The Karnataka government, thanks to an initiative taken by the State-run Institute of Nephro Urology, has decided to promote peritoneal dialysis as an alternative to haemodialysis for the benefit of the large number of kidney patients. Towards this end, a pilot project will be implemented across the State commencing from November 1.
A meeting of the governing council of the institute is scheduled to be held in Bangalore on Tuesday and is expected to take stock of the new project, apart from various other issues. Chief Minister Siddaramaiah is the chairman of the governing council, and it will be the first time that he will preside over a meeting of the council on the institute premises. Minister of State for Medical Education Sharan Prakash Patil is the vice-chairman.
At a recent meeting of the State Cabinet, it was decided to install dialysis machines in at least one taluk in each of the 30 districts of the State. At present, every district hospital has a dialysis centre comprising around six machines. With the recent decision, there will be at least 12 haemodialysis machines in every district. Manpower training for doctors, nurses and other staff to handle the new machines and conduct the dialysis procedure has been completed by the Institute of Nephro Urology, while the purchase of the requisite machines is being done by the Department of Health.
While a kidney patient has to travel to a hospital (two or three times a week depending on the requirement) to undergo haemodialysis, the peritoneal dialysis can be done at home. The State government has decided to provide financial assistance to the patients undergoing peritoneal dialysis (65 per cent of the cost) while the remaining will have to be borne by the patient.
Director of the Institute G.K. Venkatesh said the End Stage Renal Disease (ESRD) which is the terminal phase of chronic kidney disease (CKD) is a worldwide phenomenon, where patients need lifelong support mechanism to takeover the failed kidney function. Renal replacement therapy (RRT) is currently available as three modalities: (a) Renal transplantation (b) Maintenance Hemodialysis (MHD) and (c) Peritoneal dialysis (PD). He told The Hindu that of these choices, renal transplantation improves quality of life (QOL) and the life span apart from costing much less than dialysis over the long-term. However, less than a half of the kidney patients are considered for transplantation, largely because of non-availability of cadaveric organs resulting in most of them seeking dialysis. Under the pilot project which will be undertaken across the State, 25 patients will be provided the peritoneal dialysis kits and will be under regular monitoring by the doctors. As a matter of caution, they will also have to undergo haemodialysis occasionally. A scientific evaluation will be conducted after about a year and thereafter the project will be extended in full scale.
Dr. Venkatesh said the cost for haemodialysis is much higher than that of peritoneal dialysis. A haemodialysis machine has a limited patient-handling capacity (not more than six patients a day) although the machines are run for at least two shifts in all the government hospitals.