Dialysis facilities in Hyderabad not so strong

Fistula continues to remain a major issue for patients with 52 per cent of CKD patients complain of failure.

By   |  Published: 8th Oct 2017  12:11 amUpdated: 8th Oct 2017  3:59 pm

Hyderabad: Findings of a study conducted on nearly 100 chronic kidney diseases (CKD) patients in as many as 16 dialysis centres in private and public-sector hospitals of Hyderabad has highlighted the need to have a full-fledged ecosystem to meet the overall requirements of kidney patients.

Chronic kidney ailments are known to put patients under a lot financial distress and according to the month-long study, 92 per cent of the kidney patients give up their jobs after they are diagnosed with the CKD.  A majority of patients said that it’s hard to work after undergoing dialysis two to three times in a week.

About 45 per cent of the patients who participated in the study said that they spend close to Rs 5,000 towards out of pocket expenses like travel, medicines, investigations etc. Fistula, which is vital for dialysis patients, continues to remain a major issue for patients with 52 per cent of CKD patients complain of failure. Close to 5 per cent of CKD patients have also complained to have fistula failing more than twice. 

The study, which was conducted by Helping Hand Foundation (HHF), NGO working in the field of healthcare in Hyderabad, 20 per cent of the kidney patients have Hepatitis C and B infections. The infections are occurring due to lack of safety and aseptic measures that are followed by dialysis centres. The study says that fistulas once placed on patients need at least four to eight weeks to mature. “However without allowing them to mature, fistulas are used immediately, which invariably results in failure”, the study said. 

Vascular surgeons are considered as experts in taking up fistulas but there is a shortage of such specialists in both public and private health sector, another vital reason for frequent fistula failures.

According to the study, the fistula failure in a private dialysis centres is close to 50 per cent while in State-run hospital, the fistula rate failure of close to 75 per cent.  “Among Indian population, the veins are narrow and smaller when compared to Western patients and this makes the veins vulnerable to narrowing or blockage,” the HHF study said. 

What The Study Says

The study was carried out on 16 dialysis centres in Hyderabad covering 100 CKD patients.

Impact on health: 

  • 61 per cent of patients did not have BP and hypertension prior to renal disease 2. 20 per cent of CKD patients acquire Hepatitis B and C infections 3. Cost of Hep C and B treatment adds to overall costs 4. Due to high infections, many can’t undergo transplantation 

Socio-economic impact 

  • 92 per cent of CKD patients give-up their jobs2. At least 2 to 3 times they have to undergo dialysis in a week3. 45 per cent of patients spend Rs 5,000 per month for out of pocket expenses  4. Dialysis at private facilities cost Rs 2,000 to Rs 4,000 5. Patients do not get iron supplements after dialysis Fistula: 
  • Fistula failure gets reported among 52 per cent of patients2. Fistula is a passageway for haemo dialysis 3. In 5 per cent of patients, fistula fails twice4. All CKD patients below 35 years have not registered for Jeevandan

Reasons for Fistula failure: 

  • Arogysri doesn’t cover permanent catheterization for haemodialysis patients
  • Therefore, fistulas are being fixed for patients
  • Fistulas need 4 to 8 weeks to mature, but it doesn’t happen
  • 50 per cent of fistulas fail in private hospitals
  • 75 per cent of fistulas fail in Government hospitals