A dialysis (e.g., hemodialysis or peritoneal dialysis) machine is instantiated with a blockchain application to help safeguard the machine from malicious attacks and provide a reviewable transaction log. The blockchain application may operate on a component level within a single dialysis machine or multiple dialysis machines that collectively operate within a blockchain community. Multiple rules and regulations may be utilized among the dialysis machines or dialysis machine components to ensure authorized instructions alter dialysis machine operations. The verification process can occur, for example, by discrete dialysis machine components verifying the instruction with a remote service or discrete dialysis machines verifying the instruction with the remote service. When a pre-set number of components or dialysis machines verify the instruction and develop a consensus, such as 50%, 75%, 90%, etc., the target component or machine executes the instruction.