As dialysis units overflow, nephrologists in Hyderabad advocate expansion of peritoneal home-based dialysis

Government dialysis units in Telangana are full, with rising patient numbers every year. Experts now recommend home-based peritoneal dialysis (PD), which can be done at home and offers more access for rural patients. A new policy paper supports this shift

Hyderabad: In Hyderabad and districts of Telangana, the Government-run haemodialysis (HD) units at Osmania General Hospital, Gandhi Hospital, Kakatiya Medical College and Nizam’s Institute of Medical Sciences (NIMS) are perennially full, leading to long waiting lists of chronic kidney patients who need dialysis but struggle to afford it in private sector.

Access is even more difficult for kidney patients who live in remote locations and struggle to visit a local Area Hospital for dialysis sessions. Furthermore, every year, close to 2 lakh new kidney patients are added to the existing patient load, making dialysis accessibility even more difficult.

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To address these inherent challenges and limitations in haemodialysis, senior nephrologists from Hyderabad and across the country, in a recent policy paper published in the Kidney International Reports open-access journal of the International Society for Nephrology (ISN) (September, 2025), have advocated for large-scale expansion of home-based peritoneal dialysis (PD), which will ensure immediate access to life-saving dialysis for patients.

“Peritoneal dialysis is a home-based therapy. All haemodialysis (HD) units are running full. Moreover, HD needs significant space, water and electricity. Each year, 2 lakh new patients need dialysis in addition to the existing patients. Hence, opening more HD units alone will never be enough. India definitely needs peritoneal dialysis alongside HD, both must complement each other,” says Prof and Head, Nephrology, OGH and co-author of the paper, Dr Manisha Sahay.

Peritoneal dialysis is an alternative to haemodialysis that can be performed at home. It offers greater flexibility and independence to the kidney patients, since dialysis can be done at home, at work or even while travelling.

“PD offers India a powerful, decentralised opportunity to achieve equitable and sustainable kidney replacement therapy for both adults and children. Scaling up PD in India is both necessary and achievable. A centrally coordinated but locally adaptable strategy, backed by data, political commitment, and sufficient funding, can ensure that PD is not only available but also accessible and acceptable across all parts of India,” the policy paper, whose first author is noted senior nephrologist in the country, Dr Vivekananda Jha, said.

Dr Sahay points out that peritoneal dialysis is a powerful tool that empowers kidney patients. “Scaling up PD in India is achievable. This policy paper strives to provide a practical roadmap for all the Indian States on how to implement PD in a sustainable way,” says Dr Manisha Sahay.

· Government-run haemodialysis units are perennially full, creating long waiting lists

· Every year, 2 lakh more kidney patients are added to existing load

· This is overwhelming existing Government-run haemodialysis units across India

· Regular access to haemodialysis for patients in remote locations is becoming difficult

· Expansion of home-based peritoneal dialysis offers greater flexibility to patients

· PD empowers patients and a combination of PD and HD is ideal