Approximately 37 million people are currently living with chronic kidney disease (CKD) in the U.S., and experts anticipate that number will rise significantly over the next decade. Of the 661,00 Americans with kidney failure, more than two-thirds (⅔) are already on dialysis.

The overwhelmed U.S. healthcare system is seeking additional effective—and cost-effective—ways to care for patients with end-stage renal disease (ESRD). One underutilized option that’s receiving new attention is home dialysis.* 

Understanding Your Dialysis Options

Dialysis is a treatment that does the job your kidneys can no longer do effectively. There are two main types:

• Hemodialysis (HD): Uses a machine to filter your blood
• Peritoneal dialysis (PD): Uses the lining of your abdomen to filter waste

Both types can be done at home, depending on your health, lifestyle, and support system.

In-center dialysis is typically done at a clinic three times a week, with each session lasting several hours. You’re cared for by a medical team, and everything is handled for you.

Home dialysis, on the other hand, allows you to perform treatments at home—often with a partner or caregiver helping. Training is required, but many patients find that once they’re comfortable, it gives them more independence.

In recent years, newer machines and simplified training programs have made home dialysis more accessible than ever before.

Benefits of Home Dialysis

The advantages of home dialysis generally fall into three main areas: clinical outcomes, quality of life, and cost.

Clinical Benefits

Many patients on home dialysis experience better overall health outcomes. This is often because treatments can be done more frequently or on a schedule that better matches your body’s needs.

Research shows that home dialysis may help improve:

• Blood pressure control
• Anemia (low red blood cell levels)
• Phosphorus levels (important for bone health)
• Energy levels and sleep quality

You may also have fewer symptoms during treatment and recover faster afterward. Some studies suggest that home dialysis patients have fewer hospital visits and shorter hospital stays.

Emotional and Lifestyle Benefits

Let’s be honest—dialysis can take over your life if you let it. That’s where home dialysis can make a big difference.

Patients often report:

• Feeling more comfortable in their own space
• Having greater control over their schedule
• Less time spent traveling to and from clinics
• More flexibility to work, travel, or spend time with family

There’s also something powerful about being more involved in your own care. Many people say it helps them feel more in control, rather than feeling like their life revolves around appointments.

That said, it’s not for everyone. Home dialysis requires training, responsibility, and sometimes a caregiver’s help. It’s a trade-off between independence and added responsibility.

Financial Impact

Dialysis is expensive—there’s no way around it. And with more people needing treatment, the cost to the healthcare system continues to rise.

For context:

• In-center hemodialysis costs roughly $65,000–$90,000 per patient per year under Medicare
• Patients with kidney failure make up less than 1% of Medicare beneficiaries, but account for a disproportionately high share of spending

Home dialysis—especially peritoneal dialysis—is generally less expensive. Estimates suggest:

• Peritoneal dialysis costs closer to $50,000 per year per patient
• Even small increases in home dialysis use could save hundreds of millions of dollars annually

While patients don’t always see these savings directly, lower system costs can lead to better access, improved programs, and more support services over time.

Challenges and Considerations

Before you start picturing yourself skipping clinic visits forever, let’s talk reality.

Home dialysis isn’t a perfect solution. Some challenges include:

• Training requirements: You’ll need to learn how to safely perform treatments
• Home setup: Space and cleanliness matter
• Responsibility: You’re managing your own care day-to-day
• Care partner needs: Some patients need a helper for treatments

Medical factors also play a role. Not everyone is a candidate for home dialysis, depending on your condition, other health issues, or personal situation.

That’s why it’s important to have an honest conversation with your healthcare team about what’s realistic for you—not just what sounds appealing on paper.

What the Future Looks Like for Dialysis

There’s a clear shift happening in kidney care.

Health leaders and policymakers are pushing for more home-based treatment options. In fact, national initiatives have aimed to significantly increase the number of patients using home dialysis or receiving kidney transplants.

Why? Because the data is pretty compelling:

• Better patient satisfaction
• Comparable or improved health outcomes
• Lower long-term costs

Private dialysis providers are also expanding home programs, investing in training, and developing easier-to-use technology.

Still, adoption has been slower than expected. Barriers like patient education, provider training, and access to resources continue to play a role.

Translation: the system is moving in that direction—but not overnight.

Bottom Line

Choosing between home dialysis and in-center dialysis isn’t just a medical decision—it’s a lifestyle decision.

Home dialysis offers more flexibility, independence, and potential health benefits. But it also comes with responsibility and may not be the right fit for everyone.

The most important step you can take is to understand your options and ask questions. Talk with your healthcare provider about what aligns best with your health, your routine, and your support system.

At the end of the day, the “best” option is the one that helps you stay as healthy—and as in control of your life—as possible.

*Healio. (2019). “Home Dialysis Options Can Assist in Clinical Decision-Making.” healio.com

The information provided by Responsum Health is for educational purposes only and does not replace professional medical advice. Always talk with your healthcare provider before making changes to your treatment or care. Responsum Health does not endorse specific treatments, providers, or products.