The looming threat and fear of third wave of coronavirus has pushed people back inside their homes. The year 2020 showed us limitations in the healthcare infrastructure, unable to support critical healthcare issues.
There are about 20 lakhs kidney patients added in India who require 34 million dialysis sessions every year.
According to a recent Kidney International Report, a survey was conducted to determine the effect of lockdown on the care of patients with kidney disease.
Approximately 710 (28.2%) patients missed one or more dialysis sessions, 69 (2.74%) required emergency dialysis sessions, 104 (4.13%) stopped reporting for dialysis, and 9 (0.36%) were confirmed to have died. Outpatient attendance in the surveyed hospitals came down by 92.3%, and inpatient service reduced by 61%. Tele-consultation was started but was accessed by only a small number of patients.
The lives of the patients with diabetes and kidney diseases have been in disarray as patients especially on Haemodialysis (HD) have to frequently visit hospital for dialysis.
Patients suffering chronic kidney disease and diabetes are struggling to get timely treated.
These patients are left unnoticed and untreated as hospitals and other health clinics have been converted into a COVID-19 treatment center. In such a scenario, patients who are suffering from CKD and are on haemodialysis find it difficult to travel to hospitals for their sessions as these visits can lead to getting contracted with COVID. Therefore, with advanced medical options, patients can now get treated with home-based Peritoneal Dialysis.
Dr. AK Bhalla Chairman and HO Dept of Nephrology, Sir Ganga Ram Hospital, New Delhi said, “The pandemic has changed our perception of healthcare delivery, making it more remote and digitised. We understand that dialysis is still a challenge and hard to access for a large number of patients especially for those living in remote rural areas. PD makes it easier. Advancement of internet facilities and application of latest technologies have enabled Remote Patient Management (RPM) through which we can easily keep a check on the condition of the patient conducting PD at home and we can monitor their disease and treatment daily, helping us make necessary changes in their prescription if required, see their treatment data, and be alerted by programmable flags if any problem arises”.
Meanwhile, Dr. Sagar Gupta, Consultant and HOD Nephrology & Kidney Transplantation, Metro Hospital, Faridabad said that with the excessive load on hospitals to prioritise COVID-19 patients, we must be open to moving towards remote patient management for other diseases, where feasible.
“As for kidney patients, home-based and cost-effective PD therapy can enable nephrologists to treat kidney patients at home rather than continuing with hemodialysis to aid the kidney failure population in the country. This will also enable both doctors and patients analyse and choose their choice of dialysis treatment based on the patient’s lifestyle.”
Despite PD’s potential advantages, its penetration in the country is very poor. According to a report, there were just about 8,500 patients on PD in India in 2019. However, with effective reforms in our healthcare system, such progressive decisions can address challenges pertaining to accessibility and quality healthcare in the country to reach even the vulnerable and the marginalised sections of the society.