Chronic Dialysis Programme

Patients with end stage kidney disease need dialysis on a predictable schedule for as long as they are on the programme. Predictability is not a convenience. Missed and delayed sessions are one of the largest avoidable causes of hospital admission and death in Nigerian dialysis patients.

Joining the programme means a fixed slot, a named nursing team who know you, structured monthly review of your blood results, and a plan for what happens when something goes wrong.

What joining involves

You will be assessed by the nephrologist, who sets your dialysis prescription: how many sessions a week, how long each one runs, the dialysate composition and your dry weight. Baseline bloods are taken, including hepatitis B and C and HIV screening, which is standard practice in every dialysis unit because it determines machine allocation.

Vascular access is planned. If you already have a fistula we assess it. If you do not, we arrange creation and use a catheter in the meantime.

Ongoing review

Dialysis on its own is not the whole treatment. The programme also manages the complications of kidney failure, which if left alone shorten life considerably.

• Anaemia, treated with erythropoietin and iron, with haemoglobin monitored regularly
• Bone and mineral disorder, managed with phosphate binders and vitamin D analogues
• Blood pressure and fluid balance, reviewed against your dry weight
• Nutrition, with dietary review covering potassium, phosphate, salt, fluid and protein
• Access surveillance, checking the fistula for narrowing or clotting before it fails
• Adequacy of dialysis, assessed against clearance targets rather than assumed

Planning for cost

Dialysis is a long term expense and pretending otherwise helps nobody. Two to three sessions a week, plus medication, plus periodic blood tests, is a sustained cost that families need to plan for rather than meet week by week.

We will set out the cost structure clearly at the point of joining, help you understand what your HMO covers and what it does not, and tell you honestly where the limits of cover fall. Where transplantation is a realistic option, we will discuss it early, because it is usually the better long term answer both clinically and financially.