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Peritoneal dialysis at your doorstep

peritoneal dialysis system for a home dialysis
A peritoneal dialysis system for use in the home.

A government programme to expand access to treatment for kidney disease could now carry an added benefit for recipients: peritoneal dialysis in the home.

Kidney disease affects around one in every ten Indians, with around five lakh believed to be in need of treatment with dialysis. However, as previously reported by Health Issues India, seventy percent of those in need of kidney dialysis cannot avail it due to unavailability and unaffordability.

To ameliorate this situation, the Central government in 2016 unveiled the Pradhan Mantri National Dialysis Programme (PMNDP). As part of the National Rural Health Mission, the initiative sought to make kidney dialysis treatment free of charge for the underprivileged.

As noted by the National Health Portal, kidney dialysis carries a massive price tag if one is forced to pay out-of-pocket. “Since every dialysis has an additional expenditure tag of about Rs.2000,” the NHP states, “it results in a monthly expenditure for patients to the tune of Rs.3-4 Lakhs annually.” The PMNDP sought to utilise a public-private partnership (PPP) model to ensure that dialysis services are  available in hospitals at the district level, free of charge to the economically vulnerable.

The Union Health Ministry is now proposing taking the PMNDP a step further, by offering peritoneal dialysis to patients in their homes. Peritoneal dialysis is one of the two main types of kidney dialysis, the other being hemodialysis. The former filters the blood through a machine, which acts as a replacement for the damaged kidney. Once the blood is cleaned, it is returned to the body.

Peritoneal dialysis differs from hemodialysis in that blood is not removed from the body. Rather, the abdominal sac is injected with dialysate, a solution that allows for the blood to be filtered. Once injected, waste in the blood is absorbed by the dialysate.

Because of the differences between hemodialysis and peritoneal dialysis, a home healthcare method for administering the latter could be equitable because peritoneal dialysis does not carry the same burden of infrastructure and manpower as hemodialysis. By administering the treatment to patients in their homes, inpatient resources can be used more efficiently and effectively. Administering the treatment in the home also cuts the costs of travel and missed work for beneficiaries.

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