Starting a home hemodialysis program

Home hemodialysis is not a new therapy; rather it is a therapy in which interest has been rekindled due to both the continually growing end-stage renal disease population and concern about poor outcomes in patients on conventional thrice-weekly in-center dialysis. The practical issues to be considered when starting a home hemodialysis center are presented, including the choice of equipment, patient selection and training, home set-up, dialysis prescription, and patient follow-up. We outline the steps required to start a program that will be successful for patients, caretakers, and providers alike.