Majority of Indians cannot afford dialysis: Study

Though India has one of the world’s largest number of chronic kidney disease patients, majority of them die within months because they either cannot afford dialysis or drop out within months due to the cost factor.

Globally kidney diseases kill more than 20 lakh persons who cannot afford dialysis. Previous India studies suggest that each year, about 2.25 lakh new cases of chronic kidney diseases are reported and bulk of the patients die.

“That number could be an underestimation,” says Vivekananda Jha, a professor of Postgraduate Institute for Medical Education and Research, Chandigarh, who is the co-author of a study that shows India is one of the five nations with the largest number of deaths due to kidney failure.

China, Indonesia, Pakistan and Nigeria are the other four nations where less than a quarter of eligible patients receive treatment for kidney failure.

“The largest treatment gaps are in Asia. By 2030, when the number of people receiving renal replacement therapy is estimated to be around 54 million, the number of people without access to the therapy will remain substantial,” says the study, published in the Lancet on Friday.

Research by Jha and his colleagues in the last decade demonstrated that 60-90 per cent of patients drop out of dialysis within the first three months because of the cost even though almost 75 per cent patients with serious kidney complications come late to a referral hospital.

“These patients need dialysis until they can get the transplant, which is not available to a majority. Both dialysis and transplant are expensive and entail major expenditure that is a limiting factor,” Jha, who currently works as the executive director at the George Institute for Global Health, Delhi told Deccan Herald.

The cost of dialysis in government hospitals like PGI or All India Institute of Medical Sciences, Delhi varies from Rs 500-800 per session. But these institutes don’t offer long term dialysis.

In the private set up, it ranges from Rs 1,200-2,000 per session and the price goes up in the high-end corporate setups.

Less than 10 per cent of end stage renal disease patients in India receive the therapy. The cost of transplant at PGI is about Rs 70,000-1 lakh depending on patient situation whereas in private hospitals it is between Rs 3 lakh and 8 lakh.