I'd really like to learn more about the barriers you specified. It's possible that these are not real barriers, but there is a lack of information that prevents people from offering/doing home dialysis.
Professionals may be reluctant to promote home dialysis and patients may be nervous about doing home dialysis because of the possibility of complications. However, complications can happen in-center as well and staff in-center may have 4 or more patients to provide care to whereas at home there is 1 care partner to 1 patient and both get similar training to what a technician has. If home training is done well by an experienced home training nurse, a home trained patient and/or his/her care partner should know how to handle most complications. Also, dialysis clinics are supposed to provide 24/7 support to home patients, which includes someone who can answer questions about complications if the patient/care partner doesn't know what to do or has forgotten.
Can you be more specific about machines being a barrier? CAPD doesn't use a machine. When a machine is used for home HD or PD, that equipment is provided by the dialysis clinic and billed to Medicare and/or other insurance. Home training nurses teach patients how to use the type of machine that they will be using at home, including how to handle alarms and malfunctions and patients can call the machine manufacturer for technical assistance.