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HEALTH |
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BODY & MIND
Peritoneal dialysis, a hassle-free option
Tripti Nath
T he hassle free option of Peritoneal Dialysis (PD) for
persons suffering from End Stage Renal Disease (ESTD) is gaining
acceptability in India slowly, but surely. Dr Dimitros G. Oreopoulos,
Professor of Medicine and Chief, Renal Division, Toronto General
Hospital, who popularised the concept of Continuous Ambulatory
Peritoneal Dialysis (CAPD) was in India early this week at the
invitation of BAXTER to spread awareness about CAPD. Dr Oreopoulos says
it is important for nephrologists to tell patients about PD also known
as machine free dialysis as an alternative to Hemodialysis (HD). The
concept of PD was developed by two physicians, Dr Moncroef and Dr
Popovich in Texas in 1976. India, feared to be the diabetes capital of
the world, runs the risk of additional burden of ESRD. The main causes
of ESRD are diabetes and high blood pressure. Kidney transplant and
maintenance dialysis are the two treatment options for persons with ESRD.
Since there is an acute dearth of kidney donors, most patients suffering
from renal failure opt for dialysis in preference to endless waiting
period for a kidney. While HD is done at hospitals, CAPD can be done
by the patient at home. A patient on Hemodialysis is required to visit
the dialysis centre two to three times in a week. His blood is cleansed
outside the body with the help of a machine. In PD, a catheter or tube
is inserted into the patient’s abdominal cavity with a minor surgical
procedure. The self-dialysis is required to be done four to five times
everyday. The waste products from the blood diffuse out from the
peritoneal membrane into the dialysis solution, which is then drained
out of the body. Hemodialysis costs a patients Rs 9,000 to Rs 14,000
per month (minus the cost of visits to the hospital). Peritoneal
Dialysis costs Rs 15,000 every month but is possible in the comfort of
the patient’s home. The extent of awareness about CAPD can be gauged
by the fact that although 100,000 fresh cases of End Stage Renal Disease
are reported in India every year, only 3,500 patients are on Peritoneal
Dialysis. The Toronto based nephrologist said that 95 per cent of
patients of ESRD in Mexico have opted for CAPD. In Hongkong, the
response to machine free dialysis is very encouraging and 80 per cent of
ESRD patients are on CAPD. President of the International Society for
Peritoneal Dialysis, Dr Oreopoulos has trained several Indian
nephrologists including Dr George Abraham from Sri Ramchandra Medical
College and Hospital, Chennai, Dr Kamal Sud from PGI, Chandigarh and Dr
Amit Gupta from Sanjay Gandhi Postgraduate Institute, Lucknow.
Gifting visionA 19 year old boy from Thailand, who lost sight in both eyes six
years ago due to a rare allergic reaction, will be able to regain his
vision soon, according to surgeons in Singapore National Eye
Centre. Luck Pewnual underwent a revolutionary six-hour long surgical
procedure at the Singapore National Eye Centre, the designated national
eye centre in the public health network. A team of surgeons from the
Singapore National Eye Centre and a team from the National Dental
Centre, Singapore’s referral centre for specialist oral healthcare
services, are satisfied with the progress of their young patient. They
say that this is the first operation of kind in South-East Asia. The
team was led by Professor Donald Tan, Deputy Director, Singapore
National Eye Centre and Dr Andrew Tay, Consultant, Department of Oral
and Maxillofacial Surgery, National Dental Centre. The first stage of
the surgery involved five separate procedures- opening up one eye and
removing the entire inner surface of his eyelids, corneal surface and
all scar tissue from his previous eye injury, removing the inner mucosal
lining of the cheek and transplanting it onto the new surface of the
eye, removing a canine tooth and part of the adjacent bone and ligaments
from his jaw, fashioning a bolt shaped structure from this tooth bone
complex to receive a plastic optical cylinder, which is cemented into
place, and implanting the tooth bone cylinder complex into his cheek to
grow a new blood supply. The surgeons have scheduled the second stage
of the procedure in June. According to the surgeons, patients who are
completely blind and cannot benefit from conventional corneal
transplants can be considered for such a surgery.
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