s’ - and the drug (obscenely expensive) was promptly abused by Lance Armstrong - it allowed him to, effectively. “OD” on hemoglobin. They make three, one of which they license to Johnson & Johnson. The original, and the name used as a genetic for the 3 is “Epogin”. It is created form the ovaries of - get ready for this one - Chinese hamsters. How anybody decided that was a good stating place… ---
**Author:** ![SuperAbe](https://avatars.discourse-cdn.com/v4/letter/s/f17d59/32.png) [@SuperAbe](https://boards.straightdope.com/u/SuperAbe)\ **Post date:** [September 26, 2014, 12:30pm UTC](https://boards.straightdope.com/t/home-dialysis-indications-and-contra-indications/699589/7 "2014-09-26T12:30:00Z")
> [@usedtobe](#): > > It is created form the ovaries of - get ready for this one - Chinese hamsters. How anybody decided that was a good stating place… Chinese hamster ovary (CHO) cells have a interesting history: originally used in infectious disease studies, they have three characteristics that make them useful in drug development: [ol] [li]The cells grow quickly - and, thus, produce lots of proteins (key factor here);[/li][li]CHO cell lines are reasonably stable;[/li][li]Because they’ve been used for so much other research for so long, we know how to work with them (i.e. the “familiarity” factor) [/li][/ol] ([For more details than you probably want…](http://www.aiche.org/sites/default/files/docs/pages/CHO.pdf) [pdf]) ---
**Author:** ![Stuffy](https://avatars.discourse-cdn.com/v4/letter/s/f17d59/32.png) [@Stuffy](https://boards.straightdope.com/u/Stuffy)\ **Post date:** [September 26, 2014, 5:52pm UTC](https://boards.straightdope.com/t/home-dialysis-indications-and-contra-indications/699589/8 "2014-09-26T17:52:38Z")
Whether you’re a good candidate for Home Dialysis depends on how well you follow instructions, how well you can grasp new concepts and non squeemishness, oh and a non-sleepwalker. You should also check for your water quality. Some community water supplies are unsuitable for making the dialysate\* (I think I’m remembering that name right). There is normally an interview process where they try to weed out people unsuitable. Then training where more are weeded out, it’s not particularly hard. I acted as my late wifes Dialysis Tech here at home. Ask away if you want more info. ---
**Author:** ![Stuffy](https://avatars.discourse-cdn.com/v4/letter/s/f17d59/32.png) [@Stuffy](https://boards.straightdope.com/u/Stuffy)\ **Post date:** [September 29, 2014, 3:24pm UTC](https://boards.straightdope.com/t/home-dialysis-indications-and-contra-indications/699589/9 "2014-09-29T15:24:01Z")
You know this post haunted me all weekend. I should note to the OP that my wife’s passing was totally unrelated to home Dialysis, she was no longer doing home dialysis at the time of her passing. I hope my post did not cause you any undue anxiety. Sorry sometimes I’m an idiot. Stuffy PS I also posted to the thread. ---
**Author:** ![usedtobe](https://avatars.discourse-cdn.com/v4/letter/u/ec9cab/32.png) [@usedtobe](https://boards.straightdope.com/u/usedtobe)\ **Post date:** [September 29, 2014, 7:30pm UTC](https://boards.straightdope.com/t/home-dialysis-indications-and-contra-indications/699589/10 "2014-09-29T19:30:03Z")
I have an appt with the Nephrologist\* on Tuesday - at least we’ll have something to talk about (still no order for blood work).\* - - not a full-fledged one, a “Fellow” (as in “Fellowship” - a doc-in-training. She doesn’t even get business cards. In her position, I’d have super-elegent cards printed and placed in a slot with the black and white (blue trim) cards provided the “real” employees.