Hemodialysis (HD) is a life-preserving treatment for hundreds of thousands of Americans with kidney failure. But the standard schedule of in-center HD three times a week is, at best, inconvenient, and at worst, hard on the heart.

People who receive in-center HD travel to the clinic three times a week and sit in a chair for 3 to 4 hours each time while their blood is cleaned. Waiting for needle sites to stop bleeding and blood pressure to return to normal takes even more time. In-center HD patients must follow a strict schedule because the clinic treats three to five shifts of patients in the course of the day. Someone who gets to the clinic late often can’t make up the time by staying longer because the machine is needed for the next patient.

Between treatments, in-center HD patients must limit drinking fluids to avoid gaining too much weight and raising their blood pressure. The standard HD diet also restricts phosphorus, salt, and potassium. The patient may have to take several drugs to control blood pressure and other problems like anemia and high phosphorus levels. Many people who dialyze three times a week complain of feeling exhausted or “washed out” for a few hours after a session. In the course of a week, the HD patient may feel highs and lows as the body builds up fluid and wastes and then has them washed away during treatments.

Download the National Institutes of Heatlh brochure on home hemodialysis