Maintenance haemodialysis (HD) was pioneered in Seattle and rapidly became home-based. When dialysis treatment began in Australia and New Zealand, home haemodialysis (HHD) became the predominant form of dialysis. When compared with in-centre conventional dialysis, HHD is associated with superior survival and quality of life and is cheaper. There is currently significant interest in increasing the frequency and duration of dialysis and in providing more flexible dialysis regimens for patients. If the likely benefits of these treatment changes are to be fully realized HHD and self care HD services will need to expand. Dialysis units in Australia and New Zealand are better equipped than most to respond to this challenge.
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