Renal replacement therapy (RRT) is the collective term for treatments that take over when the kidneys have failed: haemodialysis, peritoneal dialysis and kidney transplantation. A fourth path, conservative kidney management without dialysis, is a valid choice for some frail or elderly people.
Choosing between them is a personal decision made over several months in a pre-dialysis or low-clearance clinic, ideally well before treatment is needed, so that a fistula, PD catheter or living donor assessment can be completed in good time.
Conditions this service looks after
- Chronic kidney disease stage 4 and 5 (eGFR below about 30 and 15)
- Kidney failure from diabetes or hypertension
- Polycystic kidney disease approaching end stage
- Glomerulonephritis with progressive loss of function
- A failing kidney transplant
- Severe acute kidney injury that does not recover
Tests you may be offered
- eGFR trend and urine protein: Estimate how soon replacement therapy may be needed.
- Blood count, bone profile, potassium and bicarbonate: Identify complications that need treatment before and during RRT.
- Hepatitis B, hepatitis C and HIV serology: Required before dialysis and transplantation; hepatitis B vaccination is given if needed.
- Vein mapping ultrasound: Plans fistula surgery.
- Cardiac assessment: ECG, echocardiogram and further tests according to risk before transplant listing.
- Tissue typing and crossmatch: For recipient and potential living donors.
Treatments available
- In-centre haemodialysis: Three sessions a week in a unit; suits those who prefer nurse-led care.
- Peritoneal dialysis: Daily home treatment through an abdominal catheter; preserves independence and remaining kidney function.
- Home haemodialysis: More frequent sessions at home after training, where programmes exist.
- Living donor kidney transplant: The best long-term outcome for those who are fit and have an eligible donor; ideally done before dialysis starts.
- Deceased donor transplant: Via the waiting list in your country of residence.
- Conservative kidney management: Symptom control, diet and medication without dialysis, focused on quality of life.
When to ask for a specialist opinion
- Your eGFR has fallen below about 20, or is dropping quickly
- You have been told dialysis is likely within a year
- You have symptoms of uraemia such as nausea, itching, loss of appetite or fluid overload
- A relative or spouse has offered to donate a kidney
- You are on dialysis and want to discuss transplantation or a change of modality
Travelling to Türkiye for this care
Dialysis of either type is lifelong and must be based where you live; moving abroad to begin it is not practical without residency and a permanent unit. What a visit can offer: holiday haemodialysis sessions booked in advance, an education and second-opinion consultation on your options, and living related donor transplantation. Turkish law restricts living donation to relatives up to the fourth degree and spouses, or requires ethics committee approval, and donors are never provided.
Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.
Frequently Asked Questions
Which is better, haemodialysis or peritoneal dialysis?
Survival is broadly similar. The right choice depends on your health, home, work and preference, and you can switch later.
Can I avoid dialysis altogether?
A pre-emptive transplant avoids it if a donor is ready in time. Some older people with other serious illnesses live as long and more comfortably with conservative care.
When should dialysis start?
When symptoms or blood results require it, not at a fixed eGFR. Starting early on numbers alone has not been shown to help.
Can I holiday abroad once on dialysis?
Yes, with planning. Haemodialysis sessions are booked at a unit near your destination and PD supplies can be delivered.