When eGFR drops below 60 sustained, or there is significant protein in the urine. Earlier referral improves outcomes.

Not always. Conservative management is an option for some patients. Dialysis (centre or home) and transplant are the main treatment paths.

Acute injury can recover. Chronic disease is usually progressive but can be slowed significantly with blood-pressure and glucose control.

No. Dialysis sessions are not painful, although needling the fistula causes brief discomfort. Sessions last 3–4 hours, three times a week typically.

Eligibility depends on age, comorbidities and donor availability. We assess and refer to transplant centres for compatible patients.

Yes. Peritoneal dialysis at home is available for suitable patients with full training and 24/7 telephone support.