Nephrocare Health Services Limited is India’s largest dialysis service provider, operating 519 clinics across India, Nepal, the Philippines and Uzbekistan as of September 30, 2025 . The company earns revenue through in-clinic dialysis, off-clinic dialysis solutions, PPP dialysis centres, consumables distribution and international operations. Its services are used by chronic kidney disease (CKD) patients requiring regular hemodialysis, delivered through asset-light, high-efficiency centres integrated with hospitals and state PPP models.

Key Clients & Major Facilities
The company's key clients include private hospitals, state governments under PPP contracts, international health departments and independent dialysis operators. Nephrocare operates 519 centres across 328 cities, including 180 PPP clinics and 259 brownfield centres, supported by greenfield expansion and international subsidiaries in Nepal, the Philippines and Uzbekistan . Facilities include India’s largest integrated dialysis networks and the world’s largest 165-bed dialysis clinic in Tashkent under a USD 75+ million PPP project.

Product Portfolio, Order Book & Execution
Nephrocare provides in-clinic hemodialysis, home hemodialysis, doorstep dialysis (DoC & DoW), PPP dialysis services, consulting, operations management and consumables supply. These services form a critical part of clients’ treatment lifecycle, with recurring, predictable demand. The Uzbekistan PPP contract ensures a minimum of 1,100 patients annually for 10 years, providing long-term revenue visibility . The Philippines acquisitions added 35+ clinics, strengthening order execution and network expansion.

Mergers, Capex & Expansion Plans
The company merged its wholly owned subsidiary NephroPlus Healthcare in 2020 for operational integration and financial strength . It expanded internationally through acquisitions in the Philippines and joint ventures in Saudi Arabia. Future plans include scaling greenfield, brownfield and PPP clinics, deeper expansion in India, and growing the Uzbekistan PPP and KSA JV operations. Its asset-light model reduces heavy capex needs while enabling rapid clinic rollout.

Employees & Banker

As of Sep 30, 2025, the company had 3,448 employees. The Banker to the Company is Citibank Limited, HDFC Bank Limited, The Hongkong and Shanghai Banking Corporation Limited.

MANAGEMENT & VISION

The leadership aims to strengthen Nephrocare’s position as India’s and Asia’s leading dialysis network by expanding domestic and global footprints, especially through PPP models and asset-light clinics. Their near-term growth outlook includes scaling high-margin off-clinic dialysis, increasing international clinics and improving operational efficiency. Long-term targets include deep market penetration in India, leadership in emerging markets like Uzbekistan and the Philippines, and expanding home-dialysis technologies. Funding for planned capex will be arranged through internal accruals, IPO proceeds, and selective strategic partnerships that maintain capital efficiency.

INDUSTRY OVERVIEW

The dialysis services industry is witnessing strong growth due to rising CKD cases, ageing population and diabetes prevalence. In India, government schemes such as PMNDP drive rapid expansion, with 1,609 clinics and over 27 lakh patients treated till 2025 . The Indian dialysis market is shifting from unorganized to organized players, delivering 20–25% growth annually. Globally, the dialysis services market is expanding due to limited access to kidney replacement therapy and rising ESRD cases. In the Philippines, the dialysis market was USD 492.2 million in 2024 and is expected to reach USD 1,361.4 million by 2029 at a CAGR of 22.6% . Nephrocare ranks among the top providers in India and the third-largest in the Philippines.

KEY RISK FACTORS

1. High Dependence on Chronic Patient Flow
   Dialysis requires patients to undergo multiple treatments weekly, so clinic utilisation is critical. Any decline in CKD patient registrations due to clinical, regulatory or market disruptions can significantly impact recurring revenue and capacity utilisation.
2. Reliance on PPP Contracts
   With 180 clinics under PPP models, changes in state reimbursement rates, policy shifts, delays in payments or contract non-renewals can affect profitability and expansion certainty, given the long duration and sensitivity of government partnerships.
3. International Expansion Risks
   Operations in the Philippines, Uzbekistan and Saudi Arabia expose the company to foreign exchange volatility, regulatory differences, compliance challenges and geopolitical uncertainties which may impact margins, asset performance or cash repatriation.
4. High Operational Complexity
   Managing 519 clinics across four countries, employing thousands of medical staff, and maintaining consistent clinical protocols involve execution risks. Any quality lapses, equipment failures or staffing shortages can impact brand trust and compliance.
5. Competition from Global & Local Players
   Nephrocare faces competition from Fresenius, B. Braun, Apollo and other standalone networks. Aggressive pricing, new clinic launches or technology-based home dialysis players could reduce market share or pressure margins.
6. Regulatory & Reimbursement Risk
   Government reimbursement frameworks such as PhilHealth (Philippines) and PMNDP (India) significantly affect pricing and revenue. Changes in coverage limits, audit norms or treatment caps can impact income predictability.
7. Acquisition Integration Risk
   Recent acquisitions in the Philippines and expansion in Uzbekistan require operational synchronization, cultural integration and quality assurance. Poor integration may lead to inefficiencies, cost overruns or slower-than-expected scaling.

KEY STRENGTHS & OPPORTUNITIES

1. Largest Dialysis Network in India
   With 519 clinics across 328 cities, Nephrocare enjoys unmatched scale, improving brand visibility, cost efficiency and patient accessibility, which strengthens recurring patient inflow and long-term market leadership .
2. Asset-Light Business Model
   Over 52% clinics operate on revenue-sharing models requiring limited capital investment, enabling rapid expansion, superior unit economics and higher return on capital versus traditional hospital-led dialysis operations .
3. Strong International Presence
   The company’s 51 clinics in the Philippines and a 165-bed PPP facility in Uzbekistan significantly boost global presence, providing diversified revenue streams and long-term contracted patient volumes under multi-year PPP programs.
4. Recurring & Predictable Revenue
   Dialysis is a chronic, non-deferrable treatment, ensuring consistent patient visits and stable cash flows. Government schemes and insurance-backed reimbursements further strengthen revenue visibility and treatment affordability.
5. Technology & Clinical Protocol Strength
   Standardized treatment protocols, digital patient records, RO water systems and advanced dialysis technology ensure high-quality outcomes, supporting patient satisfaction and retention across clinics.
6. High Growth Opportunities in Emerging Markets
   Rising CKD prevalence, low dialysis penetration and lack of organized providers in India, the Philippines, Nepal and Central Asia present large expansion opportunities through greenfield, brownfield and PPP models.