Medically reviewed by the RIIMS nephrology team · Last reviewed: June 2026
Separating fear-driven myths from what dialysis actually involves, when it is needed, and how to prepare with your doctor.
The word "dialysis" scares almost everyone who hears it. For many Indian families, it feels like the end of the road. The moment a report shows a high creatinine or a low eGFR, panic sets in. But most of that fear comes from myths, not facts. Understanding what dialysis actually does (and does not do) helps you make calmer, better decisions with your doctor.
This guide clears up the most common misunderstandings, compares the two main types of dialysis, and explains exactly what reports to carry if you want a second opinion.
What dialysis actually is
Healthy kidneys clean your blood by removing waste products and extra fluid, and they help balance salts like potassium. When kidneys can no longer do enough of this work, waste and fluid build up in the body. Dialysis is a medical technique that removes some of that extra waste and fluid on the kidney's behalf.
It helps to be honest about what dialysis is, and what it isn't:
- Dialysis is not a cure for kidney disease.
- Dialysis is not a full replacement for a working kidney. Real kidneys do many jobs; dialysis only partly does some of them.
- Dialysis supports the body by doing a portion of the kidney's cleaning work when the kidneys cannot.
Think of it as a filter that helps when your own filter is struggling: helpful and often life-supporting, but not the same as having fully working kidneys back.
Myths vs Facts
Kidney disease is surrounded by beliefs that are simply not true. Many of these myths stop people from getting the right test, treatment, and advice at the right time. Here are the ones we hear most often at RIIMS.
| Myth | Fact |
|---|---|
| A high creatinine means dialysis is certain. | Creatinine alone does not decide dialysis. Your doctor looks at eGFR, symptoms, potassium, fluid status, urine output and the full picture together. |
| Low eGFR means you must start dialysis immediately. | A single eGFR number does not trigger dialysis. The decision depends on symptoms and overall condition, evaluated over time. |
| "Dialysis started" means life is over. | Many people live active, working, balanced lives for years while on dialysis. |
| Every CKD patient will eventually need dialysis. | Not true. Many people with kidney disease never need dialysis; early care and control can slow progression. |
| Dialysis can always be stopped permanently. | Whether dialysis is short-term or long-term depends entirely on the cause and the doctor's assessment; it is never something to decide on your own. |
| Hemodialysis and peritoneal dialysis are the same thing. | They work very differently: different location, access, schedule and lifestyle fit. See the comparison below. |
| Dialysis fully replaces the kidney. | It only partly does some kidney jobs. It does not restore full kidney function. |
| You can't travel or work while on dialysis. | With planning and your team's guidance, many patients travel, work and manage daily life. |
| If a report was normal once, no follow-up is needed. | Kidney disease needs regular follow-up and repeat testing over time. |
| You can stop or change your medicines on your own once you feel better. | Never stop or change any medicine without medical advice; it can be harmful. |
The single biggest truth behind all of these: the decision about dialysis depends on many factors together, not on one scary number.
Hemodialysis vs Peritoneal Dialysis
There are two main types of dialysis. Neither is "better" for everyone. The right choice depends on the patient's condition, age, lifestyle, and financial and social situation, decided with the treating doctor.
| Feature | Hemodialysis (HD) | Peritoneal Dialysis (PD) |
|---|---|---|
| How it works | A machine draws blood out, cleans it through a special filter (dialyzer), and returns it to the body. | The body's own peritoneum (the lining inside the abdomen) is used as a natural filter, using a special fluid put into and drained from the belly. |
| Where it's done | Dialysis centre or hospital | Can be done at home |
| Frequency | Usually about 2–3 times a week | Daily fluid exchanges (several times a day, or overnight by a machine) |
| Each session | About 3–5 hours | Continuous / several exchanges through the day or night |
| Access | Fistula or catheter | Abdominal (PD) catheter |
| Lifestyle | Regular travel to a centre; supervised by trained staff | More independence and flexibility; convenient for some patients |
| Common types | Not applicable | CAPD (Continuous Ambulatory PD) and APD (Automated PD) |
| Good to know | Widely available; useful in serious situations under a trained team. | Home-based option; suitability must be confirmed by your doctor. |
Both methods can cause some short-term effects in certain patients (such as low blood pressure, tiredness, muscle cramps, headache, or nausea), and long-term dialysis carries its own considerations like anaemia and bone-mineral changes. These are managed by your medical team; not every patient gets every problem.
When dialysis may be urgent
Dialysis is usually a planned decision. But some situations are medical emergencies where waiting is dangerous. Seek care immediately if there are signs such as:
- Very high potassium, which can cause dangerous heart rhythm problems (may feel like palpitations, severe weakness, or in serious cases collapse).
- Severe fluid overload: significant breathlessness, inability to lie flat, marked swelling.
- Severe uremic symptoms: persistent vomiting, confusion, extreme drowsiness, or hiccups from a heavy build-up of waste.
These are not situations to manage at home or to "wait and watch." Go to the nearest hospital or your nephrologist without delay.
Getting a second opinion: what reports to bring
If you have been told you may need dialysis and want to understand your options, a second opinion is completely reasonable. To make it useful, carry your records so the doctor can assess the full picture rather than a single number. Bring:
- Serum creatinine (recent and any older values, to show the trend)
- eGFR report
- Potassium and other electrolytes
- Blood urea
- Urine output details (roughly how much you pass in a day) and any urine tests
- Blood pressure and blood sugar history (including diabetes records if any)
- Kidney ultrasound (or any imaging done)
- Current advice / prescriptions and notes from your treating doctor
Older reports matter as much as new ones. The direction things are moving in is often more telling than any single reading.
What RIIMS can help with (and cannot promise)
RIIMS was founded by Dr. Abhishek Gupta, whose book Kidney Kavach is built on one simple idea: the right information is the first step to the right decision. In that spirit, here is what we can and cannot do.
We can help you:
- Understand your reports in plain language, without fear or confusion.
- Get a timely second opinion on whether, and when, dialysis is being considered, and why.
- Support your diet and fluid planning alongside your treating team, so everyday choices are clearer.
- Understand both HD and PD so any conversation with your nephrologist feels less overwhelming.
We will never:
- Promise a cure, or "guaranteed" recovery.
- Claim that dialysis can be stopped permanently. Whether dialysis is temporary or long-term is a medical judgement that depends on your specific condition and is made by your treating doctor.
- Ask you to stop or change prescribed medicines on your own.
Dialysis decisions are doctor-led and report-led. Our role is to help you walk into those decisions informed, calm, and supported, because good information and steady follow-up, not fear, lead to better outcomes.
This article is for general awareness and does not replace personal medical advice. Please consult your nephrologist for decisions about your care.
Frequently asked questions
Does a high creatinine or low eGFR mean I have to start dialysis right away?
No. A single number does not decide dialysis. Your doctor considers your eGFR trend, symptoms, potassium level, fluid status, urine output and overall condition together. Many people with abnormal reports never need dialysis, and the decision is made over time, not from one test.
Can dialysis be stopped permanently once it starts?
It depends entirely on the cause and your doctor's assessment. In some situations dialysis is temporary; in others it is long-term. This is a medical judgement made by your treating nephrologist based on your specific condition. It is never something to decide on your own, and no honest clinic can promise that dialysis can always be stopped permanently.
What is the difference between hemodialysis and peritoneal dialysis?
Hemodialysis uses a machine and a filter (dialyzer) to clean the blood, usually 2–3 times a week for about 3–5 hours per session at a centre or hospital. Peritoneal dialysis uses the lining of your own abdomen as a natural filter with a special fluid, and can be done at home with more flexibility. The right choice depends on your condition, lifestyle and doctor's advice.
Can I still work and travel if I am on dialysis?
Yes, many people do. With planning and guidance from your medical team, patients on dialysis can continue working, travel and manage daily life. Dialysis is a support to your body's cleaning function. It does not automatically mean the end of an active life.
When is dialysis an emergency?
Certain situations need urgent hospital care: very high potassium (which can affect the heart rhythm), severe fluid overload causing breathlessness or inability to lie flat, and severe uremic symptoms like persistent vomiting, confusion or extreme drowsiness. If any of these occur, go to the nearest hospital or your nephrologist immediately rather than waiting.
Sources & further reading
- KDIGO (Kidney Disease: Improving Global Outcomes) — Clinical Practice Guidelines
- National Kidney Foundation (NKF)
- KDOQI (Kidney Disease Outcomes Quality Initiative)
- NIH MedlinePlus — Dialysis
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Reference and guideline names are listed for transparency; RIIMS is not affiliated with or endorsed by these organisations.
