Standard Home Hemodialysis

Standard home HD is done three times a week—or every other day—at home. You can choose your treatment days as long as you don't go more than 2 days in a row without dialysis. You can also choose your treatment times. Some people also do longer treatments than they would in-center. You and a partner learn to do HD at home on the "standard" three days a week schedule used in clinics. But, at home, you can choose when your treatments are—morning, afternoon, or evening. You can change the time or the day to fit your life.

Standard home HD benefits in brief:

Getting ready for standard home HD: Vascular access

To do any type of HD, you will need a surgeon to make you a vascular access (a way to get blood to the dialyzer).


When your access is ready to use, you'll have a few weeks of training. Your training nurse will teach you and your partner how to:

A nurse may come to your home for your first treatment to watch you and be sure that you feel confident. Once you are home, a nurse will be on call 24 hours a day, 7 days a week to help you and answer your questions.

Where can you get standard home HD?

Dialysis first started in the U.S. in the late 1960s and early 1970s. Back then, standard home HD was the most common type of treatment. In 1973, Medicare started to pay for dialysis. Many clinics began to open, and home HD faded away.

Thanks to demand from people like you, there are more home HD options. Some people even move to be closer to a center that will let them do the kind of treatment they want. Of the more than 5,000 dialysis clinics in the U.S., about 1 in 8 train people to do standard home HD. Standard home HD is offered in every state except South Dakota and Wyoming. Find a center near you.


Standard home HD takes about 5–6 hours each time a treatment is done, with set-up and clean up. It's best for you to get at least 4 hours per treatment—more is better. You decide when to start and finish the treatments.

It takes about 30 minutes to set up the machine for each run and about 15 minutes to clean it when you're done. To learn about home HD machines, check out our section on home HD equipment.

Once you're trained, you'll need to go to the clinic once a month to have your labs checked, meet with your care team, and go over your treatment logs. You'll also need time to check your supply levels, order supplies each month, and receive the shipment. You may need to make dialysate, depending on the machine you use. Your machine may need repair at times, too.

Space needed

You will need a place for a dialysis chair and the machine. Why do you need a special chair? Since you can't get up during the treatment, you will want to be comfy. HD involves blood, and you won't want to get any blood on your other furniture. Dialysis chairs can lay flat and tip you back in case you feel faint. Your clinic must provide you with a basic chair as part of your care—and you should not have to pay for it. You can pay for upgrades, like heat or massage, if you want those. Read more about coverage of home equipment

You'll also need space to store dialyzers, bottles of dialysate, bleach and disinfectant, syringes, needles, medicines, blood tubes, water test kits, etc.—depending on the machine.

Care partner tasks

Clinics require a care partner for standard home HD. Your blood pressure could drop, and you may have cramps and need someone there to help you. Each patient and partner team is unique, but in most cases it's best if you do as much of your own treatment as you can—especially putting in the needles. It's your treatment.

Most often, a family member or friend trains to be a care partner. Sometimes, people hire nurses or techs to be care partners. Medicare does not pay for home HD care partners. A few clinics pay for them—but this is very rare. In most cases, people who hire a care partner must pay for it themselves. Some pay an hourly fee, others trade free rent in a spare room for help, or even trade helping tasks with someone else on home HD.

If you work, you may be able to write off the cost of a care partner as a deduction on your taxes. If you work and get Social Security disability income, home care partner payments may count as an "impairment-related work expense." This lets you earn more and still keep a disability check.

Standard home HD may be a good choice for you if you want to:

Standard home HD may not be a good choice for you if you want to:

Who is best suited for Standard home HD?

The most vital factor in whether you are suited for standard home HD is how much you want to do it. As long as you and a partner can pass the training and learn to place your needles, you can succeed. Each program has its own way to be sure that you know what you are getting into and will commit to the training and the treatment.

Tip: Bringing HD into your home is sort of like bringing home a new baby. There is a machine and supplies to find space for, and new roles for you and your care partner to take on. The "baby" affects your home and your schedule. Planning out who you think will do what is wise—but plans sometimes need to change in real life. Talk with your partner. Be kind to each other.

Try to clear your calendar when you go through training so you can focus without a lot of outside distractions. Make meals ahead and freeze them, if you can. When you start to do your own treatments at home, expect to feel overwhelmed for the first 3 months or so—that's very normal. Hang in there. You'll get into a routine, and the treatments will get much easier. You'll be so proud of yourselves when you succeed! Thinking about standard home HD? Learn about how to choose a home dialysis clinic.

Thinking about standard home HD? Learn how to choose a home dialysis clinic.