One advantage to doing dialysis at home is that it can be done more frequently and slowly, which reduces the "washed out" feeling and other symptoms caused by rapid ultrafiltration, and it can often be done at night, while the person is sleeping.

Studies show that HHD improves patients' sense of well-being; the more they know about and control their own treatment the better they are likely to do on dialysis.

More total time dialyzing, shorter periods between treatments and the fact that fluid removal speeds can be lower (thus reducing the symptoms resulting from rapid ultrafiltration), accounts for the advantages of these schedules over conventional ones.

The Hokkaidō group was slightly ahead of the others, with Nosé's publication of his PhD thesis (in 1962), which described treating patients outside of the hospital for acute kidney injury due to drug overdoses.

[28] That these treatments took place in people's homes is hotly disputed by Shaldon[29] and he has accused Nosé of a faulty memory and not being completely honest, as allegedly revealed by some shared Polish Vodka, many years earlier.

It was inspired by the fifteen-year-old daughter of a collaborator's friend, who went into kidney failure due to lupus erythematosus, and had been denied access to dialysis by their patient selection committee.

"[30][31] In September 1964 the London group (led by Shaldon) started dialysis treatment at home.

It coincides with the introduction and arise of continuous ambulatory peritoneal dialysis (CAPD) in the late 1970s, an increase in the age and the number of comorbidities (degree of "sickness") in the ESRD population, and, in some countries such USA, changes in how dialysis care is funded (which lead to more hospital-based hemodialysis).

Uldall[34] and Pierratos [35][36] started a program in Toronto, which advocated long night-time treatments (and coined the term 'nocturnal home hemodialysis') and Agar[10] in Geelong converted his HHD patients to NHHD.

Both the B Braun and the Fresenius Baby K require a separate reverse osmosis water treatment system which allow dialysate flow rates generally from 300 to 800 ml/minute.

When changing from a 3x/week to a 6x/week schedule, if total weekly time is left the same (each session length cut in half), patients typically will still remove a little bit more waste products initially than with conventional schedules, since the blood levels of toxins during the initial hour of dialysis are higher than in subsequent hours.

Because of the long weekly dialysis time, fluid removal is very well controlled, as the rate of ultrafiltration is quite low.