Dialysis (frequency and length) and measures of health function are usually associated with adherence for in-patient services for patients with kidney failure. Adherence expectations specific to home dialysis are not reported in the literature. Home dialysis offers autonomy and flexibility for patients, whilst at the same time is closely monitored by specialist nurses. A preliminary qualitative investigation was conducted to understand how renal nurse practitioners construct adherence for patients undergoing home dialysis. Semi structured interviews were recorded, transcribed and analysed following principles of thematic analysis. Thematic analysis indicated that markers of adherence were biological or behavioural. Factors contributing to nonadherence were mental health, social, health, and system related. Adherence was found to be dynamic, and decisions about when to intervene were reported as individually determined. The patient/nurse relationship was found to be integral to notions of adherence in home dialysis. The nurses’ role was seen to be evolving and responsive. Further investigations of converging patient and nursing constructions of adherence are needed to determine if these preliminary findings are an indication that policies and procedures should recognize adherence as dynamic and grounded in the nurse-patient relationship.