The experience of individuals transitioning from in-centre hemodialysis to home dialysis after a suboptimal start

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Individuals diagnosed with end-stage renal disease may begin dialysis in a planned or unplanned manner. Recently, the term “suboptimal” has been operationalized to describe individuals who begin dialysis either without a permanent dialysis access while in the hospital or not in their selected dialysis mode. The purpose of this study was to explore the transition from hospital to home dialysis in a sample of individuals who began dialysis in a suboptimal way.


A qualitative descriptive design was used. Interviews were conducted, audio-recorded, and transcribed verbatim. Thematic analysis was undertaken.


All participants were on peritoneal dialysis at home. The overarching theme “learning to live with it” and the subthemes of “living with loss”, “managing fear”, “getting informed”, “needing support”, and “living with hope” were all expressed as representing the transition to home dialysis after a suboptimal start.


Nurses play a pivotal role in assessing informational needs and providing timely instrumental support such as assistance with home dialysis therapy to those who have undergone a suboptimal start.

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