The first call most families make after dialysis starts is for "a nurse". What most of them need is an attendant, with a nurse on the days there is a clinical task. The difference between the two, over a year of dialysis, is a large share of the household's care bill, so it is worth getting right in the first week rather than the third month.
The short answer
A dialysis patient who walks, eats, takes tablets and has a working fistula needs a trained attendant: someone for the escort to the centre, the hours after the session when blood pressure is low, the fluid chart, the renal meals and the daily weight. A nurse comes in for injections such as erythropoietin, for dressings, and full time only when the patient has a dialysis catheter, a new fistula, peritoneal dialysis, a recent transplant, or diabetes with a wound.
The cheapest good arrangement is attendant shifts on dialysis days only, three times a week, with the family covering the other four. Using the EzyHelpers home nursing cost guide, that is ₹800 to ₹1,200 a 12-hour shift, against ₹1,200 to ₹1,800 for a nurse on the same shift. Over a month of thirteen dialysis days the gap is real money, and the attendant is the right person for the work anyway.
What an attendant does, and costs
A trained attendant for a dialysis household weighs the patient each morning and before leaving for the centre, records blood pressure, counts every cup of fluid against the nephrologist's limit, cooks or supervises the renal diet, gives tablets on time with the phosphate binders at meals, escorts the patient across Bangalore traffic, and stays with them through the evening when cramps, dizziness and low blood pressure follow a session. They keep the fistula arm free of cuffs and tight sleeves and check the site after each session. They keep a handover log the family takes to the unit.
The September 2026 EzyHelpers home nursing cost guide lists a trained attendant at ₹800 to ₹1,200 for a 12-hour shift, ₹18,000 to ₹26,000 a month for a daily 12-hour arrangement, and ₹24,000 to ₹34,000 a month for a live-in attendant. Placement takes three to seven days, because the attendant is matched on renal experience and on the language the patient speaks.
What a nurse does, and costs
A GNM or B.Sc nurse does the work an attendant is not trained for: erythropoietin and insulin injections, catheter exit-site dressings, wound checks and dressings, the vitals a nephrologist wants read properly, and, for peritoneal dialysis, bag exchanges under the PD unit's protocol. A renal-experienced nurse also recognises the fluid overload and high potassium signs that send dialysis patients to emergency, and calls 108 first and the family second. EzyHelpers does not perform haemodialysis and does not supply a machine; the nurse works around the dialysis, never in place of it.
The same guide lists a nurse home visit at ₹600 to ₹1,200, a nurse 12-hour shift at ₹1,200 to ₹1,800, 24-hour nurse cover in two 12-hour shifts at ₹2,200 to ₹3,000 a day, and a live-in nurse at ₹35,000 to ₹55,000 a month. A visit can usually be booked for the next day; shifts need 48 hours' notice.
The five situations that move a household to nurse level
A dialysis catheter (a permcath or a temporary line) needs a nurse for the exit-site dressing, because an infected line is a hospital admission. A new fistula in the six to twelve weeks it takes to mature needs the thrill checked and the arm watched by someone who knows what a failing fistula feels like. Peritoneal dialysis, with three or four CAPD exchanges a day of 30 to 40 minutes each, needs a nurse trained by the PD unit for the first weeks at least. Transplant recovery, where the immunosuppressants are taken twelve hours apart and the first infection has to be caught the day it starts, needs nursing for the first month. Diabetes with a foot wound or an ulcer needs the dressing and the sugars managed by the same person. Outside these five, an attendant plus nurse visits usually covers it. The nurse for a dialysis patient page goes through each in detail.
Four monthly budgets
All four use the EzyHelpers home nursing cost guide ranges and a thirty-day month with thirteen dialysis sessions where haemodialysis applies. They cover the caregiver only.
A stable haemodialysis patient with attendant shifts on dialysis days: thirteen shifts at ₹800 to ₹1,200 comes to ₹10,400 to ₹15,600. Add two nurse visits for injections at ₹600 to ₹1,200 each, ₹1,200 to ₹2,400. Caregiver total ₹11,600 to ₹18,000.
An elderly diabetic on haemodialysis with a live-in attendant and weekly nurse visits: the live-in attendant is ₹24,000 to ₹34,000. Four nurse visits for insulin review, vitals and any dressing at ₹600 to ₹1,200 each add ₹2,400 to ₹4,800. Caregiver total ₹26,400 to ₹38,800.
A new CAPD patient with a daily nurse visit for the first month, then a live-in attendant: thirty nurse visits at ₹600 to ₹1,200 is ₹18,000 to ₹36,000 in month one, while the family learns the exchanges under the PD unit. From month two, a live-in attendant at ₹24,000 to ₹34,000 with two nurse visits a month at ₹1,200 to ₹2,400 together, ₹25,200 to ₹36,400.
The first month home after a kidney transplant: 24-hour nurse cover for two weeks at ₹2,200 to ₹3,000 a day is ₹30,800 to ₹42,000. A day nurse for the remaining sixteen days at ₹1,200 to ₹1,800 a shift is ₹19,200 to ₹28,800. Caregiver total ₹50,000 to ₹70,800, and most families step down to an attendant in month two.
How the dialysis bill compares
Bangalore hospital and dialysis-chain price guides updated in 2025 and 2026 put haemodialysis at ₹750 to ₹5,000 a session across the city, averaging roughly ₹2,300 to ₹2,900: ₹500 to ₹1,500 at a government or district hospital and free for BPL card holders under the Pradhan Mantri National Dialysis Programme, ₹1,500 to ₹2,500 at a standalone centre, ₹1,500 to ₹3,500 at a private corporate hospital and up to ₹4,000 or more at premium hospitals. At two to three sessions a week that is ₹24,000 to ₹50,000 a month, before ₹3,000 to ₹10,000 for medicines and injections and ₹2,000 to ₹5,000 for blood tests. CAPD consumables run ₹20,000 to ₹40,000 a month. Set those against the first two budgets above and the caregiver is usually the smaller line, which is why paying nurse rates for attendant work is the mistake that hurts. The dialysis patient care cost guide has the full table, including home haemodialysis and the Karnataka schemes.
What changes the caregiver price
Language comes first. A patient who cannot tell the caregiver they feel faint is not safe, so a Kannada, Tamil, Telugu or Malayalam speaker with renal experience sits at the upper end of the range and is worth it. Renal ward or dialysis unit experience is the second driver for nurses. Nights cost more than days, and 24-hour cover is two people, not one. A replacement policy matters more than the headline rate: if the match is wrong, EzyHelpers replaces the caregiver rather than asking the family to wait it out, and that should be stated before the first shift, not negotiated after.
Questions to ask any agency
Ask how the nurse's registration and the attendant's identity were verified, and whether you can see the documents. Ask what happens if the caregiver does not turn up on a dialysis day, and who covers. Ask what the replacement policy is in plain words. Ask what the nurse will not do: a straight answer is that they will not run a dialysis machine, change a prescription or a fluid limit, insert a PD catheter, or cannulate a fistula outside a dialysis unit's own home haemodialysis programme. An agency that promises more than that for a nurse in a home is promising something it should not. The general home nursing cost guide covers the same questions for non-renal patients.
Why the quote follows an assessment
Two dialysis patients with the same schedule can need different people. One has a fistula, walks, and lives with a daughter who works from home; he needs thirteen attendant shifts a month. The other has a catheter, insulin and a foot ulcer, and lives alone; she needs a daily nurse. A menu price would either overcharge the first family or send the second an attendant who is out of his depth. EzyHelpers asks about the access, the dialysis type, the other conditions and who is home, then quotes the caregiver rate on the same call, for free. The kidney and dialysis care at home page describes what the caregiver does between sessions once the match is made.