The WCOWMA-BC office has been contacted several times over the past few months regarding the impact of home dialysis on septic systems. Discussions have taken place with ROWPs impacted by this practice, the Ministry of Health and the BC Provincial Renal Agency.

The incidence of renal patients choosing to perform dialysis at home rather than in a hospital setting is increasing and of course, some of these patients live in rural areas. The number of times per week a patient performs home dialysis varies from patient-to-patient as does the number of hours a patient may be on the dialysis machine. Treatment hours per day vary from 3 to 8 hours. The flow to drain effluent produced during this time period varies as well, from 270 L for a 3-hour treatment to 720 L during an 8-hour treatment. Treatments may be performed daily or several times per week.

The effluent from this process is a mixture of reverse osmosis wastewater (90%) and a substance called dialysate (10%). Dialysate contains toxic substances that must be treated and dispersed.

WCOWMA-BC expressed concern that a septic system not designed to handle these flows could easily be overwhelmed causing issues either in the tank or the field treatment component or both. For new systems, the presence of a renal patient performing home dialysis must be identified prior to planning the system; for older systems, upgrades may be necessary to handle the potential flows. Planners and Maintenance Providers should be prepared to add this item to their homeowner/client information form.

The BC Renal Agency has created a questionnaire for patients considering home dialysis. The questionnaire specifically addresses whether or not the patient lives in a home served by a septic system, when the system was installed, what the system capacity is and whether or not the system has undergone regular inspection and maintenance. Educating the patient is the first step. The Renal Agency has also requested that WCOWMA-BC collaborate with them on an information sheet outlining best practices and considerations for patients served by septic systems as part of their patient assessment and education procedure. The development of this protocol will take place over the next six to eight weeks at which time, the finalized document will be available on the association website.