Concierge nephrology · UK
Haemodialysis, planned properly — by a consultant nephrologist.
For end-stage kidney failure — with the right access, the right modality, and a transplant work-up running in parallel from day one.
Why patients choose us
- 01
A consultant nephrologist, from the start
Not a satellite unit alone — a named renal physician who plans access, prescription, transplant work-up and long-term care.
- 02
Every modality on the table
Haemodialysis, peritoneal dialysis, home HD, transplant work-up, or a conservative pathway — we help you weigh all four before you start.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What private haemodialysis costs in the UK.
Indicative ranges across our partner units. NHS dialysis is fully funded — most patients keep the NHS pathway and add private consultant oversight. Send the details and we quote firm figures.
In short
A private in-centre session in our network: £280–£450, three times a week, home the same day.
| Service | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| In-centre haemodialysis session (single) | £280–£450 | 4 hours | Same visit |
| In-centre HD (monthly, 13 sessions) | £3,600–£5,800 | 3× weekly | Ongoing |
| Home haemodialysis programme (setup) | £15,000–£25,000 | One-off | 6–12 weeks |
| Home HD running (annual, patient share) | £18,000–£24,000 | Ongoing | Ongoing |
| AV fistula creation (day-case surgery) | £3,500–£6,500 | 90 min LA | Same day |
| Tunnelled dialysis catheter insertion | £1,800–£3,200 | 45 min LA | Same day |
| Nephrology consultation only | £250–£450 | 45 min | Same visit |
Prices vary by unit, by the nephrologist and vascular access surgeon, by session length, and by whether erythropoietin and other consumables are separately billed. NHS in-centre HD costs the health service around £26,000 per patient per year — private cover mirrors that. We come back with a firm quote within one working day.
The problem
The right modality, the right access, the right time to start.
Starting dialysis well changes the whole trajectory. A planned fistula, an honest conversation about home HD versus in-centre versus PD, and a transplant work-up already underway — that is the difference between coping and doing well.
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Not sure it is time?
eGFR alone does not decide it — symptoms, fluid and potassium do. A nephrologist tells you honestly when to start, and when to wait.
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Worried about needles?
Fistula needling stings for a second and can be numbed. Home HD, peritoneal dialysis and buttonhole cannulation all soften the day-to-day.
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Want to work towards transplant?
Living-donor work-up can start before dialysis. Deceased-donor listing runs alongside dialysis — we help you keep that door open.
The journey
From enquiry to long-term care — what happens, in order.
One nephrologist from first message to long-term follow-up — including the transplant work-up.
Phase 1 · Before starting
Access planning, off-stage for you
Phase 2 · On the day
Four hours at the unit
Phase 3 · After
Long-term, and transplant
- 01
Before
You tell us where you are
A short, confidential form. eGFR, symptoms, comorbidity, and whether dialysis has been raised or has already started.
- 02
Before
We come back with a plan
Within one working day: the right modality to consider, access options, transplant work-up and an indicative pathway. If dialysis is not the right next step yet, we say so.
- 03
Before
Vascular access is planned early
An arteriovenous fistula is created 3–6 months before dialysis is expected — the gold standard, and worth the wait. A tunnelled line is used only when time or veins say it must be.
- 04
On the day
Arrival at the unit
Weights, blood pressure, a review with the nephrologist, and needling of the fistula (or a line hook-up) by a trained dialysis nurse.
- 05
On the day
The session itself
Typically 4 hours, three times a week. High-flux membrane, blood flow 300–450 mL/min, ultrafiltration to your dry weight. You can read, work or sleep.
- 06
On the day
Home after the run
A short recovery, weight and BP re-checked, and home the same session. Fatigue for a few hours is normal on new starters.
- 07
After
Long-term care and transplant work-up
Monthly bloods, medication reviews (phosphate binders, EPO, iron, vitamin D), and — for suitable candidates — a full transplant assessment in parallel.
Typical planned start: 3–6 months from fistula creation to first session. Long-term care: indefinite, with transplant the goal for suitable candidates.
When it helps
When haemodialysis is the right step.
The situations we see most, plus the one red flag that means an emergency rather than an appointment.
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End-stage renal failure (CKD 5)
eGFR under 15 with uraemic symptoms, fluid overload or rising potassium — dialysis is the sustaining therapy.
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Failed conservative CKD management
Symptoms breaking through despite diet, medication and fluid limits — a planned dialysis start is safer than a crash landing.
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Bridge to kidney transplant
Dialysis while a suitable living or deceased donor is worked up — many transplants happen from the dialysis chair.
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Failed peritoneal dialysis
Peritonitis, ultrafiltration failure or a lifestyle that no longer fits PD — a switch to haemodialysis is common and safe.
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Acute-on-chronic kidney injury
A sudden worsening on background CKD — sometimes reversible, sometimes the tipping point into long-term dialysis.
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Certain poisonings
Lithium, ethylene glycol, methanol and salicylate overdoses can be cleared by dialysis — an ITU decision, arranged fast.
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Home HD candidate
Motivated patients with a carer and space at home — more frequent dialysis, better bloods, better quality of life.
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Red flag: uraemic emergency
Confusion, pericardial rub, refractory hyperkalaemia or pulmonary oedema mean same-day A&E, not a clinic booking.
Modality options
In-centre HD is not the only option.
What each option on the table actually involves — and which fits which patient.
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In-centre haemodialysis
Three sessions a week, four hours each, in a hospital or satellite unit. The standard NHS and private offer, with the strongest safety net.
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Home haemodialysis
Five to six shorter sessions a week — or nocturnal — done at home with a carer. Better bloods, better blood pressure, more freedom.
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Nocturnal in-centre HD
Longer, slower overnight sessions in a supervised unit — gentler on the heart, useful for patients who tolerate short runs poorly.
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Peritoneal dialysis (CAPD/APD)
Dialysis through the abdominal lining, at home, without needles. Preserves residual kidney function and independence.
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Kidney transplant work-up
Running in parallel with dialysis — bloods, tissue-typing, cardiac and cancer screening — so a donor kidney can be used quickly when it is offered.
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Conservative kidney management
For frail or comorbid patients where dialysis would not add good life. Symptom control, honest conversations, and specialist palliative care.
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AV fistula creation
The gold-standard access — created 3–6 months ahead, matures over 6–12 weeks, with the best long-term patency and lowest infection.
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Tunnelled dialysis catheter
A last-resort access for urgent starts or when veins have run out. Fine short-term, higher infection and stenosis long-term.
Our vetted UK network
A small panel of nephrologists, we picked them.
Consultant nephrologists across central London, the home counties and major UK cities. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every nephrologist in our network.
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Consultant nephrologists with dialysis and transplant experience
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Vascular access surgery by a named consultant, not a rotating registrar
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Home HD training and support for suitable candidates
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Transplant work-up available in parallel from day one
Safety and long-term outlook
What to expect — honestly.
Haemodialysis is a life-sustaining therapy that also asks a lot of the body. Knowing the common intradialytic issues, the long-term risks and the red flags is how you stay well on it.
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Intradialytic hypotension is the commonest issue
A drop in blood pressure during a run affects up to a third of sessions on some patients. Careful dry-weight setting and slower ultrafiltration usually settle it.
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Cramps, nausea and headaches happen
Most often on newer starters or on days with big fluid gains — a sign your prescription needs a tweak, not that anything is wrong with you.
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Fistula and line care matter every day
Feel your fistula thrill daily. Keep tunnelled lines dry and covered. Bleeding, redness or a lost thrill is a same-day call to the unit.
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Infection is the second biggest risk
Line-related bacteraemia runs at 2–4 per 1,000 catheter days — the single strongest reason to move from a line to a fistula when you can.
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Cardiovascular disease is the leading cause of death
Blood pressure, phosphate, fluid gains and lipids are all treated aggressively — because the heart, not the kidneys, is what usually goes.
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Bone and mineral disease creeps in
Phosphate binders, activated vitamin D and sometimes cinacalcet keep the calcium–phosphate axis in range and protect bones and vessels.
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Diet and fluid limits are real
Fluid under a litre a day if you are anuric, potassium under 5.5, phosphate under 1.8 — a dietitian is part of the team from day one.
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Dialysis disequilibrium is rare
A first-sessions phenomenon with headache and confusion — avoided by starting short and gentle. It should not recur once established.
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Red flags after a session
Fever, chest pain, breathlessness, bleeding from the access or a lost thrill are reasons to ring the unit or A&E the same day.
Reading your dialysis notes
Your dialysis review in four parts. Read the last one first.
Whichever unit you dialyse in, the monthly review letter the nephrologist sends you keeps to the same shape.
A quiet reminder
Renal numbers are precise and can read coldly — we translate them for you.
If you would like us to talk you through the letter before your review, just ask.
- 01 Header
Modality, access and prescription
Which modality you are on, what access is in use (fistula, graft, line) and the prescription — session length, blood flow, dialysate, ultrafiltration target.
- 02 Adequacy
Kt/V, URR and dry weight
Numbers the team lives by: Kt/V (target >1.2 per session), urea reduction ratio, and your current dry weight — the anchor for how much fluid comes off each run.
- 03 Bloods
Anaemia, bone and heart markers
Haemoglobin (EPO target 100–120), ferritin, phosphate, corrected calcium, PTH, potassium and albumin — the monthly panel that drives medication changes.
- 04 Impression
Plan, transplant status, next review
Read this first: what changes to your prescription or medication, where you are in transplant work-up, and when you are next seen.
Recognised by major UK insurers
Insurance cover for haemodialysis varies — most policies exclude chronic dialysis and expect the NHS to fund the therapy itself, but consultant oversight, private access surgery and inpatient stays are often covered. We confirm cover before booking.
Frequently asked
Everything we get asked about haemodialysis.
Quick answers on access, cost, home HD, transplant and how much of your life dialysis really takes up.
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How long does a haemodialysis session take?
A standard in-centre session is four hours, three times a week — twelve hours a week on the machine. Home HD is often shorter but more frequent (five to six times a week) or longer and overnight, and the total dose tends to be higher.
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Does haemodialysis hurt?
The needles into a fistula sting for a second or two — most patients numb the sites with a cream beforehand. During the run itself you feel nothing from the dialysis; the commonest bother is a drop in blood pressure, cramps or feeling washed out afterwards.
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AV fistula, graft or tunnelled line — which access is best?
A fistula is the gold standard: best long-term patency and lowest infection, but it needs 3–6 months to be created and mature. A graft is faster but clots and infects more. A tunnelled line is a last resort for urgent starts — safe short-term, riskier long-term.
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How much does private haemodialysis cost in the UK?
Roughly £280–£450 per in-centre session, or £3,600–£5,800 a month for three sessions a week. Home HD is £15,000–£25,000 to set up and around £18,000–£24,000 a year to run. NHS dialysis is fully funded — we help most patients keep the NHS pathway and add private consultant oversight.
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Can I have dialysis at home?
Yes — home haemodialysis is offered by every UK renal centre and expanding under the NHS Long Term Plan. It suits motivated patients with a carer and a spare room, and gives better bloods, better blood pressure and more freedom than in-centre HD.
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What is the alternative to haemodialysis?
Peritoneal dialysis (needle-free, done at home), a kidney transplant (best quality of life and survival), or a conservative pathway with active symptom control — the right choice depends on your health, your priorities and your support at home. A good nephrologist walks you through all four.
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How long can you live on dialysis?
It varies. Five-year survival for older UK patients on in-centre HD is around 40–50%, but younger, fitter patients — especially those who go on to transplant — do far better and live decades. Dialysis is a life-limiting therapy, but many patients live well and productively on it.
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Can I still work and travel on dialysis?
Many do. Nocturnal home HD or a flexible in-centre schedule keeps most people in work. Travel is planned around holiday dialysis — units across the UK and Europe accept visiting patients, and we help arrange it.
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Will I need a transplant later?
For most suitable candidates, yes — transplant remains the long-term goal and dialysis is the bridge. Work-up runs alongside dialysis so a living or deceased donor kidney can be used as soon as one is available.
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When should I go to A&E?
Fever with a line, heavy bleeding from a fistula, chest pain, severe breathlessness, or a fistula that has lost its thrill are all reasons for same-day emergency care — not a clinic call.