Home Hemodialysis: What You Need to Know About Dialysis at Home

When your kidneys can’t filter waste anymore, home hemodialysis, a treatment where blood is cleaned outside the body using a machine, typically performed in the patient’s home. Also known as peritoneal dialysis alternative, it gives people with kidney disease more control over their schedule, fewer clinic visits, and often better long-term outcomes.

Unlike in-center dialysis, which usually happens three times a week for four hours, home hemodialysis can be done more frequently—five or six times a week, even overnight while you sleep. This means less fluid buildup, fewer cramps, and better blood pressure control. It’s not for everyone, though. You need space for the machine, a trained helper (often a family member), and the willingness to learn how to set up, clean, and troubleshoot the equipment. The dialysis machine is complex but designed for daily use, and most patients get trained by a nurse over a few weeks before starting.

People who choose home hemodialysis often report feeling more energetic, sleeping better, and having fewer dietary restrictions. It reduces the stress of commuting to a clinic, especially if you live far away or have mobility issues. But it also means taking responsibility for your care—no nurse is right next to you if something goes wrong. That’s why training is strict, and many programs require a backup plan, like a neighbor who can help in an emergency. Insurance usually covers it, but you’ll need to check what’s included: machines, supplies, training, and support calls.

Some patients switch from in-center to home because they’re tired of the rigid schedule. Others start at home right away after diagnosis. It’s not a cure, but it can make life feel more normal. The dialysis treatment process itself is the same whether at home or in a clinic—blood is pulled out, cleaned through a filter, and returned. But the freedom to do it on your terms changes everything.

Below, you’ll find real-world guides on managing side effects, choosing the right machine, training tips, how to handle infections, and what to do if your treatment isn’t working as expected. These aren’t theory pieces—they’re written by people who’ve been through it, and by pharmacists and nurses who help them every day. Whether you’re considering home hemodialysis, just started, or supporting someone who is, this collection gives you what you need to make smart, confident choices.