The Hidden Costs of Dialysis: From AV-Fistula Setup to Maintenance

 For patients battling chronic kidney disease (CKD), dialysis is often a life-saving procedure—but the financial burden that accompanies it can be overwhelming. While most patients and their families inquire about the per-session dialysis cost in Delhi, few understand the hidden and recurring expenses that can significantly increase the total cost of care.

In this blog, we’ll uncover the lesser-known expenses surrounding dialysis, especially those related to AV-fistula setup, maintenance, medications, and emergency interventions. If you’re looking for transparent, patient-centric care, centers like Epitome Hospitals in Delhi are leading the way by offering affordable yet high-quality dialysis services.

Understanding the Basics: Dialysis Cost in Delhi

The average cost of hemodialysis in Delhi ranges between ₹2,000 to ₹5,000 per session, depending on the hospital, dialysis frequency, and additional support services required (ImpactGuru). With most patients requiring dialysis 2–3 times a week, this translates to a monthly expenditure of ₹24,000–₹60,000—just for the sessions.

What is an AV Fistula & Why It’s Needed?

Before a patient can start hemodialysis, they must undergo a surgical procedure to create vascular access—commonly known as an arteriovenous (AV) fistula. This connects an artery to a vein in the arm, allowing for easy and repeated access to the bloodstream during dialysis.

Benefits of an AV Fistula:

• Long-term reliability

• Lower infection risk compared to catheters

• Better blood flow for efficient dialysis sessions

However, creating and maintaining an AV fistula involves significant medical costs not included in the base dialysis pricing.

Hidden Cost #1: AV Fistula Creation

The initial AV fistula surgery can cost anywhere from ₹10,000 to ₹35,000 in Delhi, depending on the facility and complexity of the procedure (ClinicSpots).

Pre-surgical costs include:

• Consultations and evaluations: ₹1,500–₹3,000

• Ultrasound vascular mapping: ₹2,000–₹4,000

• Pre-op blood tests and cardiac clearance: ₹1,000–₹3,000

This makes the total AV fistula setup cost approximately ₹15,000–₹40,000. Most patients don’t budget for this as part of their dialysis cost in Delhi, but it is crucial and often non-negotiable.

Hidden Cost #2: AV Fistula Maintenance and Monitoring

Once the fistula is in place, regular monitoring and maintenance are essential to prevent blockages or infections. According to Epitome Hospitals, early intervention can prevent costly complications such as thrombosis or failure of the fistula.

Common maintenance costs include:

Service	Approximate Cost (INR)
Monthly ultrasound scans	₹1,000–₹2,000
Anticoagulant medications	₹500–₹1,500/month
Fistulograms or angioplasty	₹10,000–₹25,000
Surgical revision (if needed)	₹15,000–₹30,000

Hidden Cost #3: Emergency Hospital Visits

Dialysis patients are prone to sudden complications such as:

• Hypotension or blood pressure crashes

• Electrolyte imbalances

• Infections (especially with catheters)

• Bleeding from the AV fistula site

Emergency visits or hospital admissions can cost anywhere between ₹5,000 to ₹20,000 per incident, and are typically not covered under regular session fees.

Hidden Cost #4: Medications and Supplements

Dialysis alone isn’t enough. Most patients require a cocktail of medications, including:

• Erythropoietin (EPO) injections for anemia – ₹1,200–₹3,500 per dose

• Iron supplements – ₹500–₹1,000/month

• Calcium & Vitamin D tablets – ₹300–₹700/month

• Phosphate binders – ₹400–₹800/month

• Antihypertensives – ₹300–₹1,000/month

The average monthly medication cost can range from ₹3,000 to ₹7,000, depending on individual health conditions.

Hidden Cost #5: Routine Lab Tests

Monitoring the patient’s overall health during dialysis is essential. Regular tests may include:

• CBC (Complete Blood Count)

• Serum Creatinine & Urea

• Electrolytes (Potassium, Sodium, Phosphorus)

• PTH, Iron Studies, and Lipid Profile

Most patients undergo these every 1–2 months, costing ₹2,000–₹5,000 per cycle depending on the lab or hospital package.

Cost-Saving Options for Dialysis Patients in Delhi

Several avenues can help reduce these hidden costs:

1. Government Programs

Under the Pradhan Mantri National Dialysis Programme (PMNDP), eligible patients can receive free dialysis at empaneled government centers. However, the waiting list is long and AV fistula creation may not be covered.

2. Charitable Trusts and NGOs

Organizations like The Kidney Warriors Foundation and Sankalp India Foundation often provide AV fistula surgeries, medications, and dialysis subsidies for economically weaker sections.

3. Insurance & CGHS/ESIC Schemes

Health insurance plans now cover dialysis under chronic illness packages. Central Government Health Scheme (CGHS) and Employee State Insurance (ESI) beneficiaries can avail dialysis and AV-fistula procedures at empaneled hospitals at subsidized rates.

Why Choose a Reliable Dialysis Center?

The choice of dialysis center can greatly affect your overall expenses and treatment quality. Leading hospitals like Epitome Hospitals in Delhi offer:

• Advanced AV-fistula care

• 24/7 emergency dialysis support

• Regular screening and maintenance protocols

• Transparent pricing and patient education

Such centers not only focus on dialysis sessions but also provide comprehensive care to reduce hidden costs over time.

Final Thoughts: Plan Ahead for Complete Cost Transparency

The dialysis cost in Delhi may initially appear manageable if you’re only considering the per-session fee. But the reality is that the total monthly cost can balloon with AV-fistula surgery, lab tests, medications, and emergency care. Patients and families should plan holistically, not just financially but emotionally, to cope with the long-term nature of CKD treatment.

Choosing a transparent and patient-focused hospital like Epitome Hospitals can make all the difference. By being proactive and aware of the hidden costs, patients can make better healthcare decisions and focus more on healing than bills.