Friday, October 19, 2012

Myths about Peritoneal Dialysis

Peritoneal Dialysis (PD) is a form of dialysis that can be done at home, has fewer diet and fluid restrictions and offers an excellent quality of life. If you were to ask me which dialysis modality I would prefer, medical constraints notwithstanding, I would say Peritoneal Dialysis without thinking about it for even a second.

Unfortunately, this therapy has been badly neglected by the nephrology community. I have often thought about why nephrologists do not even mention PD to their patients when discussing dialysis. I wrote an article for Nephron Power on giving us, the patients the choice. I asked that patients be informed about all the options and then involved in the decision making process. Currently, the nephrologist makes all the decisions which is extremely unjust, unethical and unfair!

When I talk to fellow-patients about PD, I find that many of them have not even heard about it! Those who know about it have many misconceptions about it. Here, I am going to try to dispel the most common myths I have heard about PD.

People fear that with PD, the chances of infections are high. They have been told that they need to maintain their room in extremely hygienic conditions otherwise they can get infected and it can often be fatal. While it is true that hygiene is important, it is not at all difficult. Basic hygiene is all that is required. Simply keep your room clean. Basic sweeping and swobbing. The room does not have to be sterile!

The risk of viral infections on Hemodialysis is much more pronounced and with much more severe consequences! And what's worse, with Hemodialysis you're entirely in the hands of poorly qualified technicians and nurses. Whether you get infected or not totally depends on these people. Scary! At least, with PD, you are in control! Bacterial infections that are possible with PD are mostly treatable. Most viral infections that can be acquired in hemodialysis units have no known cure.

Some people also believe that PD is far more expensive than hemodialysis. Not true. These days, the cost of PD has dropped significantly. It is on par with the cost of hemodialysis. Most PD companies also have attractive loan-based schemes which makes PD very convenient without hitting your finances.

Some medical professionals also say that PD can only be done when you have some residual renal function or urine output left. False. After my transplant failed, my renal function was close to zero. I still managed beautifully on PD for six years. While it may be true that PD works better when there is some residual renal function, it is definitely not true that it can only be done when there is some residual renal function.

The six years on Peritoneal Dialysis were the best in my entire life with kidney disease. When I see unsuspecting patients being denied access to this wonderful therapy for financial reasons, it deeply saddens me. I feel helpless that unscrupulous and unethical elements at work in the medical industry put money above everything else and condemn patients to a life of hemodialysis without as much as a thought for the pain they have to endure.

3 comments:

Anonymous said...

Hi,
My mom goes for a HD as it is covered in our parental insurance. Not sure if PD is also covered under medical insurance now, never checked most recently. I wanted to know the PD expenses to see if they can be handled without insurance. Please provide some insight here...

Thanks
-Kishore.

Kamal D Shah said...

PD - 3 exchanges per day comes to about 16-17K per month.

Avinash Ghimire said...

Hi Kamal
I have gone through your blogs and would like to complement you on your upbeat disposition despite the hurdles.The grasp of medical issues you have of your own condition is excellent.I also applaud your choice of work for the kidney foundation.

I am a Nephrologist Stateside representing a few other doctors from Nepal.We are interested to begin a non profit to help advance ESRD/kidney care in Nepal where people have very limited access compared even to India.We are seeking help in this regard.Would you or the foundation you work with be interested in helping us,mostly in advisory capacity and by sharing your valuable experiences in regards to organisational setup,fund generation and prioritizing resources.We will also explore reducing the cost of ESRD care supplies like dialysis solutions,cartridges,machines etc.We are open to collaborate with private entities but in a non profit model.please let me what you think.I can be reached at avinashghimire!outlook.com.Thanks and have a great day!