What
to Expect
Starting Peritoneal Dialysis
Peritoneal dialysis uses the lining of your abdomen (the peritoneum) as a natural filter. Fluid flows in through a small catheter, dwells while it cleans your blood, and drains out. Some patients do exchanges throughout the day, while others do this overnight with a cycler machine while asleep.
Before anything begins, Cooper's team meets with you to make sure PD is the right fit. This isn't a sales pitch, it's an honest conversation about whether PD fits your body, your home, and your lifestyle.
Your nurse and care coordinator will explain exactly how peritoneal dialysis works, what daily life looks like, what the catheter involves, and what questions you should be asking your nephrologist.
What You'll Learn
How peritoneal dialysis works, the difference between APD (automated, overnight) and CAPD (manual exchanges), what your typical day or night could look like, and what happens during training.
Who Will Be There
Your Cooper nurse and care coordinator. Your nephrologist remains your prescribing physician throughout and Cooper coordinates directly with their office.
This visit isn't a checklist — it's a conversation. We'll walk through your space together, identify the best treatment area, confirm that you have adequate storage for supplies, and make sure your home environment is set up for you to dialyze safely and comfortably.
What we check during the visit?
The treatment area space, surfaces, storage for supply delivery (bags can arrive in quantity), access to running water and electricity, and any home modifications that might make treatment easier.
This is also when we get to know you, your schedule, your household, who lives with you, and how we can design your training around your actual life.
The Cooper difference
We come to you. Every visit, every time. No clinic trips, no waiting rooms. Your care team is in your home, working around your schedule, from the very first conversation.
The surgery typically takes less than an hour, and most patients go home the same day. The catheter needs 2–4 weeks to heal before PD can begin. Cooper coordinates with your surgeon and monitors your catheter placement recovery from day one.
About the Catheter
A PD catheter is a small, soft tube that exits through the skin of your lower abdomen. It's the gateway through which dialysis fluid enters and leaves your body. With proper care, it can last for years.
Healing & Exit Site Care
During the healing period (typically 2–4 weeks), Cooper's nurse visits to monitor the exit site, teach you how to care for it at home, and watch for early signs of infection.
Once your catheter has had time to heal, your nurse will perform an initial flush. This happens at your home. It's also the first time you'll see the process in action, which makes it an important step in building your confidence before formal training begins.
What happens?
Your nurse runs a small volume of dialysis fluid through the catheter and drains it. They confirm the drain is clear, the catheter flows freely, and there are no early signs of complications.
What you'll observe
The full process of connecting, dwelling, and draining — so the mechanics start to feel familiar before you're doing it yourself.
Cooper's nurse will come to your home for several sessions (typically over 5–10 days) and teach you everything you need to treat independently. The pace is yours. Some patients are ready in less time; others need a bit more, and that's completely normal. We don't move on until you're confident.
Days 1-2: Aseptic Technique
Hand hygiene, mask use, and clean environment procedures that prevent infection.
Days 2-4: Exchange Procedure & Cycler Setup
How to connect bags, dwell time, and draining correctly.
Days 3-5: Exit Site Care & Infection Signs
For APD patients, how to set up and use your overnight machine. Daily cleaning routine to keep the catheter site healthy.
Days 5-8: Troubleshooting & Emergency Protocols
What to do if something doesn't look right and when to call Cooper.
Final Days: Independent Treatment & Nurse Observing
Ordering, storage, and what to do if a delivery is late. Tracking your daily weight, fluid balance, and drain outputs.
Toward the end of training, your nurse will step back and let you run the treatment independently while they observe.
This builds the confidence you need to do it on your own with the knowledge that your team is always a call away.
Once you're treating independently, Cooper's involvement doesn't decrease, it shifts. Regular home visits, lab draws at your home, medication management, and 24/7 clinical support are all part of your ongoing care.
Regular Home Visits
Your nurse visits on a regular schedule to assess your catheter exit site, review your treatment records, and address any questions or concerns.
Lab Draws at Home
Monthly bloodwork happens in your home. No lab trips. Cooper coordinates results with your nephrologist and adjusts your prescription as needed.
What
to Expect
Starting Home Hemodialysis
Home hemodialysis filters your blood through a machine, just like in-center dialysis, but at home. Treatments are typically 3–6 times per week, all done around your schedule.
Many patients find HHD gives them better symptom control and more freedom compared to center-based treatment.
Before training begins, Cooper's team will spend time with you to make sure HHD is the right fit, and to make sure you understand what you're signing up for.
What You'll Learn
How hemodialysis works, what the machine does, what HHD looks like day-to-day, the role of a care partner, and what the training process involves.
Care Partner Conversation
HHD training includes a care partner (a family member or trusted person) whenever possible. They'll be trained alongside you and become an important part of your safety plan.
Cooper's nurse visits your home before training begins to assess your space for the dialysis machine, confirm water and electrical setup, identify where supplies will be stored, and make sure the environment is safe for home treatment. HHD machines are larger than PD cyclers, so this step matters.
What we check during the visit?
Space for the dialysis machine and associated equipment, access to running water and plumbing connections (some HHD machines require a water hookup), storage for consumable supplies, and electrical capacity.
We also get to know you — your schedule, your support system, and how to design training around the life you actually live.
The Cooper difference
HHD training at most programs happens at a clinic. At Cooper, your training happens in your home — on your machine, in your space, from the very first session.
Hemodialysis requires a way to access your bloodstream, which is called a vascular access. The preferred access for HHD is an arteriovenous (AV) fistula, created by surgically connecting an artery to a vein, usually in the arm. A fistula is durable, provides strong blood flow, and has a lower risk of infection than other access types. Cooper coordinates with your nephrologist and vascular surgeon to plan and time access placement.
AV Fistula (Preferred)
Surgically connects an artery to a vein. Needs several months to mature before use. Durable and lowest infection risk — the gold standard for HHD patients.
AV Graft or Catheter
An AV graft uses synthetic tubing and can be used sooner. A catheter may bridge while a fistula matures. Both are options while your permanent access develops.
Important timing note
Because an AV fistula needs months to mature, access planning should begin well before you're ready to start dialysis. Your Cooper care team will help coordinate this timeline with your nephrologist so nothing is rushed.
HHD training is comprehensive and that's by design. You're learning to operate a medical device, insert needles, interpret alarms, and handle emergencies. Most patients complete training in 5–6 weeks. Cooper's nurse comes to your home for every session, working alongside you and your care partner until you're both fully independent and confident.
Week 1: Machine Setup & Priming
Week 1-2: Cannulation & Needle Technique
Weeks 2-4: Alarms, Troubleshooting & Safety
Weeks 3-5: Emergency Protocols
Final Weeks: Independent Treatment & Nurse Observation
Toward the end of training, your nurse will step back and let you and your care partner run the full treatment.
This is the confidence-building moment that lets you know you're ready! Your nurse won't sign you off until you both feel it.
Regular home visits keep your access healthy, your treatment on track, and your questions answered. Lab draws happen in your home. Your prescribing nephrologist receives regular updates, and any adjustments to your dialysis prescription are coordinated directly.
Vascular Access Monitoring
HHD patients receive regular access assessments at home. Checking for signs of narrowing, infection, or complications before they become problems.
Machine Maintenance
Your equipment vendor handles machine servicing. Cooper coordinates and is available if technical issues arise between service visits.
Your Dedicated Cooper Care Team
A dedicated team is assigned to you. Not a rotating roster of unfamiliar faces. They know your home, your schedule, and your access.
This includes your:
Nurse (Clinical Lead)
Coordinator (Scheduling & Logistics)
Dietitian (Nutrition Guidance)
Social Worker (Resources & Support)
