Dialysis at Home vs. In-Center: Pros, Cons, and How to Decide

For patients with kidney failure, dialysis is a lifeline—but where you receive treatment can dramatically impact your quality of life. While in-center hemodialysis (typically 3x/week at a clinic) has been the standard for decades, home dialysis (either peritoneal or hemodialysis) is growing in popularity for its flexibility.

This guide breaks down the pros, cons, costs, and lifestyle considerations of both options, empowering you to make the best choice for your health and daily routine.

There are two primary types of dialysis:

1. Hemodialysis (HD)
2. • Filters blood through a machine.
   • Done in-center (at a clinic) or at home (HHD).
2. Peritoneal Dialysis (PD)
3. • Uses the abdominal lining to filter blood.
   • Only done at home, often overnight.

Types of Home Dialysis

• Peritoneal Dialysis (PD): Daily treatments, often while sleeping.
• Home Hemodialysis (HHD): 3–6 shorter sessions/week (like in-center but at home).

Advantages of Home Treatment

• More flexibility (set your schedule).
• Fewer dietary restrictions (gentler on the body).
• No travel to clinics (saves time and stress).
• Better long-term outcomes for some patients.

Challenges to Consider

• Training required (1–6 weeks to learn).
• Need caregiver support (especially for HHD).
• Supplies take up space at home.

How It Works

• 3–4 hour sessions, 3x/week at a clinic.
• Staff handles all equipment and monitoring.

Benefits of Clinic-Based Care

• No setup or cleanup at home.
• Immediate medical help if complications arise.
• Social interaction with nurses/other patients.

Potential Drawbacks

• Rigid schedule (disrupts work/travel).
• More dietary/fluid restrictions.
• Risk of infections (e.g., MRSA).

*Costs vary by insurance. Medicare covers 80% for both.

Medical Factors

• PD isn’t for everyone (requires intact abdominal tissue).
• HHD may not be safe if you have unstable blood pressure.

Personal Preferences

• Do you value control over your schedule? → Home dialysis.
• Prefer not to handle medical equipment? → In-center.

Caregiver Support

• Home HD often requires a helper (family or hired aide).
• PD is more solo-friendly but still needs backup support.

• Ask your nephrologist about home dialysis eligibility.
• Tour training centers to see equipment firsthand.
• Try in-center first if you’re unsure (you can switch later).

Still undecided? Contact us for a free consultation with a dialysis educator.