How doctors are saving dialysis patients

U.Tejonmayam@timesgroup.com

Chennai:07.04.2020

Access to dialysis units during the nationwide lockdown is becoming difficult for kidney failure patients and doctors arehaving to make tough decisions to continue to provide the lifesaving treatment.

Some nephrologists are advising patients to opt for home dialysis and some tertiary care hospitals are offering pick-up and drop for their patients, while a few others are recommending patients to dialysis units closer to their homes.

Nephrogologist Dr Georgi Abraham said he had recommended 50% of his 150 patients on regular dialysis to switch to peritoneal dialysis at home if they find it difficult to get to a hospital. Peritoneal dialysis requires a doctor to insert a catheter into the abdomen to help filter blood through the peritoneum, a membrane in the abdomen. In the treatment, a special fluid called dialysate flows into the peritoneum to absorb the waste. The dialysate is drained from the abdomen after it draws waste out of the bloodstream. The process takes a few hours and needs to be repeated four to six times a day. “Anybody can be on peritoneal dialysis as long as their peritoneum is healthy. But we can only suggest this option with our patients and not enforce. Even now, we are training two of our patients to perform dialysis at home,” he said.

Latha Kumaraswamy, trustee of Tanker Foundation which offers free dialysis to patients from economically weak backgrounds, said a small percentage of their patients who undergo dialysis in eight of their centres in the state have found treatment centres closer to home as they cannot access their regular facility due to the lockdown. “We have some good samaritans who bring our patients to the units. Some of our patients are autodrivers and cab drivers who can come on their own. We have 570 patients in each of our units and now about 1% in that has found centres closer to their homes,” she said.

But the biggest challenge for doctors is to protect patients who are at a greater risk from contracting Covid-19 while they visit hospitals.

Dr Rajan Ravichandran said in the absence of a rapid test kit to detect Covid-19, his patients, who come for dialysis, are tested for white blood cell count and the levels of oxygen saturation in the bloodstream, which drop if a patient has a viral infection. “We conduct these tests if patients show symptoms of fever or cough. But if they do not show symptoms and carry the virus, it’s going to be another issue,” he said.

A patient undergoing dialysis at a unit run by Tanker Foundation in Thiruverkadu