Times of India
19 April 2010
By Shailvee Sharda
Lucknow, India

The automated peritoneal dialysis (APD) facility was inaugurated at the Balrampur Hospital on Sunday. This should ease the financial burden on patients suffering with end stage renal disease (ESRD).

Till now, this facility was available only at the Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGI). Balrampur Hospital has also become the first government hospital in UP to provide APD to patients. The hospital is already providing haemodialysis and routine peritoneal dialysis to patients through its nephrology unit.

ESRD refers to chronic kidney disease (CKD) in which functioning of the kidney cannot be revived. Cityb asednephrolo – gists point out that due to lack of awareness, patients with CKD approach hospitals after over 50% of their renal functionality is affected. In India, at least 16% population suffers from CKD.

Nephrologists say that early detection and prevention of renal problems is essential as the available treatment – dialysis and transplant – are costly and almost unaffordable for more than 80% patients. Dialysis (cleaning waste products from the kidney) is a life–long requirement and costs between Rs 18,000 to Rs 20,000 per month in a private hospital while transplant costs may range between Rs 5–8 lakh and is hugely dependent on a suitable donor.

“Balrampur Hospital would be an exception as far as dialysis is concerned. It would be offering APD at a nominal cost of Rs 400 per session,” claimed head of the nephro unit at Balrampur Hospital Dr SNS Yadav. The hospital authorities informed that no money will be charged from government sector employees and below poverty line (BPL) card holders. Doctors, however, said that appointment and availability of the service may be a concern as at present the hospital only has one machine. Departmental sources, however, said there are plans to install three more such machines.

Talking about APD, Dr Yadav said the method involves the use of a portable machine for the purpose of dialysis. The biggest advantage of APD is that it is a nightbased therapy which means that no external help is required once the process starts. This also minimises interference to work and hindrances to daily activities. Medically speaking, APD allows dialysis of patients tested positive of hepatitis B and C, among those in whom vascular access is difficult and those suffering with cardiac ailments as well. This will also aid patients hailing from distant locations by reducing the number of visits to the hospital. The hospital has also initiated training sessions for attendants so that they can carry out dialysis at home.

Prof Amit Gupta, head, SGPGI’s nephrology department, still emphasises on prevention of kidney diseases. “If one has diabetes, hypertension or frequently suffers from urinary tract infections (UTI), one is at the risk of developing CKD and requires continuous clinical examination. More than 50% of CKD cases occur in people suffering from diabetes and hypertension,” he said.

Doctors advice undergoing preventive health check ups like urine test, blood test and abdominal ultrasound regularly for early detection of any damage to the kidney. Diabetes patients and those suffering from hypertension need regular check ups of their kidneys. Common among adults, CKD affects the functioning of the heart too.

Chronic Kidney Diorder
Warning Signs

• Fatigue
• Lack of concentration
• Poor appetite
• Disturbed sleep
• Muscle cramps at night
• Swollen feet and ankles
• Puffed eyes, especially in the morning
• Dry, itchy skin

Prevention
Have your urine, blood & blood pressure checked regularly by your doctor if you are hypertensive, diabetic or simply above 50 years of age.

• Control blood sugar levels
• Control high blood pressure
• See your doctor if you think you have a bladder infection
• Stop smoking
• Cut down on weight
• Take salt–restricted diet
• Avoid processed food