Aug 17, 2023
‘I Feel Amazing:’ DaVita patient shares how solo home hemodialysis has changed her kidney journey

When Vanessa Tupuola started on dialysis in 2013, she treated in-center. She was interested in trying a home treatment option but wasn’t a candidate for peritoneal dialysis (PD) and didn’t have a dedicated care partner needed for home hemodialysis (HHD).* Her care team watched Vanessa struggle with in-center treatments: She frequently missed treatments due to lack of transportation and struggled to maintain healthy phosphorus and potassium levels.

But when she talked with her nephrologist about trying solo HHD** — in which the patient can treat alone without a care partner with a nephrologist order — things started to change.

“When we see our patients, we should always ask, ‘Is my patient living their best life?’” says Dr. Bernie del Rosario, VP of clinical affairs for DaVita Home. “If they’re struggling, missing treatments or have labs not hitting goals, it’s an opportunity to consider another path. For patients like Vanessa, their physicians can identify whether home dialysis, including solo HHD, can give them the independence, flexibility and control to succeed.”

Home Hemodialysis?

A lot like in-center hemodialysis, HHD is done in the home setting using a smaller, user-friendly machine that removes excess fluid and cleans toxins from your blood. While people treating with HHD typically have a care partner, someone who can help with their treatments, some individuals may be identified by their nephrologists as a candidate to treat without a care partner during waking hours — solo HHD.**

HHD is often associated with shorter recovery time between treatments, less stress on the heart and better blood pressure control.1 While hemodialysis is typically performed three times per week, nephrologists may prescribe more frequent treatments, based on specific clinical and individualized needs.****

Patients considering home dialysis may also explore peritoneal dialysis, another home modality. Learn more about the two treatment options here.*


Now, Vanessa feels like she’s equipped to manage her health on her terms and is excited for what’s next with support from her DaVita care team. Vanessa is becoming a patient HHD advocate and is planning to pursue a kidney transplant.***

Recently, Vanessa caught up with her social worker, Sarah Daro, and dietitian, Kristen Perrico, about her experience with dialysis:

Sarah: How long have you been on dialysis and how did you end up treating in-center?

Vanessa: I started dialysis during my senior year [of high school] in 2013 while living with my family in American Samoa. I got really sick, and my mom became worried. I went to the doctor a few times and was given antibiotics, but I never heard my kidneys were failing. Due to the lack of healthcare resources in American Samoa, my mother and I moved to Las Vegas. As soon as I got here, I went to the emergency room and was admitted. I began dialysis shortly after and was placed at a pediatric [center] on hemodialysis.

Sarah: What reservations did you have about treating at home?

Vanessa: I had always been interested in treating at home, but at the time, I did not have much support. My mom was working two jobs to support our family, and my sister was living in Alaska. Without a care partner available, I just stuck with treating in-center.

Sarah: What finally motivated you to treat at home?

Vanessa: Eventually, the doctor told me he believed I was a good candidate for solo [HHD], and I was excited.

Sarah: Can you explain the relationship between yourself and the HHD support nurse? How was it helpful to treat at home?

Vanessa: Felita (HHD Nurse) and I have a great relationship. I know I can call her if I need anything and she will always be there to help me. She lets me be independent but is also very supportive and helpful when I need her.

Sarah: How did you feel about treating alone without a care partner and as the first person in the area to do so?

Supporting Patient Success

Feeling nervous or even scared, like Vanessa did, can be a common experience for patients as they start dialysis.

To help support patient success, DaVita care teams provide thorough training and connect with patients regularly to address questions and concerns about their care. 

This includes walking through how to use additional required equipment, like the access leak detection device, which helps identify blood loss, to help patients perform treatments safely at home.  

Vanessa: I was excited and scared. Excited because I felt like I could do it and I could be successful, but scared because it was unknown.

Sarah: Has your life improved overall because of treating at home?

Vanessa: My life has improved so much! I am more energetic, and I can spend more time with my family and friends. I feel amazing! I was always so tired before, and now I can just do my dialysis and I feel amazing.

Kristen: How do you feel like your life has improved in regards to your diet?

Vanessa: I have become much more compliant with my diet, and my numbers have improved. I feel like I can eat more of what I want because of the more frequent dialysis.****

Sarah: What advice would you give someone thinking about doing home dialysis?

Vanessa: Go for it! It might seem scary at first, but in the long run, it will be worth it.*

Sarah: What are you most excited about for the future?

Vanessa: I am really excited to become a patient advocate for HHD. I hope to one day get a kidney transplant!***




Content has been edited for length and clarity.

Please note:

*Service provider and modality selection are choices made exclusively between the patient and nephrologist.

**Per DaVita policy, HHD requires a care partner unless the nephrologist orders solo HHD after discussing potential clinical risks with the patient.

***DaVita continues to champion transplant and recovered renal function.

****Although home hemodialysis is often prescribed with a more frequent schedule, often called more frequent dialysis (MFD, the physician must evaluate the individual clinical needs of each patient and consider both the potential benefits and risks. While there could be potential quality of life and physiological benefits to MFD, there is also risk of a possible increase in vascular access procedures and the potential for hypotension during dialysis.

  1. Shafiee MA, Chamanian P, Shaker P, Shahideh Y, Broumand B. The Impact of Hemodialysis Frequency and Duration on Blood Pressure Management and Quality of Life in End-Stage Renal Disease Patients. Healthcare (Basel). 2017 Sep 2;5(3):52. doi: 10.3390/healthcare5030052. PMID: 28869490; PMCID: PMC5618180.