A few reasons.
Firstly, they absolutely will live for the rest of their life. Guaranteed.
Second, there is usually a disease process in the background that caused the renal failure, and the disease is not confined only to the kidneys. This is not cured, but only partially controlled, by dialysis.
Third, the arteriovenous shunts (access ports) can eventually fail, and there are only so many times and places they can be made.
Fourth, as others have said, it is an incomplete and episodic treatment, as opposed to normal renal clearance which is continuous.
Vaguely (eli5) imagine a pool cleaner or fish tank cleaner). Running non-stop at a low level (excluding issues of power consumption) is a more effective way of maintaining clean water. Dialysis is like running the pool cleaner 4 hours, 3 times a week at full speed and having to add chemicals because it is always starting to turn green by the time it is due for a clean.
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