Why no dialysis unit in every district, asks SC

kidney dialysis

The Supreme Court on Monday issued notice to the central and all state governments, asking them why they should not set up a dialysis unit in every district.

A bench headed by Chief Justice P. Sathasivam issued notice on a PIL when senior counsel A.M. Singhvi told the court that two lakh people were dying in the country every year due to renal failure, or a rate of 547 people per day or two people per minute.

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The public interest litigation has been moved by advocate Sanjeev Panigrahi, who said there are 671 districts in the country and the number of dialysis unit in each district should be commensurate to its size and population. (Read: What you should know about kidney dialysis)

Dr Deepa Jayram tells you more about dialysis.

What is dialysis?

Dialysis is a form of treatment that is advised for patients suffering from end-stage kidney disease. Usually when a patient has chronic kidney disease the doctor classifies it into stages based on the percentage of kidney function the patient has. This is calculated using certain formulae based on the patient's serum creatinine levels. Generally when a person's kidney function is less than 10 to 15 per cent of what it should be, dialysis is prescribed.

How is a dialysis done?

Dialysis can be done in a number of ways. However, the most common methods are Hemodialysis and Peritoneal dialysis. Generally both methods are accepted well by patients but there are certain risks and complications that could occur.

  • Hemodialysis is a method of dialysis where the patient goes to a hospital which has a dialysis unit or the patient has a dialysis machine at home. In both cases, medical supervision is a must. Dialysis works by pumping the blood of the patient through a filter which cleans the blood. The clean blood is then returned back to the body. The whole process usually lasts about four hours and is generally done three times a week. In order to perform hemodialysis the patient will be fitted with a catheter that is placed in one of the big blood streams in the body, usually found in the neck or the leg. However, there is risk of the catheter getting infected. An innovation that has helped in reducing the number of infections is the use of an AV graft or AV fistula. During the process the patient may feel dizzy because of the blood pressure dropping, nausea, vomiting, cramps in the legs, severe headaches, chest pain and palpitations.
  • Peritoneal Dialysis is another form of dialysis which is based on fluid exchange. The doctor places a small tube or catheter in the patient's abdomen. Through this catheter, a 'dialysis solution' is pumped into the patient's abdomen. Dialysis is successful when the fluid built up within the patient's body gets transferred through the peritoneum (a membrane lining the walls of the abdominal cavity) into the abdomen and thus the dialysis solution contained in it.

The fluid is drained out after about four to six hours, and a fresh bag is introduced into the body. This is a more gentle form of dialysis which is done on a daily basis. It can be done at home or in a clinic. One of the main drawbacks of this method, however, is that there is a risk of infection of the lining of the abdomen also calledperitonitis, or an infection of the skin around the catheter.

Dialysis can help a patient live a full and healthy life if treated on time, albeit with the right medical help and a few precautions.

With inputs from IANS

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