I was diagnosed with Kidney Disease in July 1997. Ours was a middle class family. Both my parents had their entire lives' savings wiped out in the first few years of my being diagnosed with Kidney Disease. I started working part time only after I switched to PD in 1999. Effigent happened in 2000. For the first few years of Effigent, I drew only a nominal salary.
I started doing Daily Nocturnal Home Hemodialysis in May 2006. NephroPlus was not started until December 2009. I hadn't even met Vikram.
So I got onto Home Hemodialysis when our financial condition was still precarious. Well, it was not like we couldn't make ends meet. We had money for the basics of life. Not a whole lot more.
But despite all this we could make it work. My mother took a bank loan for the HD machine. We dug into our finances for the RO and so on and got started.
The point I am trying to make is that you don't really need to be stinking rich to be on home hemo. You do need guts though. To undergo a therapy which only a very small number of people are doing requires some courage. But hey, if I could do it thirteen years ago when home hemo was only something you read about on the internet, with all the advancements that have happened since then, it should almost be a piece of cake now!
One major challenge that you associate with hemodialysis is averted to a large extent if you do more frequent, long duration dialysis at home. That way, since the fluid weight gain is not a whole lot, you are removing fluid at a low, gentle rate and that reduces the chances of any complications while on dialysis.
Yes, you do need a good technician. This is true for India. At least in my experience, I find it easier to do home hemo if you have a tech supporting you. This could be a family member as well. The trouble though is that training for home hemo is practically non-existent in India. In such cases, techs are ideal. They like the extra money. You get the comfort.
You can also get all the consumables on your own and manage the entire process end to end on your own. If you do that, the cost is going to probably be around the same as that you are paying in the centre, give or take.
There are companies that provide home hemodialysis. If you don't want to take the hassle of managing the entire process yourself, this could be useful. You may not even need to pay upfront for the machine. Everything is taken care of for you by them.
But if you have it in you to manage everything on your own and can put in a small initial investment, then home hemo can actually cost about the same as your neighbourhood dialysis centre. You need the courage. It is possible though.