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Last Updated 09/11/16

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The benefits of daily hemodialysis treatments seem obvious. Daily treatments more closely resemble normal kidney function than three-times-a-week treatments. It also means fewer dietary and fluid restrictions as well as fewer medications. Patient testimonials about the benefits of daily treatments are abundant.

Medicare payment policy, also known as the composite rate, is based on three-times-a-week dialysis. This is, at first glance, less expensive for the government than daily treatments. Evidence is building, however, that daily treatments may result in overall lower healthcare costs for end-stage renal disease patients by reducing hospitalizations and lowering overall drug costs.

The most expensive cost component of a hemodialysis treatment is the patient-care (nursing) labor. This can be greatly reduced by performing hemodialysis treatments in the home. A new generation of home hemodialysis machines is currently under development that greatly simplifies their operation and reduces the burden on a home partner. The Internet also makes remote monitoring of the dialysis machines by trained professional staff affordable and convenient.

Warning:  Changes should never be made in a patient's treatment or care based solely on the information found here.  Every patient has unique healthcare concerns and considerations and all these factors must all be taken into account before any changes can be safely made.  All medical and therapeutic decisions must come from a qualified health care provider.  Read RenalWEB's Legal Disclaimer before proceeding.

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"Who Matters Most?": Clinician Perspectives of Influence and Recommendation on Home Dialysis Uptake. - Accepted Article abstract from Nephrology. - September 6, 2016

"Data suggest the nephrologists are the most influential member of the pre-dialysis team. This contrasts with perceptions of survey respondents who view pre-dialysis nurses as most influential. Nephrologists' recommendations are likely to be a successful way of increasing home dialysis. A single point increase in nephrologist decisional power is associated with a 6.1% increase in the prevalence of home dialysis."

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Dose Targeting Metrics in Conventional and Intensive Maintenance Dialysis - Early View abstract from Seminars in Dialysis. - September 4, 2016

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Every Other Day Nocturnal Home Hemodialysis: An Alternative Approach to Reduce Burden - Article from Nephrology News & Issues. - August 31, 2016

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More Dialysis Has Not Proven Much Better - Early View Abstract from Seminars In Dialysis - August 24, 2016

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Personal Support Worker (PSW)-Supported Home Hemodialysis: A Paradigm Shift - Free, full-text, Early View article from Hemodialysis International. - August 22, 2016

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Extended-Hours Hemodialysis Is Associated with Lower Mortality Risk in Patients with End-Stage Renal Disease - Articles in Press Abstract from Kidney International - August 20, 2016

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The Success of Home Dialysis in Australia and New Zealand - Posting from the KidneyViews blog. - August 18, 2016

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Treatment Frequency and Mortality among Incident Hemodialysis Patients in the United States Comparing Incremental with Standard and More Frequent Dialysis - Article in Press abstract from Kidney International. - August 12, 2016

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blue ball Latest Scientific Journal Articles on Home and Daily Dialysis Continually Updated!
Home Dialysis Central web site
Nocturnal Home Haemodialysis web site
Home Dialyzors United web site
Current Issues of Home Dialysis Central Newsletter
Current Issue of At Home with AAKP an electronic newsletter produced and distributed by the American Association of Kidney Patients (AAKP)
Alliance for Home Dialysis web site
Home Hemodialysis Fact Sheet (pdf format requires Adobe Acrobat reader.) from the American Nephrology Nurses’ Association
PD and Home Hemo Coverage Maps from the Home Dialysis Central web site
Home Hemodialysis from the National Kidney Foundation (NKF) web site
Home Hemodialysis: Helping Patients Lead a Healthier Life online seminar from the American Association of Kidney Patients (AAKP)
Home Hemodialysis from the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC)
Home Dialysis DVD from Home Dialysis Central web site
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GUIDE, a Structured Predialysis Program That Increases the Use of Home Dialysis from Clinical Kidney Journal. - May 30, 2016

Home Dialysis Assessment Tool (pdf) from the Home Dialysis Central web site
Book: Daily and Nocturnal Hemodialysis by Lindsay, Buoncristiani, Lockridge, Pierratos, and Ting © 2004

Book: Help, I Need Dialysis! How to have a good future with kidney disease by Dori Schatell, MS and Dr. John Agar © 2012

Nocturnal Home Hemodialysis - A First Person Account, Part I and Part II by Michael Williams

Self-Cannulation - Video via Renal Fellow Network web site

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A Home Dialysis Slide Show—And Sign Up For A Meeting! from the NxStage web site

blue ball Search result for Nocturnal dialysis by Google Continually Updated!
Home Dialysis web sites by Yahoo! Continually Updated!
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Find a home dialysis center in your area from the Home Dialysis Central web site
The following Frequently Asked Questions (FAQs) were prepared by the staff of the Nocturnal Home Hemodialysis (NHHD) program at the Humber River Regional Hospital in Toronto.
Lynchburg Nephrology (Virginia) has their Nightly Home Hemodialysis (NHHD) Program.
Rogosin Kidney Center of The Rogosin Institute is the first center in the New York City metropolitan area to offer patients nocturnal hemodialysis. This type of self care home dialysis offers patients independence and freedom for day time activities.

Four, well known, not-for-profit dialysis providers:

Northwest Kidney Centers
Satellite Healthcare

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  PUBMED SEARCHES (National Library of Medicine's MEDLINE Database)
daily dialysis AND hemodialysis Continually Updated!
home hemodialysis Continually Updated!
nocturnal AND dialysis Continually Updated!
MEDLINE / Pubmed Information from the National Library of Medicine
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  K/DOQI™ -  Kidney Disease Outcomes Quality Initiative
NKF-K/DOQI Clinical Practice Guidelines


Clinical Practice Guidelines and Clinical Practice Recommendations 2006 Updates
K/DOQI Home Page from the National Kidney Foundation web site
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Care-Partners for Home Dialysis discussion page
Daily, Home, Nocturnal Hemodialysis Discussion Forum - RenalWEB Discussion Forum
Home Dialysis Central Face Book discussion page
Home Dialyzors United Face Book discussion page
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Adequate Hemodialysis Therapy - topic page from RenalWEB
Hemodialysis Dose and Adequacy from NIDDK
Clinical Practice Guideline on Adequacy of Hemodialysis - a book available from the Renal Physicians Association web site
Consensus Statement: Mortality and Morbidity of Dialysis from the NIH Consensus Development Program (written in 1993 with 1998 update)
United States Renal Data System (USRDS) 
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E-mail to RenalWEB on the Hemodialysis Adequacy Topic
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