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Last Updated 04/19/20

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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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Alliance for Home Dialysis Request that Home Dialysis Training Services Be Approved for Telehealth - Notice from the Renal Physicians Association and letter (2-page pdf) from the Alliance for Home Dialysis. - April 16, 2020

blue ball Expanded Home Hemodialysis: Case Reports - Online First Abstract from the International Urology and Nephrolog. - April 15, 2020
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4th ASN COVID-19 Webinar on April 9th:  Considerations in the Home Dialysis Setting (NTDS page description) - This 60-minute webinar includes a report from the front lines, infection prevention and control considerations in the home, and advocacy updates related to care of patients on home dialysis. Webinar resources are as follows. - April 14, 2020

•  Webinar recording – mp4
•  Slide handout – (57-slide presentation)
•  Speaker bios – (3-page pdf

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COVID-19 Risks Could Speed Transitions To At-Home Dialysis - Article from Connecticut Public Radio. - April 13, 2020

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Speaker: System Barriers Block Advancing American Kidney Health Goal for Home Dialysis - Article from Healio (registration required). - April 8, 2020

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Fresenius Medical Care North America Highlights Home Growth and Telehealth Success - Press release. - April 6, 2020

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Tablo® Hemodialysis System Receives FDA Clearance for Home Dialysis - Press release. - April 1, 2020

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CARES Act to Improve Options for People on Home Dialysis - Article from Kidney News Online. - March 30, 2020

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ESKD Treatment Choices Model: Responsible Home Dialysis Growth Requires Systems Changes - (10-page pdf) Early Access perspective piece from Kidney360. - March 27, 2020

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Letters from NxStage Regarding COVID-19 - Page from the Home Dialyzors United web site. - March 17, 2020

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blue ball Latest Scientific Journal Articles on Home and Daily Dialysis Continually Updated!
blue ball Home Dialysis Central web site
blue ball Alliance for Home Dialysis web site
blue ball Current Issues of Home Dialysis Central Newsletter
blue ball Book: Daily and Nocturnal Hemodialysis by Lindsay, Buoncristiani, Lockridge, Pierratos, and Ting © 2004
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Book: Help, I Need Dialysis! How to have a good future with kidney disease by Dori Schatell, MS and Dr. John Agar © 2012

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GUIDE, a Structured Predialysis Program That Increases the Use of Home Dialysis from Clinical Kidney Journal. - May 30, 2016

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Home Hemodialysis – A Review of Literature - Posting from the Renal Fellow Network blog. - June 26, 2019

blue ball Home Dialysis Assessment Tool (pdf) from the Home Dialysis Central web site
blue ball Home Dialysis DVD from Home Dialysis Central web site
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Home Dialysis Lecture Series (2018) from UKidney web site

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Home Dialysis Toolkit - resource to assist facilities in meeting the requirements of the Conditions of Coverage from the Medical Advisory Council (MAC) of the Forum.

blue ball Home Dialyzors United web site
blue ball Home Hemodialysis from the National Kidney Foundation (NKF) web site
blue ball Home Hemodialysis Fact Sheet (pdf format requires Adobe Acrobat reader.) from the American Nephrology Nurses’ Association
blue ball Home Hemodialysis | Preparing for Treatment video from the Satellite Healthcare web site
blue ball Nocturnal Home Haemodialysis web site
blue ball Nocturnal Home Hemodialysis - A First Person Account, Part I and Part II by Michael Williams
blue ball PD and Home Hemo Coverage Maps from the Home Dialysis Central web site
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Self-Cannulation - Video via Renal Fellow Network web site

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Tips for Home Dialysis Success - KidneyTalk podcast from Renal Support Network web site 

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Video: A Home Hemodialysis Treatment Step-by-Step - 43-minute YouTube video by Tami Ramsey, a nurse who does home hemodialysis herself.

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Video (29 seconds) from Home Hemodialysis Patient David Belim - Facebook posting. - August 21, 2018

blue ball Search result for Nocturnal dialysis by Google Continually Updated!
blue ball 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 2015 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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