Cooper's care team works closely with you and your nephrologist.
Together, we'll determine whether home hemodialysis is the best fit for your health, your home, and your lifestyle. This page is here to help you understand what HHD involves so you can come to that conversation informed.
Overview
What is Home Hemodialysis?
Home hemodialysis (HHD) is a treatment that uses a dialysis machine to clean your blood when your kidneys can no longer function properly. Like in-center dialysis, blood is filtered through a dialyzer to remove waste and excess fluid — but treatments are done from the comfort of home on a schedule that fits your lifestyle.
HHD is often performed more frequently than in-center dialysis, which may help patients experience better energy levels, improved blood pressure control, and fewer symptoms between treatments.
The
Process
How Home Hemodialysis Works
Each HHD session involves the same three phases. Understanding what is happening helps you feel in control of your own treatment — which is one of the core advantages of treating at home.
1
Access
Blood leaves the body
Blood is drawn from your vascular access through two needles (or catheter ports) connected to tubes that carry it to the dialysis machine. About a pint of blood flows through the machine per minute.
2
Return
Clean blood returns
The filtered blood is returned to your body through your access. This cycle continues throughout the session — typically 2 to 3.5 hours — until the prescribed volume of blood has been cleaned.
The machine also monitors your blood pressure, flow rates, and other vital parameters throughout treatment, alerting you with alarms if anything needs attention. Your Cooper nurse teaches you exactly what each alarm means and how to respond.
Before You
Begin
Vascular Access and Your Connection to Treatment
What is it and the various types.
Hemodialysis requires a reliable way to access your bloodstream. This is called a vascular access.
It's one of the most important aspects of your HHD care. Your Cooper team and nephrologist will work with your vascular surgeon to plan the right access for you — ideally well before your first treatment.
There are three types of vascular access. The AV fistula is considered the gold standard and is the preferred choice whenever possible.
Preferred access for HHD
Gold Standard
First Choice
Created by surgically connecting an artery and vein — usually in the forearm or upper arm
The vein grows larger and stronger over time, providing strong blood flow
Lowest risk of infection and clotting of all access types
Can last for many years with proper care
Needs 6 weeks to 4+ months to mature before use — plan ahead
Second choice access
Second choice
Connects an artery and vein using a soft synthetic tube placed under the skin
Good option when blood vessels are not strong enough for a fistula
Can be used within 2 to 6 weeks after placement
Higher risk of clotting and infection than a fistula
May need repair or replacement over time
Temporary or bridge access
Temporary
For Bridge Use
A soft tube placed in a large vein, usually in the neck or chest
Ready to use immediately after placement
Often used while a fistula or graft matures
Higher risk of infection and slower blood flow than fistula or graft
Typically used short-term; can be permanent if other options aren't possible
Access planning should begin as early as possible.
Because an AV fistula can take months to mature, your nephrologist and Cooper care team will coordinate with your vascular surgeon well in advance of your target start date — so you're never in a position where you have to rush or settle for a less-than-ideal access.
Flexibility
Your HHD Schedule
You choose what fits.
One of the most meaningful advantages of HHD is that treatment frequency and timing adapt to your life, not the other way around. You and your care team will choose a schedule together based on your clinical needs, lifestyle, and preferences.
Both schedules involve more frequent treatment than traditional in-center hemodialysis (typically 3 days per week). That increased frequency is one of HHD's key clinical advantages — more frequent sessions remove waste and fluid more gently, which is associated with better blood pressure, less fatigue, and improved quality of life.
Benefits of Home Hemodialysis
For the right patient, HHD offers some of the best clinical outcomes available in dialysis. Combined with a level of independence and control that in-center treatment simply cannot match.
HHD tends to do well for:
People who are motivated, detail-oriented, and want to take an active role in managing their health
Those who value flexibility and want to dialyze on a schedule that fits their work, family life, or other commitments
Patients who live far from a dialysis center and want to eliminate the physical and time burden of in-center treatment
Active individuals — those who work, travel, or have active lifestyles that don't fit around a three-day clinic schedule
Patients who want to be in control of their healthcare — HHD puts you at the center of every treatment decision
Still unsure if home hemodialysis is right for you?
The
Journey
Getting started with HHD
Starting HHD is a comprehensive process but Cooper's team walks alongside you at every stage. The goal is for you to feel fully confident and independent before you treat on your own.
1
Talk to your doctor and Cooper's team
Your nephrologist evaluates whether HHD is appropriate and refers you to Cooper. Cooper can also coordinate directly with your nephrologist's office to get the conversation started.
2
Plan your vascular access early
Because an AV fistula needs months to mature, access planning starts as soon as HHD is identified as your path. Cooper coordinates with your nephrologist and vascular surgeon to align the timing of access creation with your treatment start date.
3
In-home training (3 to 8 weeks)
Your dedicated Cooper HHD nurse comes to your home for every training session. You'll learn machine setup and priming, self-cannulation (inserting your own needles), blood pressure and weight monitoring, alarm response, emergency protocols, and how to get safely off the machine if the power goes out. Cooper trains you and your care partner together. We don't sign you off until both of you feel confident.
4
Machine and supply setup
Your dialysis machine is delivered and set up in your home. Cooper's team coordinates equipment installation, confirms your water system connection, and ensures everything is ready before your first independent treatment. Setting up your machine is as straightforward as connecting it to your water supply — your nurse will walk through it completely.
6
Begin treatment with 24/7 support
Your nurse observes your first independent treatment from setup through completion. From that point forward, your Cooper care team is available around the clock. You're independent — and you're supported.
How
We Support You
You aren't doing this alone.
Cooper is a home dialysis-only provider. Every service we offer, from your first visit to your ongoing care, happens in your home. Here's what that looks like in practice.
What Cooper Home Health provides throughout your HHD journey:
All of the following happen at your home, on your schedule, no clinic required.
In-home training with your dedicated HHD nurse
Help with vascular access care and monitoring
Equipment and supply coordination at your home
Monthly in-home lab draws and medication administration
Remote monitoring for safety and peace of mind
Ongoing telehealth visits and coaching
Direct coordination with your nephrologist
24/7 clinical support — a real person, not a voicemail
