A leaflet appeared in my dialysis unit this week asking patients to take part in a survey about home haemodialysis. The researchers want to understand why some people choose home treatment and why others do not.

It is a worthwhile question. Home haemodialysis has many advantages. People can dialyse on their own schedule, avoid travelling to a unit, and often have greater flexibility in how they organise their treatment.

But as I looked at the leaflet, sitting in my dialysis chair, I realised something important: I do not want dialysis at home.

That does not mean I think home dialysis is a bad idea. For many people it is life-changing. But it is not what I want for my life.

One reason is simple. Home is where I escape dialysis.

Three times a week I travel to the dialysis unit. I sit in the chair. The machine does its work. Then I leave. When I walk through my front door, dialysis stays behind. My home is still my home.

If the machine were in my house, that boundary would disappear. A room would become a treatment space. Supplies would need to be stored. The reminders of kidney failure would be impossible to ignore.

There is another reason, too: movement.

On dialysis days I walk to and from transport, around the unit, and generally get more steps than I would if treatment happened entirely at home. Living with kidney failure already encourages inactivity. Home dialysis might be more convenient, but for me it could also mean becoming more sedentary.

I value the routine of leaving the house. I value seeing other people. I value the separation between treatment and everyday life.

There is also reassurance in knowing that nurses are nearby. After nearly eight years on dialysis, I understand my treatment well. I participate actively in my care. Yet there is still comfort in knowing that if something goes wrong, help is only a few steps away.

Perhaps the biggest reason, however, is psychological.

Chronic illness already occupies enough space in my life. It affects what I eat, what I drink, where I travel, and how I plan my week. I am not eager to give it a permanent place in my home as well.

For some people, home haemodialysis represents freedom. For me, freedom means something slightly different. It means having a place where I can be a husband, a writer, an organist, a reader, and an occasional cat servant—without a dialysis machine humming in the background.

Home haemodialysis is a good option. It is just not my option.

And that is okay.