Dialysis treatment

What is peritoneal dialysis?

Peritoneal dialysis is a way of removing waste from your body when your kidneys have failed. It uses the thin internal lining of your abdomen (the peritoneum) as a filter. Fluid is drained into the abdomen through a peritoneal dialysis tube. The fluid absorbs waste from the blood vessels and is then drained out into a bag. There are two types of peritoneal dialysis; CAPD, which involves draining a bag of fluid into and out of your abdomen 3-4 times per day, and APD in which your peritoneal dialysis catheter is attached to a machine overnight which drains the fluid in and out for you.

What are the advantages of peritoneal dialysis?

Peritoneal dialysis allows you to have dialysis treatment at home. We teach you to perform the treatment yourself so that you can be completely independent. It is a flexible treatment so it can be tailored to your needs, including fitting it around your work, holidays and your social life.

How do I start peritoneal dialysis?

If your kidney function is deteriorating the specialist doctors and nurses will talk to you about all your treatment options including peritoneal dialysis. One of our home therapies nurses will then visit you at home, to see what facilities you have in place and to advise you about anything you can do to optimise your home before you start dialysis treatment. This will also allow them to understand your needs and goals to tailor the treatment to you. We will also invite you to information events to learn more about the treatment.

Once you are ready to start dialysis you will be asked to come to hospital to have your peritoneal dialysis tube inserted. This is a slim, flexible, plastic tube which will be inserted inside your abdomen and emerge about 10 cms to the side of your tummy button. This is usually a day case procedure although some patients need to stay in hospital overnight to recover. We then wait for a few days (usually 2 weeks) before starting to teach you how to perform the dialysis. You will be thoroughly trained so that you feel confident and happy performing the dialysis yourself.

What do we offer at Nottingham?

Our dedicated home therapies team will be on hand to support you once you start peritoneal dialysis. Our nurses are based in the Home therapies unit which is part of the Renal Unit at Nottingham City Hospital. You will be allocated a named nurse who will visit you at home, monitor your treatment, and help you with any problems that arise. You will also come to clinic to see a consultant or speciality doctor - usually every 3-6 months.

Contact us

Home therapies manager - Sister Wendy Spooner.

PD lead consultant – Dr Jenny Allen.

Tel: 0115 969 1169 Ext: 54432

Clinic

• Thursday 14.00-17.00 alternate weeks
• City Hospital Renal out-patient clinic

We offer a home haemodialysis training programme for those patients who are looking for more flexibility than in-centre haemodialysis can offer.

Training takes place in the main City dialysis unit over 4-16 weeks, dependent on your personal needs. It covers all aspects of haemodialysis, so that you become your own expert.

• Fistula or line care
• Fistula needle insertion
• How the dialysis machine works
• Education about your fluid management and diet
• Education about you blood pressure
• Education about your medications

The home haemodialysis nurse trainer, Fran Valencia, will visit you at home to discuss the programme with you and your family.

Your home is assessed for suitability by our renal technicians. They will check that the room you have chosen has a good water supply and drainage or, if not, can be adapted to provide this.

You will need a suitable space for the machine, and space for storage of a months’ worth of supplies for haemodialysis. The hospital provides all that you will require, and you will manage your own stock ordering once you are home.

Other members of your family can be involved too, and can become your main dialysis carers.

Once you have trained and we all feel confident, you will be allocated a home therapies community nurse. Your first two weeks at home will be supervised by the nurse trainer and your home therapies community nurse. After this they will visit you monthly to take blood samples and to support you at home.

Home haemodialysis offers you a sense of wellbeing, confidence around your own dialysis needs and control over your treatment. You have the option to dialyse more frequently and at times that suit your needs. As long as you are completing enough hours per week of haemodialysis, you can choose to dialyse overnight whilst you sleep, or at any time during the day. This can then fit in with your family, work and lifestyle needs. You are no longer dictated to by haemodialysis, but instead can get your life back to suit you.

Dialysing more frequently at home, but for less hours at a time, has been shown to improve heart health, as there is less build-up of fluids and toxins between sessions. You usually get fewer post dialysis symptoms such as nausea, fatigue or headaches. Most home haemodialysis patients report feeling very well again and prefer to dialyse in this way. Night time, or nocturnal dialysis, will free up your whole day, and offers a very long, slow gentle dialysis. Patients who choose this option can usually come off their blood pressure tablets and diet restrictions, so can lead a much more “normal“ life again.

Quotes from home haemodialysis patients include “ I can now say yes to invitations to go out”,” I attach myself to the machine at night, dialyse and sleep, detach in the morning, and go to work. So life goes on” and “ this is the best thing I have ever done for myself”.

Please read the attached information leaflet.

Contact us

If you would like further information please contact the home haemodialysis nurse trainer Fran Valencia or the home therapies sister Wendy Spooner.

Tel: 0115 969 1169 Ext: 54432

Clinic

• Thursday 14.00-17.00 alternate weeks
• City Hospital Renal out-patient clinic

The Nottingham City Hospital Haemodialysis Unit aims to provide high quality, research based care and adapt this to your needs.

We have 40 dialysis stations for patients that require this treatment. We care for nearly 200 patients per week. Patients typically dialyse three times per week – either Monday Wednesday Friday or Tuesday, Thursday and Saturday. There are 3 patient shifts – morning, afternoon and evenings. We try to offer you a shift that matches your circumstances and preference.

Patients on the dialysis unit are invited to be actively involved in their treatment and care. The Shared Care dialysis programme helps patient’s gain knowledge and skills so they can participate and manage their own dialysis treatment.

We also offer a home dialysis training programme and this is supported and managed by small group nurses. This helps patients and their families dialyse at home, in their own environment.

Dialysis unit manager - Sister Helen Houlahan

Renal dialysis consultants - Dr Linda.Bisset and Dr Mark Jesky.

Contact us

Tel: 0115 969 1169 Ext: 56602 or 56410

The Mike Cassidy Renal Unit is situated on the King’s Mill Hospital Campus in Sutton-in-Ashfield. The Renal Unit serves patients in the north of the county to reduce visits to the main Nottingham hospitals.

The Unit comprises of a 20 bed, nurse led, dialysis unit with a dedicated team of staff who look after approximately 80 patients during the week - Monday to Saturday.

We also run a number of outpatient clinics throughout the week. These include dialysis, pre dialysis, transplant and general nephrology clinics.

Dialysis unit manager – Charge Nurse Damion Abbey.

Renal dialysis consultant - Dr Simon Roe.

Out patient clinic consultants – Dr Catherine Byrne, Dr Mark Jesky, Dr Ashok Poduval and Dr Jenny Allen.

Transplant clinic specialist nurse – Sister Jo Stacey.

Contact us

Tel: 0162 3622 515 Ext: 3682

The Shipley Dialysis Unit at Ilkeston Community Hospital has 16 haemodialysis stations that run two shifts per day from Monday to Saturday. Patients are invited to share as much of their care as they feel comfortable to do, fully supported by the team of specialist nurses and healthcare assistants.

The team are committed to treating every patient as an individual and to offering the highest quality care. Patient transport and holiday dialysis organisation are co-ordinated by our unit receptionist, Claire Tuckwood.

The unit is a site that actively encourages clinical research and patients have contributed to some of the biggest studies in kidney medicine over the last 10 years.

lkeston Dialysis Unit is a friendly place and we’re happy to welcome visitors.

Dialysis unit manager - Sister Tina Goodridge.

Renal dialysis consultant - Dr Matt Hall.

Contact us

Tel: 0115 969 1169 Ext: 59910

Diaverum provide a purpose built, privately managed facility in Gamston, South Nottinghamshire. Clinical management of the fifteen-station renal unit is overseen by Nottingham University Hospitals NHS Trust.

The unit dialyses over 50 patients over 6 days per week and the unit also has a separate area for training patients in home dialysis or self care. The unit is adjacent to Ling’s Bar Hospital and can sometimes provide dialysis treatment for patients who require a period of rehabilitation after a hospital admission.

A haemodialysis clinic is undertaken fortnightly and a general nephrology clinic is also undertaken weekly providing choice for patients in South Nottinghamshire to receive renal care away from the main renal unit at Nottingham City Hospital.

The centre is accessible, with good car parking facilities. The unit offers holiday sessions throughout the year for patients travelling around the Nottingham area in the East Midlands.

Dialysis unit manager - Attila Juhasz

Renal dialysis consultant - Dr Rakesh Patel.

Contact us

Tel: 0115 969 1169 Ext: 37523