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What are your hemodialysis options?

Explore your hemodialysis choices, whether at home or in a center, to help with managing your kidney disease. Find out the benefits and considerations to help you stay healthy.

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March 26, 2025
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Julie Dominguez, MD
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3 minutes

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Treatment Options
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What is hemodialysis?

Hemodialysis (HD) is a treatment option for end-stage kidney disease (ESKD) that can be done at home or in a center. During HD, you are connected to a dialysis machine through two needles in your access site. Your blood is filtered in the machine to remove waste, toxins, and fluid and returned to your body.

Home hemodialysis (HHD)

Home hemodialysis (HHD) is done from the comfort of your own home. If you choose HHD, you will attend training at a center for 4-6 weeks. Once you complete training, your care team will help you create a flexible treatment schedule that best fits your lifestyle and health needs. This can be 4-6 days a week for 3-5 hours per session. You might also be able to dialyze longer overnight.

Benefits of HHD
  • More flexibility and freedom with treatment scheduling
  • More privacy and family time while treating at home
  • More control over your own care
  • More frequent treatments to help you feel your best
  • Possibly fewer medications and dietary restrictions
Things to consider with HHD

You can do HHD alone or with a care partner. If you choose to have a care partner, they will also attend training to understand the process—from setting up the machine, to placing needles, to monitoring and cleaning up.

You will also have a nurse from your center available 24 hours a day for emergencies and questions. Technical support from the manufacturer of your dialysis machine is also available 24 hours a day.

Once you get started with HHD, you will most likely go to your center twice a month for blood work and visits with your care team.

Traveling with HHD

If you have travel plans, your care team can arrange for your supplies to be delivered to your destination. You can transport your machine in your luggage as medical equipment without additional costs.

In-center hemodialysis

If you choose in-center HD, you will receive treatment at a dialysis center. Your care team will assign a treatment schedule, which is three days a week on Mondays, Wednesdays, and Fridays or on Tuesdays, Thursdays, and Saturdays. Your treatments will be at the same time on those days. Most people dialyze for 3-5 hours in a recliner chair, in a large room with other people receiving treatment.

Benefits of in-center HD
  • Trained medical staff on site if you need assistance
  • No major training needed
  • No need to store supplies at your house
  • Opportunity to be around other people on dialysis
  • The same schedule every week
Things to consider with in-center HD

Since in-center HD usually means less frequent dialysis than home HD, you may have more diet and fluid restrictions. It might also mean less energy and longer recovery between treatments.

With in-center HD you have more limited flexibility in scheduling. Some people find it hard to work or go to school. You should also consider the need for transportation to and from your center and the cost and travel time this will take.

Traveling with in-center HD

It’s important to complete your in-center dialysis as prescribed to feel your best. If you’re planning to travel, your care team can help you arrange dialysis at centers near your destination.

Comparing your options

Category
Home Hemodialysis (HHD)
In-Center Hemodialysis
Benefits
•  More flexibility and freedom with scheduling
•  More privacy and family time
•  More control over your own care
•  More frequent treatments
•  Possibly fewer medications and dietary restrictions.
•  Trained medical staff on site
•  No major training needed
•  No need to store supplies at home
•  Opportunity to be around other people on dialysis
•  The same schedule every week.
Things to Consider
•  Can be done alone or with a care partner (who also attends training)
•  A center nurse and manufacturer support are available 24 hours a day
•  You'll likely visit your center twice a month for blood work and check-ins.
•  Usually less frequent dialysis, which may mean more diet and fluid restrictions and longer recovery
•  More limited scheduling flexibility
•  Transportation, cost, and travel time to your center.
Traveling
•  Your care team can arrange for supplies to be delivered to your destination
•  You can transport your machine in your luggage as medical equipment at no additional cost.
•  It's important to complete treatment as prescribed
•  Your care team can help arrange dialysis at centers near your destination.

Choosing the best access type for you

If you choose HD, you will need an access site for treatment. Your care team will help you choose between a fistula, graft, and catheter. Taking care of your access and avoiding infection is an important part of treatment.

We are here to help

We are here to support you along the way. Reach out if you have questions about your hemodialysis options.

This serves only as a guide. Talk with your healthcare provider for more information based on your health needs.

Julie Dominguez

Julie Dominguez, MD

Vice President, Medical Office, Interwell Health

Julie Dominguez, MD, is a nephrologist with extensive experience in private practice nephrology and medical education. At Interwell Health, she helps advance high-quality kidney care programs that support patients and clinicians. Dr. Dominguez earned her medical degree from the University of Texas Southwestern Medical Center, completed her Internal Medicine residency at Duke University, and completed her Nephrology fellowship at the University of California San Diego.