The Hindu : Kerala News : Dialysis can be done at home

Online edition of India's National Newspaper
Wednesday, Oct 11, 2006
ePaper

Kerala

Kerala

Dialysis can be done at home

Staff Reporter

The technique is called the continuous ambulatory peritoneal dialysis

KOCHI: Many patients with kidney failure in the State are finding it hard to get dialysis done with institutional help. It is in this context that a technique called peritoneal dialysis, which can be done at home, is catching on here.

Nearly 200 patients in the State are on peritoneal dialysis. A woman had been doing it for the last nine years.

The concept was introduced in 1977 by Dimitrios Oreopoulos, Professor of Medicine, University of Toronto, who was in Kochi recently for creating awareness about the technique and speaking about its merits and demerits.

The technique, called the continuous ambulatory peritoneal dialysis (CAPD), can be done at home with minimal extra support. For the aged and children, the method will require help, while others can do it on their own and continue to do their respective jobs. The procedure requires filling up the abdominal cavity with a specially prepared fluid two or three times a day and draining it at appropriate intervals. Waste materials in the body get collected into this fluid through the peritoneum membrane, which is eliminated when the fluid is drained.

The costs continue to be high here, said Dr. Oreopoulus.

However, the solutions used for CAPD have undergone drastic changes, with better ones being brought out by medical companies, he said. There have been quite a few innovations in reducing the rate of infections and loss of proteins from the body, he said. Once the solutions are made here, the cost will definitely come down, he added.

Compared to haemodialysis, the technique is advantageous because it cuts down the frequent visits to hospital, avoids blood loss — problem inherent to haemodialysis and it is more comforting to people with cardiac ailments too. Since it is a continuous process, patients do not develop any swelling in the body or have any breathing problem. It also permits a patient to take a normal diet.

"When I introduced the technique, there were 40 patients ready to try it out." One of his patients had been doing CAPD for the last 23 years, he said. About 8 per cent of his patients have been doing it for the last 10 years, he added.

This treatment modality is not in competition with other modalities, he said. All the three modalities during a renal failure are complementary to each other, Prof. Oreopoulus said. Haemodialysis, peritoneal dialysis and kidney transplant are the three modalities.

Worldwide, only 15 per cent of renal failure patients are on peritoneal dialysis, while the rest are on haemodialysis, he said.

The disadvantages are development of peritonitis, an infection of the peritoneum because of the use of catheter used to fill the fluid into the abdomen and drain it; is a common infection and there will be damage to the peritoneum membrane because of the high concentration of solution. One of the side effects can be a rise in the blood sugar level too. Pharmaceutical companies have developed better solutions to beat these disadvantages, Dr. Oreopoulus said. Better solutions at a better cost will definitely help in many renal-failure patients lead quality life, he added.

Printer friendly page
Send this article to Friends by E-Mail

Kerala