Home dialysis is the option to receive dialysis treatments in the comfort of your home, rather than at a center.  

There are two types of home dialysis therapies to consider—peritoneal dialysis (PD) and home hemodialysis (HHD). Talk with your doctor and care team to determine if PD or HHD might be a good therapy option for your health and lifestyle needs. 

PD uses blood vessels in the lining of your abdomen to remove toxins and extra fluid from your blood. Typically, PD patients can perform therapy on their own at home. PD treatments are done daily, so waste and toxins in your blood don’t have a chance to build up as much between treatments, compared to in-center hemodialysis.

ICHD uses a machine to remove blood from your body, clean it, and return it to your body. Treatments are traditionally performed at a dialysis center 3 times a week, for about 4 hours per session.

HHD follows a similar treatment procedure as ICHD but is usually done in the comfort of your home, and more frequently, 5 or 6 days a week. More frequent hemodialysis may lead to improved health and quality-of-life outcomes.¹ Your doctor may prescribe HHD to be performed during the day—with or without a care partner—or overnight while you and your care partner sleep, which is referred to as nocturnal HHD.

Studies have shown that there are several clinical and lifestyle benefits to more frequent home dialysis, including:

• Greater schedule flexibility

• Improved sleep quality²

• Improved post-dialysis recovery time³

• Improved appetite⁴

• Increased likelihood to be on the kidney transplant list⁵

There are some risks with all medical procedures and treatments. Serious adverse events in home dialysis are relatively rare*. Home dialysis equipment is safe to use with both procedural steps and system alarms in place to help prevent any adverse events from occurring. In addition, your home training nurse will review all the precautions and procedures needed to avoid and prevent any adverse events. Patient retraining and periodic technique checks may also help mitigate these risks. Please review full risks and responsibilities below.

*Tennankore KK, et al. Am J Kidney Dis. 2015;65(1):116-121.

For most patients, supplies and equipment are covered by their insurance or Medicare, but it is important to review coverage with your insurance provider to learn more about what options are available to you. Your social worker and insurance coordinator can also help you with this process and identify opportunities for reducing costs. 

Many patients may be candidates for home therapy, including patients with pre-existing conditions or disabilities. Interested patients should discuss this with their care team, who can review their specifics needs and help determine what is best for them.  

If you choose to do home dialysis, you and/or your care partner(s) will be responsible for all aspects of the dialysis treatment from start to finish, including but not limited to:

• Setting up the dialysis equipment

• Cannulation (inserting needles)

• Taking vitals

• Responding to and resolving all system alarms with the help of Technical Support, if needed

• Monitoring blood pressure

• Maintaining a clean and safe environment for treatment

Both you and your care partner(s) will be trained by your provider so you’re equipped to respond to any health emergencies that might occur during treatment at home, including dizziness, nausea, hypotension (low blood pressure), and fluid or blood leaks. 

Your care and home training teams will work to train you as soon as possible. In some cases, training may begin in-center with an overview of each system and therapy, a review of the first few elements of training, and an opportunity to ask questions. You will go home after training is completed, and you and your care team feel you are ready.

There is no recognition or nomination program required to go home. If you are interested, start by talking to your physician to determine if home dialysis is right for you. Once you have a prescription from your physician, the center can introduce you to your home training team, who will help you get started. 

Some in-center clinics have a program called Experience the Difference. Ask your care team if this is something they offer. The program offers in-center hemodialysis patients the opportunity to have more frequent hemodialysis treatments in your own center for 1-2 weeks without giving up your current in-center time slot. During this time, you will discover and potentially experience some of the benefits made possible by dialyzing more frequently.

No. It may be an option for you to perform home dialysis without a care partner. PD, for example, is typically performed without the help of a care partner. Solo HHD during waking hours with a NxStage system is possible for many patients with additional training from their care team. Your care team will work with you to determine what is the best approach for you. 

Yes. Home dialysis offers much greater schedule and lifestyle flexibility, as you are not tied to a specific time slot on your treatment days. You can work with your doctor to determine the treatment schedule that works best for you.

Every prescription is based on the individual’s particular health and lifestyle needs. Work with your doctor to determine what home modality option best fits your clinical and lifestyle needs and how often you will be required to treat. 

When starting dialysis, there are different types of dialysis access to consider. PD uses one type of access – a PD catheter. This is a flexible tube placed in your abdomen, with a small piece of tubing left outside of the body. People on HD typically use an arteriovenous (AV) fistula or graft. There is some flexibility for patients with special health requirements. Talk to your doctor about which access type is best for you.

You and your doctor will discuss your specific health and lifestyle needs, and what is important to you. Based on those needs, your doctor will determine the specifics of your prescription. It is important to have regular conversations with your doctor about your treatments and any negative symptoms you experience as your prescription should be updated based on how you are feeling.

Past abdominal surgery doesn’t automatically disqualify a patient from doing PD. Interested patients who have had a prior surgery can work with their doctor to assess their ability to do PD treatments. 

Patients start home dialysis with a wide range of residual kidney function. Talk to your doctor to see what treatment option is right for you. 

It is important that the treatment area remain clean to help avoid the risk of an infection. Most often, people choose to designate one room or area as their treatment space and keep it clean. This does not mean the entire house or dwelling needs to be spotless at all times. If you choose to perform home dialysis, your home training care team will provide education around how to properly care for your designated treatment area. 

Many patients on home therapies participate in water activities. Follow the guidance of your doctor regarding what water activities can be enjoyed safely.

Yes, whether you have chosen PD or HHD, you are allowed to take showers. You need to wait for a new catheter site to heal before showering. Always follow the guidance of your doctor regarding what method is best based on your specific care plan and needs.

There are no home decor restrictions to home therapy, including carpet.

There is no education requirement to be on a home modality, and both HHD and PD patients have a wide range of education backgrounds. Your care team will provide training and support so that you are well prepared to perform home dialysis. 

Typically, no physical home modifications, such as plumbing or electrical, are needed for HHD with a NxStage system or for PD. 

Many people who select a home therapy report feeling better physically when performing more frequent treatments¹, and studies have shown that there is a higher likelihood of receiving a transplant for both PD and HHD.^6,7