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    Published On : Mon, Oct 26th, 2015

    Maharashtra Govt and Siemens to jointly set up dialysis centres in Nagpur – will it help poor patients?

    Nagpur: Accepting a proposal by Corporate giant Siemens, Maharashtra state government will start dialysis centers at Government Medical college (GMC) and Indira Gandhi Medical college (IGMC) in Nagpur by January 2016. It would be first of its kind centre, which would also impart training and the entire responsibility of its functioning would be handled by corporate giant Siemens.

    The proposal by Siemens has been cleared by the chief minister’s office and the health Ministry would soon be signing an MOU regarding this. Siemens officials have told the chief minister’s office that they would be able to make the 20-bedded dialysis center functional by January next year.This is good news for Nagpur since it seriously lacks in affordable dialysis facility for majority of Nagpurians. Except for a paltry few in Govt. hospitals which are often not working, patients have to depend on pvt hospitals and Doctors, where most often the costs are prohibitive.

    The cost of dialysis in Nagpur

    The cost of each hemodialysis (HD) session in varies from Rs 150 in government hospitals- but mostly available in big cities like Mumbai and Delhi – to Rs 2000 in some corporate hospitals. The monthly cost of HD in most private hospitals average Rs 12000 and the yearly cost of dialysis is Rs 1, 40000, equivalent of $3000, which is in sharp contrast to an annual cost of $60,000 in the US and UK. So we are the cheapest in the world and yet more than 90% of Indians cannot afford it.

    The cost of an AV fistula construction is Rs 6000 to Rs 20000 from a government hospital to varying grades of private hospitals. This is an operation that patients have to undergo before dialysis can be begun. The average cost of erythropoietin per month is Rs 4000 (bio similar) to Rs 10000 (the pioneer brand). These are chemicals that the kidneys make naturally when functioning well but have to substituted artificially for CKD patients.

    What is dialysis?

    Dialysis is the artificial process of eliminating waste (diffusion)and unwanted water (ultrafiltration) from the blood. Our kidneys do this naturally. Some people, however, may have failed or damaged kidneys which cannot carry out the function properly – they may need dialysis.

    In other words, dialysis is the artificial replacement for lost kidney function (renal replacement therapy).

    Dialysis may be used for patients who have become ill and have acute kidney failure (temporary loss of kidney function), or for fairly stable patients who have permanently lost kidney function – they are said to be suffering from Chronic Kidney Disease. CKD.

    When we are healthy our kidneys regulate our body levels of water and minerals, and remove waste. The kidneys also produce erythropoietin and 1,25-dihydroxycholecalciferol (calcitriol) as part of the endocrine system. Dialysis does not correct the endocrine functions of failed kidneys – it only replaces some kidney functions, such as waste removal and fluid removal.

    Who suffers from CKD

    Diabetes and High Blood pressure are two known causes. Other problems like kidney stones, tumour in kidneys, pressure on kidneys due to enlarged prostrates ca n also cause kidneys to stop functioning.

    It is also hereditary where kidneys can begin failing for no obvious reasons.

    Fortunately, unlike other vital organs like heart and lover, we have two kidneys, so if one fails the other can still maintain kidney functions. It is only when both fail that a person has to go in for dialysis and ultimately kidney transplant.

    The incidence of CKD in India

    There are no known detailed and accurate figures since many cases go undiagnosed and or unreported. But since Indians have a propensity to suffer from both High blood pressure and Diabetes, the number of kidney patients is very high. This is a given which most physicians will agree on.

    This brings us to the saddest fact – More than 90% of Indians cannot afford dialysis. Costs are so prohibitive that even middle class will hesitate and find it unaffordable.

    t of kidney transplant varies from Rs 50000 in a government set-up to Rs 300000 in an average private hospital. Also the yearly maintenance cost post transplant for drugs amounts to Rs 12 0000 per year or Rs 10000 per month.

    Sunita Mudaliar Associate Editor

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