Southeast Iowa Regional Medical Center Nephrology Partners with Southeastern Renal Dialysis to Offer Home Hemodialysis

When you are told you have kidney failure and need treatment to stay alive, it can be a difficult time in your life. According to the National Kidney Foundation, 660,000 people in the United States live with kidney failure. Finding the right care and support and learning about the treatment options available to you is the first step in living with this condition.

Dialysis is one of those treatment options. Hemodialysis is a treatment that replaces the work of kidneys to clear wastes and extra fluid from the blood using a special filter called a dialyzer or artificial kidney. Blood travels through plastic tubing to the dialyzer, where it is cleaned and then returned into the body. Most people with kidney failure visit a dialysis center, like Southeastern Renal Dialysis, multiple times a week for hemodialysis treatments.

Another relatively new alternative is home hemodialysis which follows the same basic process, but the patient and a care partner are trained to do the dialysis treatment in the home.

Southeast Iowa Regional Medical Center Nephrology in partnership with Southeastern Renal Dialysis started training their first patient for home hemodialysis in August of 2022. They received certification from the State of Iowa for a home hemodialysis program in January of 2023. They currently have four patients trained to perform home hemodialysis with capacity to grow the program. They are currently using Outset Medical’s Tablo Hemodialysis System.

Tablo is a hemodialysis machine designed to improve patient experience and outcomes. It's a mobile system that fits seamlessly in patients’ homes, requiring only tap water and an electrical outlet to work. The easy-to-use, automated device wirelessly connects with the patient’s health care team, enabling real-time remote treatment monitoring and reducing the record-keeping burden for the patient.

Dr. Maria Story is a nephrologist overseeing the program at Southeast Iowa Regional Medical Center. She explains the benefits home hemodialysis provides patients in addition to the convenience factor, “It is unclear exactly why, but patients tell us they feel substantially better using the Tablo machine compared to using a dialysis machine in center. Patients report less cramping, muscle cramping is very common in dialysis, less fatigue, and better sleep among others. People doing home hemodialysis generally dialyze four days per week as compared to three days per week at the dialysis unit. They have improved management of fluid accumulation on the body and some of their lab work also is under better control, which allows people to be a little bit more flexible with their diet.”

Other benefits reported include taking less medication to control blood pressure, bone disease and anemia, having fewer and shorter hospital stays, and enjoying better quality of life.

Tim Torgler was one of the first Southeastern Renal Dialysis patients to be trained to use home hemodialysis and started in-home treatments in September of 2022. He shares why he chose home hemodialysis, “Home hemodialysis is a great option to consider if you work or have a busy schedule. The ability to perform the dialysis on alternating days and on off hours allows you to continue to participate in family and other outings which are difficult when you are doing in-center dialysis. Home hemodialysis allows you the freedom to continue to enjoy more opportunities and have your dialysis in the comfort of your own home.”

Home hemodialysis is not a good fit for everyone. Dr. Story explains further, “We have a team-based approach to evaluating potential candidates, which includes Dialysis Nurse, Social Worker, Nurse Practitioner, and Physicians. Patients need to be physically and mentally able to perform their own hemodialysis. Mostly they need to have a strong interest in taking responsibility for their own health and be willing to commit to doing dialysis treatments at home independently. They need a clean and stable living environment. Most people will have a care partner, which can be a spouse, parent, adult child, or close friend that will participate in training with them and be available to assist during home hemodialysis treatments.”

Like in-center hemodialysis, home hemodialysis is covered by insurance. “Any patient who has end-stage renal disease will have Medicare insurance, even if they are under age 65. Medicare will cover any dialysis modality, which includes home hemodialysis, peritoneal dialysis also performed by the patient, at home, and in-center hemodialysis,” commented Dr. Story.

Southeastern Renal Dialysis (SRD) is an organization jointly owned by Jefferson County Health Center, Henry County Health Center, and Southeast Iowa Regional Medical Center with dialysis centers in Iowa in Fairfield, Mount Pleasant, West Burlington, Fort Madison and Keokuk. They currently have 160 patients receiving hemodialysis at all of the locations.

Mr. Torgler explains why he chose Southeastern Renal Dialysis, “The staff and providers at SRD are like family. They provide excellent care for their patients, and truly care about you and your wellbeing.”

Southeast Iowa Regional Medical Center Nephrology Clinic’s physicians and advance practice professionals diagnose and treat kidney disease. They provide proven treatments that may include medicine and diet management of underlying conditions. After beginning treatment, patients can expect to continue seeing a nephrologist throughout their lives.

People living with kidney failure should talk to their nephrologist about the best treatment option for them. But for patients in Southeast Iowa, it is nice to know those options include home hemodialysis.

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Pictured: Maria Story MD FACP CHS, Carry Holtkamp RN BSN, Taylors Stevens RD at our home hemodialysis training room in Mount Pleasant