CHENNAI: As growing incomes give India’s millions access to first world staples such as cars and cell phones, the population is also experiencing an unpleasant byproduct of westernised lifestyles — an epidemic of diabetes and the kidney disease it causes. The number of dialysis centers in India is rapidly increasing. India’s demand for dialysis is growing at a rate of 31 per cent, compared to 6 percent in the US and 8 percent in the rest of the world. India has more than 50,000 patients who receive long term dialysis.
Being diagnosed with kidney disease can be quite unnerving. Having to get on with dialysis, even more so. Many of us treat dialysis as a problem. It is important to realise that dialysis is the solution (albeit, non-ideal) to the problem of kidney disease. Kidney disease is the problem that dialysis attempts to solve. Dialysis is attempting to replace kidney function. Kidneys are probably the only vital organs which can be realistically replaced by artificial means.
Maintenance dialysis, which serves as an alternative to kidney transplantation, is a well-recognised modality of treating patients having end stage renal disease. Several thousands of patients all over the world are surviving and achieving reasonable quality of life on maintenance dialysis.
Unfortunately in our country the quality of dialysis delivered to patients can vary from center to center. Good quality of life and survival on maintenance dialysis depends on following major factors namely — dose of dialysis delivered or solute removal achieved, time on dialysis, adequacy of nutrition, family and socio-economic support, management of co-morbid illnesses and prevention and management of infections.
Cross infections are a very serious problem facing dialysis today.
A third of people who are on maintenance hemodialysis eventually get infected with a chronic viral disease. The disease is usually Hepatitis C. Some people also get infected with Hepatitis B or HIV. Centers that follow stringent infection control processes eliminate cross infections completely. At the SIMS Hemodialysis Centre, we do not use common trolleys for starting and closing dialysis sessions, the same betadine, spirit, plasters, gauze and other disposables for different patients, and disinfect machines after every session. We avoid reusing tubings for every one and dialysers for sero positive patients.
The centre also has dedicated TV sets for every patient with an earphone, free Wi-fi access.
(The writer is a doctor at SIMS Hemodialysis Centre)