There are those who simply want to keep their medical matters out of the house. Blum says that though she could do nocturnal hemodialysis if she wanted to, she does her treatment in the evenings because she doesn't want to bring her medical matters into her and her husband's bedroom.
But the use of at-home machines is largely limited, despite being covered by Medicare and health-care programs, because of personal fears. Some go as far as to think they could "bleed out" in their sleep if they were on nocturnal dialysis.
"There's not enough education," says Berkowitz. "People don't think they can do it."
Lorch, who also runs the at-home nocturnal dialysis program at the Rogosin Center, says it's an entirely safe way to undergo dialysis.
"New York State requires electronic monitoring, so if something goes wrong, there's someone watching. We give it about a two-minute period, and if the alarm hasn't shut off by then, we call them," says Lorch. "If they don't respond we call again shortly after, and if they still don't respond, we call 911. The problem is there's really no incentive for people to do it."
Lorch also believes that physicians are hesitant to suggest at-home treatments because they don't want to lose their patients. In-center dialysis clinics might also have similar motivations, despite the tremendous improvement that has been seen in at-home hemodialysis patients.
Patients who switch to at-home hemodialysis have even reported better general health as a result.
Bill Peckham, 45, of Seattle, says that home dialysis has given him more energy and a clear mentality.
Since starting home dialysis in 2001, Peckham hasn't been hospitalized once, something that occurred relatively frequently while he was on in-center treatment.
"I've been able to cut down on medications," Peckham says. "It's given me more energy and even gotten my blood pressure under control. It's been a dramatic improvement."
He added, "With in-center treatment, you forget what feeling good feels like."