Table 1.

Potential causes of home hemodialysis technique failure and management approaches

DomainsProblemsPotential Solutions
Patient/care partner burnoutTreatment frequencyIncremental hemodialysis
Treatment lengthNocturnal hemodialysis
Care partner support
Respite hemodialysis
Major medical eventsMajor surgical proceduresTechnique audit
Stroke, other cardiovascularRetraining
Bacteremia/other infectionsStaff-assisted dialysis
HypotensionHome health aides
Remote monitoring/telemedicine
Medication timing
Dialysis procedure relatedDialysis accessStaff assistance
Cannulation difficultiesCare partner training
Change in access site/typeRetraining
Dialysis equipmentDialysate bags
Change in water qualityWater filtration systems
Plumbing issuesFinancial support for plumbing
Dialysis monitoringMedication timing
Use of new psychoactive medications, such as opioidsCare partner training