I am gathering information on why centers are not offering the home-hemo option. If you work in a center that does not offer this option, please let me know the reasons. Once the reasons are gathered maybe we can look for a solution.

I am a nurse with a husband on home hemo. I do not work in a center, but hear a bit about the issue of offering home hemo. One argument is that the initial and first year or so costs are greater than for in-center. The longer a person is on home hemo, the less the cost.(fewer calls, consults, problems, etc.) But oftentimes, a pt. opts for a transplant in the first year or so, rather than staying on home. So home hemo programs continue to incur high pt. start-up costs, then lost the pts. either to transplant or in-center. (The burnout rate for home hemo can be high).

My experience is in traditional 3x/week dialysis, so maybe the arguments don't hold for daily, nocturnal.

Strictly as a nurse, I would look at what's best for the pt. not cost, but, of course, that's not always the way things work.