The Telegraph
Since 1st March, 1999
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Clinic trains patients on dialysis at home

More than 100,000 people are affected by kidney failure or end-stage renal disease in the country every year, and Calcutta accounts for hundreds of such patients, who need super-speciality treatment.

While kidney transplantation remains the therapy of choice for most patients, for those who cannot be transplanted or in the event of transplant failure, dialysis is the only available option. The dedicated peritoneal dialysis (PD) centre at AMRI Apollo Hospitals, “the first of its kind in the city”, promises to bring down treatment cost and reach out to a wider section.

“Calcutta caters to the entire eastern region and the Northeast in kidney care and our new system of managing PD patients is proving a boon to distant cases, as well as active professionals based in the city,” says Arghya Majumdar, consultant nephrologist at the Dhakuria multi-speciality hospital. The PD unit has been set up with support from Baxter India, a leading supplier of continuous ambulatory peritoneal dialysis therapy for people with end-stage renal disease in the country.

In peritoneal dialysis, the blood is cleansed inside the body using the body’s own peritoneal membrane as filter, as opposed to haemodialysis, where blood is pumped through an external filter by a machine and returned to the body. While peritoneal dialysis is self-administered and is a home-based therapy, haemodialysis requires two to three sessions per week of around four hours each, and is usually carried out in a hospital.

“Since all dialysis is life-long, patients find home-PD convenient, since it frees them from rigorous, time-consuming hospital sessions,” says Majumdar, who has embarked on “a structured training module” for patients to make them better-versed with this relatively new treatment option. Over a period of around three weeks, the hospital is providing hands-on training to patients on this method, which is being used by over 1,50,000 patients worldwide today.

“The first part of the training programme is a briefing on the dos and don’ts. Patients are then familiarised with the technique through videos and CD-ROMs, so that they know exactly what to do and how. This is a much safer option than sending nurses out to demonstrate the process, which had often led to serious complications like peritonitis in the past,” says Majumdar.

The hospital is also planning to arrange accommodation for outstation patients during the course of the training programme in future. On completion of the training, patients are expected to carry out the process on their own at home, “requiring around 10-15 minutes”. As part of the monitoring routine, a dialysis-adequacy test is done at the hospital’s PD unit periodically. “Besides, patients are provided with a helpline so that they never feel insecure and can stay constantly in touch.”

AMRI Apollo Hospitals aims to become a “comprehensive nephrology hub” and has put in place a six-phase plan to be completed in another year’s time, to reach the goal. “With the commissioning of the PD unit, using bio-compatible polysulfone membranes in haemodialysis and introducing paediatric nephrology, we have taken concrete steps ahead. The hospital will continue to take this exercise forward, which should culminate in a kidney-transplant facility,” says CEO Jose Verghese.

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