Kidney failure is frightening. Understanding it helps.

Dialysis does the part of the kidneys' job that keeps you alive: it removes waste products and excess fluid from the blood, and helps keep salts such as potassium in a safe range. In haemodialysis, blood is pumped out through a filter and returned. In peritoneal dialysis, the lining of your own abdomen is used as the filter and fluid is exchanged through a soft catheter. The honest limit, in the words of the US National Institute of Diabetes and Digestive and Kidney Diseases, is that dialysis "can replace part, but not all" of your kidney function, which is why diet, fluid limits and medicines are still needed alongside it.

Modern guidelines say the decision is driven by symptoms, not by a number on a blood test. The IDEAL trial (New England Journal of Medicine, 2010) randomised 828 people to an early or a late start and found no difference in survival or other important outcomes. KDIGO frames the decision as a composite of symptoms, signs, quality of life, preferences and laboratory results, typically when the eGFR is somewhere between 5 and 10; NICE in the UK advises considering dialysis when symptoms of uraemia affect daily living, or at an eGFR of around 5 to 7 if there are no symptoms. The blood test is a warning light, not a starting gun, and the timing belongs to you and your kidney team together.

There are four legitimate paths: in-centre haemodialysis, home haemodialysis, peritoneal dialysis, and conservative (supportive) care, which manages symptoms actively without dialysis. A kidney transplant is a fifth path, but most people need dialysis while they wait for one. NICE guidance (NG107, 2018) says everyone likely to need kidney replacement therapy should be offered a genuine choice, including conservative care. Conservative care is an active treatment decision, not giving up, and for someone who is very old or frail the extra time dialysis buys can be small while the time it costs is real.

Yes, haemodialysis is provided. AMSA Healthcare has managed haemodialysis services in Seychelles since 2015 and describes units at Seychelles Hospital in Mont Fleuri, Mahe (the same site is sometimes called Victoria Hospital) and at Baie Ste Anne Hospital on Praslin. The Ministry of Health's 2023 national survey reported 230 people on haemodialysis in the country. Peritoneal dialysis is not documented as available in Seychelles, and no kidney transplant programme is documented either, so neither should be assumed. Details, capacity and contact numbers change, so confirm anything you plan to rely on directly with the renal unit.

We cannot tell you, and we will not guess. There is no publicly available, authoritative statement of whether the Seychelles renal unit accepts visiting patients, on what terms, at what price or with what lead time, so any figure you find online should be treated with suspicion. What is well established is how to go about asking. Allow at least six weeks, and realistically three months. Your home unit must send your virology status (hepatitis B, hepatitis C and HIV), recent bloods, your full dialysis prescription and your medication list. Ask the host unit, in writing, to confirm that it runs virus surveillance and segregates patients with blood-borne viruses: if it cannot, UK units may treat you as positive on your return and suspend you from the transplant list for six months.

No. Dialysis.sc publishes general education about kidney disease and dialysis. It does not diagnose, it does not give drug doses, and it never tells anyone to change their treatment. Kidney failure is highly individual: the right dialysis prescription, fluid allowance, diet and medicines depend on your blood results, your remaining kidney function and your other conditions, and only your own kidney care team can set them. Use this site to understand your situation and to ask better questions, then take the decisions with the people who know your case.