Kansas City, Mo. ? In all but one important way, Jessica McCafferty is a typical 13-year-old. She likes to spend time with her friends, ride her bike, talk on the phone.

But Jessica hasn’t been able to do those things until recently. A kidney disease that has afflicted her since she was 2 years old left her too tired and in too much pain to do much but sit on the couch.

All that changed in March, when Jessica began doing her dialysis at home. While a small but growing number of doctors are encouraging adult patients to try home hemodialysis, Jessica is one of the first children in the U.S. to try the new treatment.

Dialysis becomes necessary when the kidneys become so weak that they can no longer filter waste and excess fluid from the blood. Currently, most of the 400,000 Americans with kidney disease are required to spend four hours, three times a week, hooked up to machines at hospitals or dialysis centers.

Proponents believe the home dialysis machines will improve patients’ health because it will clean the blood six times a week, rather than three, and will reduce the high risk of infections faced by dialysis patients.

Most home dialysis done by adults is peritoneal dialysis, which uses the lining of a patient’s abdomen to filter out waste. But the procedure is complicated enough that few patients were able to do it.

The current home dialysis movement is for those using hemodialysis, in which a machine takes in a person’s blood, cleans it, and returns it to the body.

Jessica McCafferty, 13, waits while her mother, Candace McCafferty, prepares to give her a dialysis treatment at their Kansas City, Mo., home. Her mother says the home treatments have dramatically increased Jessica's quality of life and has made her a

Jessica is doing her dialysis at home six days a week, usually in the morning, for two to three hours. She’s using the NxStage System One, a portable machine about the size of a small television.

High blood pressure is a frequent problem for dialysis patients, and Jessica was taking four medicines twice a day before the home hemodialysis. Now, she’s not on any medicine.

Quality of life

The change has transformed her life, say Jessica and her mother.

“I’m even able to stay overnight with friends,” Jessica said. “Before I was pretty much just sleeping and not moving.”

The improved health and social life experienced by Jessica and others using home hemodialysis comes mostly from cleaning the kidneys every day, rather than three times a week, doctors say.

“She is a whole new person,” said Jessica’s mother, Candace McCafferty. “She has not felt this good for many, many years.”

In the past, some adults did home hemodialysis, but it required a machine about the size of a refrigerator and changes to most homes’ water and electrical systems. The smaller machine plugs into a home’s electrical system, does not require special plumbing and is portable.

Individualized approach

“We all believe that the current approach to hemodialysis may not be optimal for all patients,” said Dr. Bradley Warady, Jessica’s doctor, who is director of dialysis and transplantation at Children’s Mercy Hospital in Kansas City. “We want to provide a number of different approaches to providing dialysis, have a better individualized approach.”

Children’s Mercy and Texas Children’s Hospital in Houston are testing children on home hemodialysis for the next several months. Texas Children has enrolled its first child, whose family is training to use the machine at the hospital before taking it home, said Dr. Stuart L. Goldstein, director of renal dialysis at the hospital.

“I personally believe home dialysis will be the dialysis of choice in the future,” Goldstein said. “Our whole goal is to get transplants for patients, but if we can’t offer that, we are very interested in this technique.”

Both doctors stressed that the research is not to test the NxStage, which was given FDA approval last month, but to watch the impact of daily dialysis on children. Besides other benefits, the doctors hope daily dialysis will help reduce inflammations that often plague kidney dialysis patients.

The largest barrier to home hemodialysis is finding children who have caregivers willing to spend weeks learning how to run the machine and who are then able to do it nearly every day at home.