When 52-year-old Sumita was first diagnosed with kidney failure, the journey of managing the disease for the next one decade was extremely challenging. With both the kidneys affected, she was on haemodialysis, which meant frequenting the hospital thrice a week, following a specific diet and living with financial constraints. Living in the outskirts of a city in a rural village only made the battle worse. It was only after she was introduced to Peritoneal Dialysis (PD) that the disease became more manageable for her. Unfortunately, the prevalence of PD remains abysmally low in India due to lack of awareness and the myth of the procedure being more expensive. In a country where we have over 2 lakhs kidney patients, only 6,500 patients carry PD.
Sumita is among the 2,20,000 patients on chronic dialysis in India. From financial constraints to commuting challenges, while dialysis helped millions of kidney patients manage their condition, many of them are not even able to access the treatment due to mounted challenges.
On World Kidney Day, experts underline the importance of “Living Well with Kidney Disease” and throw light on how to fight the challenges that stand before us, in making this disease more manageable. Experts underline the pressing need to educate patients, policy makers and practitioners in effective kidney disease prevention.
“The biggest challenge for kidney patients is the lack of awareness about the choices they have, from treatment options to food, most of them do not know that they can actually control their lifestyles with just better knowledge. For instance, options like PD allow patients to conduct dialysis at home, on their own. Most patients do not know the basic differences between the two to make an informed choice. Fortunately, today, we have online knowledge-building platforms like www.yourdialysisjourney.in to guide people on the new treatments, share ways to effectively manage their symptoms and instil a sense of control in patients”, said Dr Aakash Shingada Director – Kidney Associates Pvt Ltd. Nephrologist and transplant physician, Namaha hospital Kandivali, Mumbai.
Experts feel that the need of the hour is to not only raise awareness but also encourage preventive behaviour, make patients understand the role of systematic screening , educate medical professionals about risk reduction mechanisms of Chronic Kidney Disease (CKD), more specifically in cases of high risk populations.
The next important step is to strengthen the infrastructure in district hospitals, ensuring affordable multispecialty care includes dialysis and patients are imparted with substantial knowledge on PD as well.
While the government has taken significant steps to include PD in its policies to ensure free access, the penetration of these policies remains low. Take, for instance, the Pradhan Mantri National Dialysis Programme (PMNDP) which was rolled out in 22 states and union territories, however, the implementation has been initiated only in 4 states so far. The initiative is supported by National Health Mission and provides free of cost dialysis to patients below poverty line.
“When we talk about PD, the restrictions to its access are many. However, with Insurance Regulatory and Development Authority (IRDAI) taking the plunge to including home-based dialysis or Peritoneal Dialysis (PD) under the ambit of insurance policies, India is taking significant steps to make PD accessible. That said, we are still a long way from making treatments like PD affordable for kidney patients”, Dr. Umesh Khanna, Consultant Lancelot hospital.