Why would you want to go to the trouble of learning to do home HD—and having a machine in your home—when the staff at the center will do it for you? There are lots of reasons:

• You can control your own schedule at home, so it is much easier to keep your job, care for children or an aging spouse or parents, etc.
• Your access will last longer with just one person putting needles in it, and you are much less likely to get an infection at home than in a center. This means less time in the hospital and a better chance of living longer.
• You can do more dialysis at home, so you feel much better and have more energy and fewer symptoms. This helps you to plan ahead and know that you'll be able to do things you want to do.
• When you get more dialysis, you have fewer diet and fluid limits. Your diet and fluids may even be normal—and you don't have to take (and pay for) as many drugs.
• With more HD, your blood pressure is likely to be normal, which can protect your heart from left ventricular hypertrophy (a type of heart failure that is the leading cause of death in people on dialysis).
• With more HD, your blood chemistry levels are closer to normal all the time, which may help prevent long-term problems like neuropathy (nerve damage), amyloidosis (build-up of a waxy protein in the joints, tendons, and bones), and bone disease.
• When you do your own dialysis, you gain vital knowledge about how to care for yourself that will build your self-esteem and win you the respect of medical staff.

Patients who choose home HD like the freedom of choosing their own schedules and being in charge of their treatments:

My wife has assisted my dialysis treatments at home for the past one and a half years. As a result of being able to choose the time of my hemo sessions, I have been able to work full time despite dialysis. When I feel that I need it, I have dialyzed more often or for longer periods of time. During the past one and a half years, I have felt great! –James

I treat myself 5 days a week. My treatment time is 2 hours. (I am pretty little and also get a good flow with my fistula.) I have been using NxStage for about a year now and really like it. It took me about a month to learn the machine and feel like I could handle it on my own. It really is very easy and, to tell you the truth, I would not want to go back to a unit. It is so nice to be able to do my treatment when I want in the comfort of my own home. The machine is easy to set up and does take little room. My machine sits on a TV stand that I bought at Target. –Vanessa

My father just turned 79 and we do dialysis here at home 5 days a week. He is still very active with the 250+ pecan trees in his orchard, runs his pecan shelling machinery in the fall, and grows over 200 orchids in his hobby greenhouse. There are many options today for kidney failure, and I am very happy that we have found one for our family setup. Yes, we have had to adjust our schedules here at home and at work, but now that we have a routine in place, everyone here is very happy with the results. As of this week, Dad now sets up and primes his own machine, and once I get the needles in place and we take our first readings, I start my work day and am in contact (next door) by cell phone all the time. He takes all of his own other readings and charts them in the process, and I show up later to do the rinse-back. My wife has almost learned the whole setup from watching my Dad and me, and my 75-year-old mother is learning some aspects also. With a family team we have back-up after back-up after back-up so the work is spread out where no one is stressed at all. –Michael