Switching to Home Dialysis: A Simple Guide for You and Your Family
10/01/2026
Starting dialysis can bring a lot of questions. You may wonder where treatment will happen, how often you will need it, whether you can continue your normal routine, and whether dialysis can be done at home.
For many people with kidney failure, home dialysis is an option. Dialysis at home can include home hemodialysis, which uses a dialysis machine to clean the blood and remove extra fluid. If you are considering hemodialysis at home, kidney dialysis at home may offer more flexibility than center-based treatment.
This guide explains at home dialysis, how a home dialysis machine works, who may be a candidate, how training works, and what to expect when making the transition.
Can You Do Dialysis at Home?
Yes. Some people with kidney failure can receive dialysis at home after completing an evaluation and training program.
There are two main forms of home dialysis: home hemodialysis (HHD) and peritoneal dialysis (PD). They work differently and are not appropriate for everyone.
This article focuses primarily on home hemodialysis, which uses a dialysis machine and a vascular access point to filter waste and remove excess fluid from the blood.
Whether home hemodialysis is appropriate depends on your medical situation, ability to complete training, home environment, treatment plan, and the availability of appropriate support.
A nephrologist and home dialysis care team can help determine whether it is a suitable option for you.
What Is Home Dialysis?
Home dialysis means receiving dialysis treatment in your own home rather than traveling to a dialysis center for every treatment.
With home hemodialysis, blood is circulated through a dialysis system that removes waste products and excess fluid before returning the blood to the body.
Treatment schedules can vary. Depending on the prescribed treatment plan, home hemodialysis may be performed several times per week, more frequently for shorter sessions, or overnight.
The schedule is individualized based on your medical needs. It should not be changed without guidance from your kidney care team.
It is also important to understand that home dialysis is a broader term. It can refer to both home hemodialysis and peritoneal dialysis. Dialyze Direct focuses on home hemodialysis, so the information in this guide primarily relates to hemodialysis performed at home.
How Does Hemodialysis at Home Work?
The basic dialysis process is similar whether treatment happens at home or in a dialysis center. The major difference is that, with home hemodialysis, you and your trained care partner take a more active role in the treatment process.
A typical home treatment may involve these steps:
1. Prepare the Treatment Area
Before treatment begins, you prepare the machine, supplies, treatment chair or bed, and the surrounding area.
The space should be clean, well-lit, and organized so that supplies and equipment can be reached easily.
2. Set Up the Dialysis Machine
The machine is prepared according to your prescribed treatment and the instructions provided during training.
Depending on the equipment, this can involve connecting tubing, preparing the dialysate, checking supplies, and completing safety checks.
3. Connect to Your Vascular Access
Home hemodialysis requires vascular access that allows blood to travel between your body and the dialysis system.
Your training team teaches you how to care for your access and, when appropriate, how to place dialysis needles safely.
4. Begin the Treatment
During treatment, the machine moves blood through the dialysis system. Waste products and excess fluid are removed before the blood is returned to your body.
The machine also monitors important treatment parameters and may provide alarms when attention is needed.
5. Finish and Clean Up
After treatment, you disconnect according to your training instructions, dispose of used supplies safely, clean the equipment as directed, and record relevant treatment information.
Your dialysis team uses treatment records, laboratory results, symptoms, and other information to help manage your care.
What Is a Home Dialysis Machine?
A home dialysis machine is equipment used to perform hemodialysis outside a dialysis center.
The machine controls important parts of the treatment, including blood flow, treatment time, fluid removal, pressure, and other treatment parameters depending on the equipment being used.
Home dialysis machines vary in size and design. Some newer systems have been developed specifically to make home treatment easier to set up and manage.
However, a home dialysis machine does not mean a patient simply receives a machine and starts treatment independently. Proper training, medical supervision, supplies, vascular access, and an appropriate home setup are important parts of home hemodialysis.
Your dialysis provider determines which equipment is appropriate for your treatment.
What Does Dialysis at Home Require?
Home hemodialysis involves more responsibility than receiving treatment at a dialysis center.
Before starting, your care team may evaluate several parts of your situation, including:
- Your overall medical condition
- Your vascular access
- Your ability to learn treatment procedures
- Your home treatment space
- Electrical and water requirements
- Storage space for dialysis supplies
- Availability of a trained care partner
- Your ability to respond to machine alarms and treatment problems
- Your insurance and coverage
- Your ongoing support from a dialysis care team
The home itself may need some preparation. Depending on the equipment, this can include access to electricity, water, drainage, and adequate space for the machine and supplies.
Your home dialysis team can assess the space and explain what changes may be needed.
Who Can Have Hemodialysis at Home?
Home hemodialysis is not automatically appropriate for everyone who needs dialysis.
A healthcare provider will consider your medical condition and whether you can safely manage the treatment requirements.
You may need to demonstrate that you can learn important skills such as:
- Setting up the dialysis machine
- Following infection-control procedures
- Monitoring vital signs
- Caring for your vascular access
- Responding to machine alarms
- Recording treatment information
- Cleaning equipment
- Handling and storing supplies
- Recognizing when you need medical assistance
Many home hemodialysis programs also require a trained care partner. This person may be a family member or friend who completes the training with you and helps with treatment when needed.
The exact requirements vary by program and individual circumstances.
How Long Does Home Dialysis Training Take?
Training is an important part of starting home hemodialysis.
You and your care partner learn how to prepare the machine, perform treatment safely, prevent infection, monitor yourself during treatment, respond to alarms, care for your vascular access, clean equipment, and manage supplies.
The length of training varies depending on the patient, dialysis program, equipment, and skills involved.
The National Institute of Diabetes and Digestive and Kidney Diseases notes that home hemodialysis training may take several weeks, with some programs requiring approximately three to eight weeks of training.
The goal is not simply to learn how to operate a machine. Training is designed to help you understand the entire treatment process and what to do if something does not go as expected.
What Does a Day on Home Hemodialysis Look Like?
One potential benefit of home hemodialysis is that treatment can sometimes be incorporated into your daily routine.
However, there is no single schedule that applies to everyone.
Some people may receive conventional home hemodialysis several times a week. Others may have shorter, more frequent treatments or longer treatments during sleep, depending on their prescription.
For example, a person’s routine might look like:
- Morning: Wake up, take medications as prescribed, eat breakfast, and complete normal morning activities.
- Afternoon: Complete work, household activities, appointments, or other daily responsibilities depending on the treatment schedule.
- Evening: Prepare the treatment area and complete a scheduled home dialysis treatment.
- Night: Some treatment plans may involve longer overnight treatments while the patient sleeps.
Your nephrologist determines the appropriate treatment schedule. The purpose of home treatment is not to create one standard routine but to allow the prescribed dialysis schedule to be incorporated into your life when medically appropriate.
Benefits of Home Hemodialysis
Home hemodialysis may offer several potential advantages, although the experience is different for every patient.
More Scheduling Flexibility
Treatment at home may provide more flexibility because you are not always tied to the operating schedule of a dialysis center.
Some home hemodialysis schedules can be arranged around work, family responsibilities, and other daily activities.
More Frequent Treatment Options
Some home hemodialysis programs offer more frequent or longer treatment schedules. These options can change how much fluid is removed during each treatment.
Your medical team determines whether a particular schedule is appropriate for you.
Less Travel to a Dialysis Center
Receiving treatment at home can reduce the need to travel to a dialysis center for every dialysis session.
This can be particularly relevant for people who live far from a dialysis facility or have difficulty arranging transportation.
Greater Involvement in Your Treatment
Home dialysis requires patients and care partners to understand more about the treatment process.
For some people, taking a more active role can make it easier to incorporate dialysis into their daily routine.
Potential Quality-of-Life Benefits
Research and clinical guidance have reported potential benefits associated with home hemodialysis, including greater treatment flexibility and, for some patients and schedules, improvements in how they feel and function.
However, home dialysis is not automatically better for every patient. The right treatment depends on individual medical needs, lifestyle, support, and preferences.
Home Hemodialysis vs. In-Center Hemodialysis
| Home Hemodialysis | In-Center Hemodialysis | |
| Location | Patient’s home | Dialysis center |
| Schedule | More flexibility may be possible | Usually scheduled by the center |
| Equipment | Machine and supplies at home | Equipment provided at the center |
| Training | Patient and often care partner receive training | Clinic staff perform most treatment tasks |
| Travel | Less routine travel to a center | Regular travel to and from the center |
| Responsibility | Patient and care partner manage more treatment tasks | Center staff manage most treatment tasks |
| Support | Home dialysis team provides ongoing clinical support | Dialysis center staff provide treatment support |
Neither option is right for every person. Discuss both approaches with your nephrologist and dialysis care team.
What Are Common Concerns About Dialysis at Home?
Is Home Dialysis Safe?
Home hemodialysis can be performed safely when patients receive appropriate training and follow their prescribed treatment procedures.
Training covers infection prevention, vascular access, machine alarms, vital signs, treatment records, equipment cleaning, and other safety procedures.
Patients should also know how to contact their dialysis team and what to do in an emergency.
Do You Need a Care Partner?
Many home hemodialysis programs require or strongly encourage a trained care partner.
A care partner may help with treatment preparation, machine setup, monitoring, supplies, and responding to problems.
The exact role depends on the program and patient’s needs.
Do You Need a Special Room?
You need an appropriate treatment area where the machine can be safely operated and supplies can be stored.
Depending on the dialysis system, the treatment area may need adequate electrical power, water access, drainage, good lighting, and enough room for equipment.
A home dialysis professional can help assess the space before treatment begins.
Will You Have to Store Dialysis Supplies?
Yes. Home hemodialysis requires supplies to be stored at home.
The amount depends on the treatment program and equipment. Your dialysis provider can explain how much storage space you need and how supplies will be delivered and organized.
Can You Travel While Using Home Hemodialysis?
Travel may still be possible, but it requires planning.
You may need to arrange supplies, equipment, treatment, medications, and medical support before traveling.
Talk with your dialysis team well in advance of any trip so they can explain what arrangements are needed.
How Do You Switch From In-Center to Home Dialysis?
Moving from in-center treatment to kidney dialysis at home is a process rather than an overnight change.
Step 1: Talk With Your Nephrologist
Start by discussing whether home hemodialysis is medically appropriate for you.
Ask about treatment schedules, vascular access, training, equipment, care-partner requirements, and potential benefits and challenges.
Step 2: Complete a Home Assessment
A home dialysis team may evaluate your treatment space, electrical requirements, water access, drainage, and storage options.
This helps determine whether your home can accommodate the equipment and supplies.
Step 3: Prepare Your Vascular Access
Home hemodialysis requires appropriate vascular access.
Your healthcare team will explain which access is appropriate for you and how to protect it.
Step 4: Complete Training
You and your care partner, when required, learn how to perform the treatment and manage common situations that can occur during dialysis.
Step 5: Set Up Your Equipment
Your dialysis provider helps arrange the appropriate equipment and supplies.
Your treatment area is prepared according to the requirements of your dialysis system.
Step 6: Begin Home Treatment
Once your care team determines that you are ready, you can begin your prescribed home dialysis routine.
Your dialysis team continues to monitor your treatment, laboratory results, symptoms, and overall progress.
Does Insurance Cover Home Dialysis?
Coverage depends on your insurance plan and individual circumstances.
For people with ESRD who qualify for Medicare, Medicare Part B can cover certain home dialysis services and supplies, including home dialysis training, equipment, and supplies when eligibility requirements are met.
Medicare also covers certain home dialysis support services, but it does not cover every possible home-related expense. For example, Medicare does not generally cover paid dialysis aides who assist with home dialysis.
Because insurance coverage can vary, speak with your dialysis provider, insurance company, or financial counselor before beginning treatment.
Why Choose Dialyze Direct for Home Hemodialysis?
Choosing home dialysis means choosing a care approach that needs to fit into your medical needs and everyday life.
Dialyze Direct focuses on home hemodialysis and provides support designed to help patients and care partners understand and manage treatment at home.
Our approach includes guidance throughout the home dialysis process, from preparing for treatment to learning how to use the equipment and managing your ongoing dialysis routine.
If you are considering dialysis at home, our team can help you understand whether home hemodialysis may be an option and what the next steps may involve.
Talk With Your Dialysis Care Team
If you are asking, “Can you do dialysis at home?”, the answer may be yes, but the decision depends on your individual situation.
Home hemodialysis can provide another way to receive kidney replacement therapy while potentially giving you more flexibility around your treatment schedule. It also requires training, preparation, equipment, supplies, and active participation from the patient and, in many programs, a care partner.
If you are considering home dialysis, talk with your nephrologist and dialysis care team about your options. They can help you understand whether hemodialysis at home is appropriate and what you would need to safely make the transition.
Frequently Asked Questions
Yes. Some people with kidney failure can receive dialysis at home after medical evaluation and appropriate training. Home dialysis may involve home hemodialysis or peritoneal dialysis, depending on the patient’s medical needs and treatment plan.
Home hemodialysis is a form of dialysis performed at home using a dialysis machine. The machine circulates blood through a dialysis system to remove waste products and excess fluid according to the patient’s prescribed treatment plan.
The basic purpose of hemodialysis is the same, but the setting and responsibilities differ. At home, patients and care partners receive training and manage more treatment tasks, while center staff perform most treatment tasks in-center.
A home dialysis machine is equipment used to perform hemodialysis at home. It controls important parts of treatment, including blood flow, treatment time, fluid removal, pressure, and other treatment parameters depending on the machine.
Eligibility depends on individual medical needs, the ability to complete training, vascular access, home conditions, and available support. A nephrologist and home dialysis team can determine whether home hemodialysis is appropriate.
Training time varies by patient and program. NIDDK reports that home hemodialysis training may take about three to eight weeks. Training covers machine setup, infection prevention, access care, alarms, monitoring, cleaning, and supplies.
Dialysis itself is not necessarily painful, although inserting needles for hemodialysis can cause discomfort. Patients may also experience symptoms during or after treatment. Tell your healthcare team about pain or other symptoms.
Some patients can transition from in-center hemodialysis to home hemodialysis. The process generally involves medical evaluation, home preparation, vascular access, training, equipment setup, and ongoing support from a dialysis care team.
References
- Home Hemodialysis Benefits and Technology
https://www.kidney.org/kidney-topics/home-hemodialysis
Details benefits like reduced medication needs, improved quality of life, and advancements in home hemodialysis machines (2025). - Home Dialysis Overview
https://www.kidney.org/kidney-topics/home-dialysis
Compares home vs. in-center dialysis, emphasizing flexibility, dietary freedom, and cardiovascular benefits (2025). - Home Dialysis Guide
https://www.kidneyfund.org/treatments/dialysis/home-hemodialysis
Outlines eligibility, training processes, and lifestyle considerations for home dialysis (2023). - Empowering Home Dialysis Workshop Report
NIDDK Workshop Summary (2021)
Discusses systemic challenges, training protocols, and equity in home dialysis access. - ESRD Payment and Home Dialysis Coverage
CMS Policy Update (2024)
Explains Medicare coverage for home dialysis machines and payment incentives under the ESRD Prospective Payment System. - Global Trends in Home Dialysis Adoption
Frontiers in Nephrology (2024)
Analyzes rising interest in home dialysis, regional disparities, and strategies to improve uptake. - Home vs. In-Center Dialysis Outcomes
PubMed (2019)
Information contained in this blog is for informational or educational purposes only and does not substitute professional medical advice or consultations with healthcare professionals. The content is not intended to be comprehensive or exhaustive, and it does not apply to any specific individual’s medical condition. Always refer to the personalized information given to you by your doctor, or contact us directly.
Dr. Allen Kaufman is the Chief Medical Officer and Senior VP for Clinical & Scientific Affairs at Dialyze Direct, with over four decades of experience in Nephrology. He began his career in 1980 and has held leadership roles including Chief of Nephrology & Hypertension at Beth Israel Medical Center (1998–2004), Chief of Dialysis at the Bronx VA Medical Center (1982–1990), and Chief of the Yorkville Dialysis Unit at Beth Israel and the Renal Research Institute (1990–2000). Dr. Kaufman has authored over 100 scientific publications and served as Principal or Co-Investigator on numerous NIH-funded research studies. A Fellow of the American College of Physicians, he is board-certified in Nephrology and Internal Medicine. He earned his medical degree from the University of Rochester and completed training at the Hospital of the University of Pennsylvania and Mount Sinai in New York. Dr. Kaufman is widely recognized with multiple “Best Doctor” and “Patients’ Choice” awards.