Create your own dialysis schedule, allowing you to spend more time doing the things you enjoy
Home Dialysis: Understand Your Options, Know Your Rights
Home dialysis, which means doing your dialysis at home, can lead to better health, more freedom and a higher quality of life. Yet too many patients, especially Black and Hispanic/Latino patients, are never told that it can be an option. You are your best advocate. Talk to your doctor to find out whether home dialysis could be right for you.
STAY INFORMED
Home dialysis: An equity issue
Black and Hispanic/Latino people are more likely to have kidney disease. Yet they are 25% less likely to use home dialysis than White people. Sometimes, no one explains that home dialysis is possible. Other times, because of implicit bias (unconscious stereotypes that affect how we see and treat people.) Some health care professionals may not believe patients of color can manage dialysis at home. These barriers keep thousands of people from a treatment that could improve their health and quality of life.
EMPOWER YOURSELF
You are your best advocate
Being your own advocate means speaking up for your health needs, asking clear questions, and making sure you understand all of your options. It includes requesting information in plain language, bringing someone with you to appointments for support, and asking for second opinions if something doesn’t feel right. Advocating for yourself can help make sure you receive fair treatment and have access to the best care available.
Home dialysis Everyone should know their options
Despite the advantages, Black and Hispanic people are about 25% less likely to use home dialysis than White people. This can be due to a lack of awareness about home dialysis, but unfortunately, some health care professionals assume people of color do not have the skills or may not meet the requirements for home dialysis. As a result, many Black and Hispanic patients are not given the option of experiencing the benefits that home dialysis often provides.
By the numbers
- 25%
Black and Hispanic/Latino people are 25% less likely to use home dialysis than White people.
- 13%
Just 13% of dialysis patients were using home dialysis in 2020
- 45%
45% of dialysis facilities were not yet certified by Medicare to offer home dialysis in 2019.
Barriers to home dialysis
Medical bias (assumptions that a health care professional may have)
- For years, kidney function tests (such as eGFR or estimated glomerular filtration rate) included race as a factor, making Black patients' kidneys seem healthier than they were.
- Health care professionals sometimes assume patients of color won't be able to manage home dialysis or follow instructions, even when there's no evidence for that.
Information and education gaps
- Many Black and Hispanic/Latino patients are not told home dialysis is an option, or it's explained in rushed, technical language.
- It's hard for some patients to understand their health choices if they don't have translators or information that makes sense for their background.
Financial challenges
- Patients from underserved communities may not have insurance that covers training or supplies.
Societal barriers
- In some neighborhoods, fewer dialysis centers offer home training.
- Long travel distances, limited public transportation, and language barriers make evaluation or training harder.
- Housing issues, like small or crowded living spaces or unstable housing, can make it difficult to meet equipment requirements.
- Home dialysis requires both the patient and a care partner to complete training, which can be difficult for people who do not have someone available or able to help.
LEARN WHAT WORKS FOR YOU
Exploring home dialysis begins with you
Home dialysis is not for everyone, but there are benefits that could improve your quality of life. With home dialysis, treatments happen more often than in-center dialysis, which can lead to better health, fewer side effects, and more time to spend with family and friends.
Possibly continue working
Travel more easily: many home dialysis options have portable equipment that makes it possible to dialyze in different places, such as a hotel or a friend's house
Visit Kidney Kitchen
Enjoy more freedom with what you can eat: since home dialysis happens more often than in-center dialysis, you may have more freedom in what and when you eat. Foods high in potassium, phosphorus, or fluids might be less restricted, depending on your treatment schedule. Always work with your kidney dietitian and doctor to make a meal plan that fits your dialysis needs and feels right for you.
Fewer dialysis side effects
Challenges of home dialysis
Home dialysis gives you more freedom, but it also takes planning and responsibility. Knowing the possible challenges can help you prepare and feel more confident in your care.
- You won't have a health care professional with you during each treatment.
- You'll need space to store supplies and a clean area for treatments.
- Some equipment may require special electrical outlets or plumbing.
- Training can take a few weeks to complete (home hemodialysis only).
- A care partner is usually required to qualify (home hemodialysis only).
- The dialysis solution used in peritoneal dialysis contains sugar, which can sometimes cause weight gain.
- You may miss the social connection of seeing other dialysis patients during treatments.
Home dialysis resources
Learn about home dialysis
Each person’s ability to do dialysis at home is different and depends on medical and personal factors. Talk with your doctor or care team about whether this treatment might fit your needs and lifestyle. Together, you can review your options and decide what makes the most sense for you. Explore your dialysis options with our decision-making guide. This easy-to-use tool helps you compare treatments and choose the option that fits your life and goals.
Exploring home dialysis begins with you
Ask about home dialysis. If you are in the later stages of kidney disease and at risk for kidney failure, ask your doctor to explain all your treatment options, including home dialysis.
Get a second opinion. If you are currently doing in-center dialysis, tell your doctor you want to be considered for home dialysis. If they turn you down, ask for a second opinion. You can also ask to talk with a social worker to discuss the reasons you were turned down.
Involve your health care team. Talk with your health care team about how to meet the requirements for home dialysis. For example, your social worker may suggest ways to make space in your home for the dialysis equipment you need.
Assistance with insurance
Get help paying
If you have kidney failure and are unable to afford the cost of your health insurance premiums, the American Kidney Fund's Health Insurance Premium Program (HIPP) may be able to help. HIPP helps lower the financial challenges faced by people from communities of color and low-income households. About two-thirds of people who receive help from HIPP are people of color.
Understanding your home dialysis
Check out this video to explore the differences between in-center and home dialysis, and the pros and cons of each. Speakers discuss the differences between in center dialysis and home dialysis. Patients, caregivers, and providers will better understand when and why someone may need treatment, as well as when, over time, their decisions may change.
Get involved and join the fight
Join AKF's movement for kidney health equity. Learn how to become a Kidney Health Coach, apply for grants, partner with us, train as an advocate, or share your story to help prevent kidney disease and support communities.
Blog
Thriving on your terms: Dialysis at Home Summit emphasizes the benefits of managing kidney disease on home dialysis
The American Kidney Fund (AKF) and Home Dialyzors United (HDU) partnered for a second year in a row to host the annual Dialysis at Home: Kidney Community Event on Thursday, Sept. 14. Read our recap of the event.