Haemodialysis and kidney failure: the state programme, transplantation and travel

What is dialysis and how do its two types differ?

The kidneys clean the blood of metabolic waste and excess fluid and keep the body's salt and acid-base balance. When their function declines so far that they can no longer do this, dialysis takes over part of the work. In haemodialysis, the patient's blood passes through a machine, the "artificial kidney", is cleaned by a filter and returns to the body; this usually takes place at a dialysis centre several times a week, in sessions lasting several hours. It requires vascular access: a fistula, a graft or a catheter.

Peritoneal dialysis uses the lining of the abdominal cavity, the peritoneum, as a filter: a special solution is introduced into the abdomen through a catheter and, after a set time, drained out together with the waste. Patients or family members often carry out this method at home, after training. Which method suits a particular person better depends on many medical and everyday factors. The only treatment that removes the need for dialysis is a kidney transplant, but it is not suitable for everyone and also raises the question of a donor.

Who is included in the state dialysis programme?

In the 2026 state healthcare programmes, dialysis is in Annex 15, under the programme "Dialysis and Kidney Transplantation" (programme code 27 03 03 04). The programme's aim is to maintain and improve the condition of people with end-stage kidney failure; it is run by the National Health Agency, and its 2026 budget is 52 million GEL.

The programme has two groups of beneficiaries. Permanent beneficiaries are Georgian citizens with end-stage kidney failure and/or who have received an organ transplant, as well as other persons held in penitentiary institutions, even if they have no official identity document. Temporary beneficiaries are patients with an acute kidney diagnosis who still need dialysis after their hospital stay ends.

Acute kidney failure: the 90-day rule

A temporary beneficiary receives dialysis after hospitalisation for no more than 90 days from the onset of the acute kidney injury. If kidney function has not recovered within this period, the patient becomes a permanent beneficiary. For the family, this means dialysis must continue without a break after discharge from hospital: before discharge, confirm at which centre and from which day.

Enrolment in the programme is through a non-materialised voucher, meaning the family does not receive a paper voucher: the provider centre notifies the agency of the case electronically. If the notification is made more than 24 hours after the service started, the centre is only paid from the day of notification; this is the centre's obligation, but it helps to know why you are asked for documents on the very first day. The rules for registering beneficiaries and transferring between centres are approved by the agency in agreement with the Ministry.

What does the programme cover, and how many sessions?

The table is based on Annex 15 of Government Resolution No. 655 of 2025. The tariff is the amount the state pays the centre; a programme beneficiary receives dialysis as state assistance.

The 157-session limit often raises questions. The programme states directly: if an additional session becomes necessary during the year in line with the national clinical guideline, the provider carries it out free of charge. In other words, the limit restricts the centre's payment, not the patient's treatment. Likewise, when delaying dialysis would put life at risk, for example with a sharp rise in potassium, severe metabolic acidosis or respiratory failure caused by fluid overload, connection to the machine must happen without delay.

Switching method, from haemodialysis to peritoneal dialysis or the other way round, happens without obstacles when a medical indication is presented. If the centre refuses, ask for the refusal and its grounds in writing.

Dialysis equipment, supplies and medicines are bought centrally under the Law on Public Procurement; in 2026 this component accounts for almost half of the programme budget, 24.5 million GEL. The supplies are handed over to programme providers free of charge according to need, and centres report monthly to the agency on their use. This means the patient should not have to buy solutions, filters or other consumables separately. With peritoneal dialysis, when you take supplies home, keep a record of the quantities received and the expiry dates, and inform the centre immediately if anything runs short.

Starting dialysis: what to sort out in the first weeks?

Starting dialysis often comes unexpectedly, and the family faces medical, financial and everyday issues all at once. The list below brings together the organisational steps that cost the most if they are put off:

• Confirmation of registration. Ask the centre whether it has notified the agency of your case and from what date the service counts under the programme.
• Session schedule. Agree the days and times in writing, especially if you work or study; ask about the rules for changing the schedule at the same time.
• Plan for vascular access. If dialysis started with a temporary catheter, ask the doctor when and where permanent access is planned, because its cost is included in the programme.
• Copies of documents. Keep the discharge summary, Form 100 and the latest test results in one folder and in digital form too; you will need them all together when changing centre, travelling or being assessed for a transplant.
• Transport and the family budget. Find out at City Hall whether the municipality has a transport or one-off assistance programme, and if the family is considering social assistance, the assessment rules are explained in the social status guide.
• The question of a transplant. Ask the nephrologist early whether a transplant is being considered in your case and what tests the assessment requires, so that the family can think about a donor in good time.

What role do Universal Healthcare and the municipality play?

The dialysis programme covers outpatient, long-term dialysis, but a person with kidney failure also has other medical needs: hospitalisation, cardiovascular complications, operations, tests. This part is funded under the general rules, mainly by Universal Healthcare, with the co-payment for your category. Kidney replacement therapy in acute kidney failure also appears in Universal Healthcare inpatient services, where the cost of a dialysis session is recorded as a separate item. How the co-payment is calculated is explained in the Universal Healthcare guide, and for medicines not included in the dialysis programme, see the medicines funding guide.

A hard everyday side of dialysis is transport: getting to the centre several times a week is a large expense in the regions. Some municipalities cover this through a social programme. For example, Martvili Municipality's 2025 budget provided registered residents on dialysis with 750 GEL per quarter, 3,000 GEL a year, for transport to the centre. The amount and conditions of such assistance change every year and from one municipality to another, so check the current year's rules with your City Hall; how to search is described in the municipal assistance guide.

Kidney transplant: in Georgia or abroad?

In Georgia, kidney transplant surgery is funded by the same programme, at actual cost but up to a maximum of 20,000 GEL. This is a planned inpatient service: to have the patient recognised as a beneficiary, Form No. IV-100/a, a copy of the ID, a cost estimate where needed and a completed application are submitted to the agency, after which the agency issues a approval letter. Under the general rules of the programmes, the approval letter must be issued within 10 working days of the application at most, or the applicant must be informed in writing of the circumstance preventing it.

Removing an organ from a living donor in Georgia requires consent established by law. Under the new Law "On Human Organ Transplantation", in force from 1 September 2026, every living donation, including of a kidney, needs the consent of the Living Donation Commission and of a court, and the donor must be the recipient's relative, spouse or a person close to them. Check the practical procedure and timescales with the transplant centre. The general route for organ transplants is described separately in the organ transplantation guide.

When a transplant is planned abroad

Families usually consider a foreign centre when they have a related donor and want to benefit from a particular centre's experience, or when the medical team recommends involving another centre in a complex case. Bear in mind that many countries require strict proof of kinship between a foreign donor and recipient: in India, for example, permission from a special committee and confirmation from the embassy are needed, as described in the India guide. State co-funding for the cost of an operation abroad is considered individually, through the referral commission; the rules for this route are explained in the guide to funding treatment abroad.

After you return, continuity of medicines is important. The programme provides immunosuppressive medicines to Georgian citizens who have received an organ transplant, on a facility's prescription and through a pharmacy. Before you leave, find out how a patient operated on abroad is enrolled in the medicines component and what document this requires, so that your supply does not run out on the day you return.

How to plan dialysis when travelling abroad?

People on dialysis are not barred from travelling, but every session has to be booked in advance at a foreign centre, which needs a free place and your medical data. The state programme pays providers taking part in the programme, so the cost of sessions abroad usually has to go into the family's own plan; before you leave, ask the agency and your centre what happens to your registration during this period.

1. Choosing a centre and booking a place

   Contact a dialysis centre in your destination city several weeks ahead, give the dates and session frequency, and ask for the price in writing.

2. Preparing the medical package

   Centres usually ask for a nephrologist's report with the dialysis regimen, records of recent sessions, a description of the vascular access, a list of medicines and recent test results, including markers for viral hepatitis and HIV infection.

3. Translation

   The package is needed in English or the language of the country. Dialysis parameters, doses and laboratory units must be rendered precisely in the translation.

4. Medicines and insurance

   Take enough medicines for the trip in their original packaging, with a copy of the prescription. Check how your travel insurance policy treats a chronic condition.

The rules for taking medicines across the border are described in the guide to medicines when travelling. If you need a visa, confirmation from the dialysis centre will also be useful in your visa package; our medical visa service can help with this part. After you return, show the foreign centre's session records to your nephrologist so they can assess the continuity of treatment and changes in your test results.

Documents and funding sources in one table

Locally, you will most often need three documents: Form No. IV-100/a with the diagnosis's ICD-10 code, the discharge summary if dialysis started during a hospital stay, and a copy of your ID. For a foreign centre, we translate Form 100 through our Form 100 translation service, and test results and session records as part of laboratory test translation. A medical document needs an apostille only if an authority in the receiving country asks for one, which you can check with the apostille tool.

Solidaroba.ge does not provide funding and does not represent state bodies. Advocat.Ge lawyers, through our funding search service, prepare applications to the commission and appeal refusals, and in disputes over changing centre or method they can also help on the patient's rights side.

Frequently asked questions about dialysis and kidney failure