Home Dialysis: Building a Safer Routine at Home

For people living with kidney failure, dialysis is a life-sustaining treatment that removes waste and excess fluid from the blood when the kidneys can no longer perform those functions effectively. Although dialysis is often associated with treatment in a clinic, some patients may be able to receive home dialysis. 

Home dialysis can offer greater flexibility and allow treatment to better fit into a person’s everyday life. However, bringing dialysis into the home also brings new responsibilities. Patients and caregivers must learn how to operate equipment, maintain a clean treatment space, monitor potential complications, manage supplies, and properly dispose of medical waste. 

Safe sharps disposal is one important part of that larger home care routine, especially for patients performing home hemodialysis. 

Key Points 

What Is Home Dialysis? 

Dialysis helps perform some of the work normally handled by healthy kidneys. According to the Centers for Disease Control and Prevention, dialysis is a treatment for people whose kidneys are failing or are no longer working properly. It does not cure kidney failure, but it can remove waste and excess fluid while helping the body maintain a healthier balance. 

There are two primary forms of dialysis that may be performed at home: home hemodialysis and peritoneal dialysis. 

Home Hemodialysis 

Hemodialysis uses a machine and filter to remove waste and excess fluid from the blood. Blood travels from the patient’s vascular access point to the dialysis machine, passes through a filter, and returns to the body. 

Depending on the patient’s treatment plan, vascular access may involve a fistula, graft, or catheter. Patients using a fistula or graft may need to insert needles into the access site during each treatment. The National Kidney Foundation’s home dialysis guidance says that patients and care partners are trained to prepare equipment, monitor vital signs, insert and remove needles when applicable, record treatments, and recognize when they need professional assistance. 

Home hemodialysis may provide more scheduling flexibility than traditional in-center treatment. But it also requires patients and caregivers to take an active role in care responsibilities. 

Peritoneal Dialysis 

Peritoneal dialysis uses the lining of the abdomen, called the peritoneum, to help filter the blood. A cleansing fluid enters the abdomen through a catheter, remains there for a prescribed period, and is then drained. 

Some patients perform manual exchanges throughout the day, while others use an automated cycling machine overnight. Unlike home hemodialysis, peritoneal dialysis does not typically require needles to access the bloodstream during each treatment. However, patients must still carefully manage supplies and treatment-related waste. 

The right dialysis option depends on the patient’s health, home environment, lifestyle, support system, and clinical needs. These decisions should always be made with a qualified kidney care team. 

Why Home Dialysis Is an Important Part of Renal Care 

Home dialysis represents more than a change in treatment location. It reflects a broader shift toward giving patients more participation in their own care. 

The National Institute of Diabetes and Digestive and Kidney Diseases mentions that home dialysis options may provide patients with more freedom to arrange treatment around work, family responsibilities, and other parts of daily life. At the same time, home treatment requires education and ongoing support. 

For renal care providers, helping a patient transition home means considering the full treatment experience. That includes whether the patient has adequate storage, access to the necessary utilities, a suitable treatment area, caregiver support when needed, and a clear process for handling medical supplies and waste. 

A successful home dialysis program should not simply move clinical tasks into the home. It should provide patients with the tools, education, and support needed to manage those tasks confidently and consistently. 

Creating a Safer Home Dialysis Environment 

A home treatment space does not need to feel like a hospital room, but it does need to support safe care. The area should be clean, well-lit, organized, and protected from unnecessary activity. 

Patients may need room for a dialysis machine, treatment supplies, cleaning materials, records, and waste containers. The National Kidney Foundation recommends identifying a clean treatment area and a separate place to store supplies, which may include several weeks’ worth of materials. 

Sharps containers and other waste receptacles should be part of this setup from the beginning. A sharps container should be placed close enough to the treatment area where used needles can be discarded immediately. 

Patients should follow the procedures taught by their dialysis team, including instructions for hand hygiene, equipment care, vascular or catheter access, and identifying signs of infection. The CDC emphasizes that people receiving dialysis can face serious infection risks and should regularly inspect their access site and notify their care team about redness, swelling, drainage, or other concerning changes. 

The Role of Sharps Disposal in Home Hemodialysis 

The word “sharps” includes more than traditional syringes. The U.S. Food and Drug Administration identifies connection needles and sets used to transfer fluids during home hemodialysis as examples of medical sharps. 

Once used, these items may contain blood and can cause accidental needlestick injuries if they are left unsecured or placed loose in household trash or recycling. This can put patients, family members, caregivers, children, sanitation workers, and others at risk. 

Used needles and other sharps should be placed directly into a puncture-resistant sharps container after use. They should never be left loose on treatment surfaces, placed directly in a trash or recycling bin, or flushed down a toilet. The container should also be stored upright and away from children and pets. 

Once the container reaches its marked fill line, it should be sealed and replaced. A sharps container should never be forced closed or overfilled to make room for additional items. 

Patients should ask their dialysis care team which treatment supplies belong in a sharps container and how other dialysis waste should be managed. Not every item used during treatment is considered a sharp, and requirements for home-generated medical waste can vary by state and community. 

How PureWay Supports Home Dialysis Patients 

PureWay helps simplify an important part of the home dialysis routine: the collection and return of used needles and other approved medical waste. 

Each PureWay mail-back disposal system includes a puncture-resistant sharps container, return packaging, a prepaid shipping label, and treatment of the returned waste. Once the container reaches its fill line, the patient seals it according to the included instructions, places it in the provided return packaging, and mails it back for proper processing. 

This approach can be particularly helpful for people who do not have a convenient local disposal location or who would prefer a disposal option that does not require an additional trip outside the home. 

Because home hemodialysis may generate sharps more frequently than weekly or occasional injectable treatments, capacity is an important consideration. A 1.2-gallon PureWay system may work as an initial option for lower-volume needs or limited treatment-related sharps. Patients generating sharps regularly may find that a 3-gallon PureWay system provides more practical capacity and requires fewer returns. 

Actual needs will depend on the prescribed treatment schedule, the types and sizes of sharps used, and how quickly the container reaches its fill line. Patients should confirm which items are appropriate for the container with their care team and choose a size that fits safely within their treatment area. 

Safe Disposal Is Part of Patient-Centered Care 

Home dialysis can give patients greater control over when and where they receive treatment. That independence should be supported by systems that make the responsibilities of home care easier to understand and manage. 

Sharps disposal may represent only one step in a much larger treatment process, but it has a direct effect on the safety of the home. When disposal is planned from the beginning, patients are less likely to rely on improvised containers, store used needles for extended periods, or place sharps in household waste. 

For dialysis providers, discussing sharps disposal during home training can help ensure that patients understand not only how to perform treatment, but also how to manage what comes afterward. 

PureWay’s role is to make that final step simpler. By providing a complete mail-back sharps disposal system, PureWay helps patients and caregivers move from collection to return and treatment through one organized process. 

For more information on PureWay or medical waste disposal please visit www.purewayathome.com for more information.  

Frequently Asked Questions About Home Dialysis 

What are the main types of home dialysis? 

The two main types are home hemodialysis and peritoneal dialysis. Home hemodialysis filters blood through a machine, while peritoneal dialysis uses the lining of the abdomen and a cleansing fluid. A kidney care team can help determine which options may be appropriate for an individual patient. 

Does home dialysis require special training? 

Yes. Patients and, when applicable, care partners receive training in treatment procedures, equipment use, infection prevention, recordkeeping, supply management, and what to do if a problem occurs. Patients should not attempt home dialysis without appropriate clinical training and support. 

Does every home dialysis patient use needles? 

No. Home hemodialysis patients with a fistula or graft may use needles during treatment. Peritoneal dialysis uses a catheter in the abdomen and generally does not require needles for each exchange. Supplies and procedures vary, so patients should follow the instructions provided by their dialysis team. 

How should needles from home hemodialysis be discarded? 

Used needles and other sharps should be placed directly into an appropriate sharps container after use. They should not be placed loose in household trash or recycling. Patients should follow their care team’s instructions and applicable state or local disposal requirements. 

What size sharps container is best for home dialysis? 

The appropriate size depends on treatment frequency, the type of sharps used, available storage space, and how quickly the container fills. PureWay’s 1.2-gallon system may suit lower-volume needs, while the 3-gallon system may be more convenient for patients who generate sharps regularly. Never fill a container beyond its marked fill line. 

This article is for general educational purposes and is not a substitute for medical advice. Patients should follow the treatment, infection-prevention, and disposal instructions provided by their nephrologist and home dialysis care team.