The first meeting with a home haemodialysis provider or a peritoneal dialysis unit is a sales conversation as much as a clinical one, and families usually leave it having been told what the programme offers rather than having asked what it does when things go wrong. These twelve questions cover the gaps. Take them on paper, write the answers down, and compare providers on the answers rather than on the brochure.
1. Who is the supervising nephrologist, and how do we reach them?
A home programme is only as safe as the doctor behind it. Ask for the nephrologist by name, whether they have seen the patient, and how a problem at home reaches them: a direct number, a duty doctor line, or a message through the technician. A good answer names a doctor who will review the patient before the programme starts and a number that is answered outside clinic hours.
2. Who comes to the house, and how often?
For home haemodialysis, ask who does the installation, who attends the first sessions, and how often a technician visits once the family is running sessions alone. For CAPD, ask whether the unit visits the home at all or whether all follow-up is at the hospital. A clear answer sounds like a schedule: a technician at every session for the first fortnight, then weekly, then on call. A vague answer means nobody has decided.
3. What happens when the machine alarms at 11 pm?
Alarms are routine, and the family will see many. Ask what the trained response is, whether the technician is reachable at that hour, and how long the wait is if they need to come. A good provider hands over a written plan for the common alarms and a number that is answered at night. If the answer is "it rarely happens", ask again.
4. What is the care-partner requirement, and who can be trained?
Every home haemodialysis programme requires a trained care partner present for the whole session. Ask whether that person must be a family member, whether a nurse from outside the programme can be trained instead, and what the training covers. The realistic question for the family is who can be free for three to four hours three times a week for a year. If the answer is nobody, a care-partner nurse is the alternative, and the provider needs to be willing to train her.
5. How is the water treated and tested?
Haemodialysis uses a large volume of water and it has to be purified to a clinical standard, which is what the reverse osmosis unit does. Ask who installs and services the RO unit, how often the water is tested and by whom, and what happens if a test fails. A good answer names a servicing interval, a testing schedule with written results, and a plan to pause sessions if the water is out of range. Anyone who cannot answer this in detail should not be installing a machine in your home.
6. What power backup do we need?
A power cut mid-session is a clinical event. Ask what the machine and the RO unit draw, whether an inverter is enough or a generator is needed, how long the backup must last, and whether the provider inspects the set-up before the first session. Expect a specific answer in terms of the equipment, not a general reassurance that Bangalore power is fine.
7. What is included in the price, and what is billed separately?
Home haemodialysis programmes in Bangalore are quoted per session or per month by the provider, with no public list price. Ask for the quote in writing and then ask what is outside it: consumables, the technician's visits, RO servicing, blood tests, the initial plumbing and electrical work, and what happens if the machine needs a replacement part. For CAPD, ask the unit what the monthly consumables come to and whether delivery is included. Bangalore hospital and dialysis-chain price guides updated in 2025 and 2026 put CAPD consumables at ₹20,000 to ₹40,000 a month and automated PD at up to about ₹1,00,000 a month, which is a useful sanity check on the quote.
8. How are emergencies handled, and at which hospital?
Ask which hospital the programme sends a patient to, whether that hospital knows the patient is on home dialysis, and who calls the ambulance. In Bangalore the government ambulance is 108. A good answer names the hospital, confirms the nephrologist has admitting rights there, and says plainly that the care partner calls 108 first and the unit second for a collapse, chest pain or bleeding that will not stop.
9. How is training done, and how long before the family runs a session?
Ask how many supervised sessions the family or nurse gets, whether there is a written checklist and plan for the patient, and how the provider decides the care partner is ready. For CAPD, ask how many days of training the unit gives and whether it retrains after a peritonitis episode. A good answer has a number of sessions and a sign-off step; a bad one is "it depends on how quickly you pick it up".
10. What are the exit criteria?
Every home programme should be able to say when it sends a patient back to the centre: blood pressure that will not hold on dialysis, repeated access problems, a care partner who is no longer available, or a home that can no longer meet the water or power requirements. Ask directly. A provider with clear exit criteria has thought about safety; one without them has thought about enrolment.
11. What do insurance and government schemes cover?
Recurring dialysis reaches insurance caps faster than one-off surgery does, so ask the insurer for the per-year limit before signing with a provider, and ask the provider whether their invoices are accepted for reimbursement. On the public side, the Pradhan Mantri National Dialysis Programme provides free haemodialysis for BPL card holders at district hospitals and reduced rates for others, Ayushman Bharat-Arogya Karnataka has been extended to peritoneal dialysis, and in September 2025 the Karnataka government ordered a pilot of free peritoneal dialysis at home for 350 patients identified by district nephrologists, about ten per district. Whether your patient qualifies is a question for the nephrologist, and it is worth asking before the private quote is accepted.
12. How does the provider work with an outside nurse as care partner?
If a family member cannot be the care partner, the practical route is a GNM or B.Sc nurse trained on the patient by the provider's unit. Ask whether the provider has done this before, whether they will train the nurse alongside the family, and whether the nurse can sign the session log. The answer should be yes to all three. EzyHelpers supplies that nurse; it does not supply the machine, the technician or the nephrologist, and it books the nurse only once the family has chosen a provider and has a start date.
What the answers tell you
Write the answers next to each question and read them back the same evening. A good provider will welcome all twelve, because a family that understands the programme is the family that runs it safely. A vague answer to the emergency question or the water question is a reason to walk away, whatever the price. Once you have chosen, the kidney and dialysis care page covers the nursing and attendant support that sits around any of the three options, and nurse shifts can be booked with 48 hours' notice.