Breathlessness at rest, chest pain, or drowsiness in kidney failure are emergencies. Go to hospital now. Fluid overload and high potassium can be rapidly fatal. Also seek urgent care if you have missed dialysis sessions and feel unwell.
The kidneys can no longer clear waste or balance fluid, and life depends on dialysis or a transplant. Transplant is better than dialysis on almost every measure that matters — survival, energy, diet, and freedom.
One thing is worth knowing early: a transplant performed before dialysis has begun generally does better than one performed after years on it. If your kidney function is falling, this conversation should start now rather than later.
Chronic kidney disease is staged from one to five by the estimated glomerular filtration rate. Stage five, below fifteen, is end-stage — the kidneys can no longer sustain life unaided.
The commonest causes worldwide, and across the countries our patients travel from, are diabetes and high blood pressure. Glomerulonephritis, polycystic kidney disease, obstruction and repeated infection account for much of the rest. In some patients no cause is ever identified because the kidneys are already too shrunken to biopsy by the time they are examined.
Dialysis sustains life but replaces only a fraction of normal kidney function. Haemodialysis typically means three sessions a week of four hours each, with fluid and dietary restriction between them, and it constrains work, travel and family life considerably. Peritoneal dialysis offers more independence but has its own demands.
Transplant is better on almost every measure — longer survival, more energy, fewer restrictions, and a life not organised around a machine. It is not a cure, and it commits you to immunosuppressive medication for life with regular monitoring. But for most patients who are suitable, it is transformative.
A kidney transplant performed before dialysis has started — a pre-emptive transplant — generally gives better graft survival and better patient survival than one performed after years of dialysis. Yet the conversation is frequently delayed until dialysis is well established. If your kidney function is declining and a family member might donate, begin the assessment when your eGFR falls towards twenty rather than waiting for dialysis to become necessary. The paperwork alone takes four to eight weeks, so early planning matters.
Blood tests define the stage; further tests find the cause and prepare for transplant.
Send your creatinine and eGFR with dates so we can see the trend, your urine protein result, the kidney ultrasound, and — most usefully of all — your blood group and the blood groups of any family members who might donate. That single piece of information determines whether a straightforward transplant is possible, whether ABO-incompatible transplant would be needed, or whether a paired exchange should be explored.
Slowing the decline comes first. Transplant is the goal where a donor exists.
Rigorous blood pressure control, medication that protects the kidneys, tight diabetes control, avoiding anti-inflammatory painkillers and unregulated herbal remedies, and treating anaemia and bone disease. Good management can add years before dialysis or transplant becomes necessary.
One kidney from a near relative, usually removed laparoscopically, implanted in the recipient's lower abdomen. Recovery is quicker than most people expect and the results are considerably better than dialysis. Under Indian law the donor must be a near relative with embassy certification and Authorisation Committee approval.
Where the only willing donor has an incompatible blood group, antibodies can be removed beforehand with plasma exchange and medication. Alternatively, two families with mismatched pairs may exchange donors — expressly permitted under Indian law with committee approval. Both open transplant to families who would otherwise have no option.
Haemodialysis three times weekly, or peritoneal dialysis at home offering more independence. It sustains life and is the right answer where transplant is not possible. Good dialysis with proper access, anaemia treatment and dietary support makes a substantial difference to how people feel.
This is the first and decisive question. Without one, transplant in India is not available to a foreign national.
Determines whether a standard transplant is possible or whether ABO-incompatible or paired exchange routes are needed.
Cardiac assessment matters — heart disease is common in kidney failure and is the leading cause of death in these patients.
If no near relative can donate, we will tell you at the outset that transplant in India is not open to you, and help you think about optimising dialysis instead.
Fluid overload and high potassium are emergencies treated by dialysis where you are. Transplant planning resumes once you are stable.
Photographs taken on your phone are fine. Reports in Arabic, Russian or Bengali are fine — we translate them ourselves.
On almost every measure, yes — longer survival, considerably more energy, far fewer dietary and fluid restrictions, and a life not organised around a machine. It is not a cure and it requires immunosuppressive medication for life with regular blood tests. But for most suitable patients it is transformative rather than merely preferable.
No. A transplant performed before dialysis begins generally does better for both the kidney and the patient. If your kidney function is declining and a family member might donate, start the assessment as your eGFR approaches twenty. The embassy paperwork alone takes four to eight weeks, so early planning is practical rather than premature.
Often yes, by two routes. ABO-incompatible transplant removes the recipient's antibodies against that blood group beforehand with plasma exchange and medication. Alternatively, paired exchange between two families with mismatched pairs is expressly permitted under Indian law with committee approval. Both add cost and time but they open transplant to families who would otherwise have none.
Kidney donation is generally safe and most donors return to normal life within weeks, usually after laparoscopic surgery with a short hospital stay. It is not risk-free — it is major surgery on a healthy person — and donors need lifelong monitoring of their remaining kidney. Your brother will be assessed independently and may withdraw at any time without explanation.
Living donor kidneys commonly function well for fifteen to twenty years or more, and often longer where the donor is a well-matched relative and the recipient takes immunosuppression reliably. The commonest reasons for earlier failure are rejection from missed medication and recurrence of the original disease.
The kidney will be rejected, frequently irreversibly, and you may return to dialysis permanently. Immunosuppression is lifelong and non-negotiable, along with regular blood tests to check drug levels. Before you travel home we make sure the medication is available where you live and that a local doctor can monitor it — that arrangement is part of the treatment.
Send your creatinine and eGFR with dates, and — most useful of all — your blood group and those of any family members who might donate.
Your reports go directly to our medical team. We do not share your records with hospitals until you tell us to.
WhatsApp +91 83035 86344 · Phone +91 83035 86344 · Email tibhind@gmail.com
Coordinators available 9:00–20:00 IST. We speak Arabic, English, Russian and Bengali.