Peritoneal dialysis, best for ill kidneys

One of the most recent reports titled “India’s Health of the Nations States,” throws extensive light on the snowballing burden of non-communicable diseases (NCDs). Heart diseases, stroke, diabetes, and others are the lifestyle diseases which have become a cause of great concern over the years.

However, one disease that is often undermined is chronic kidney disease (CKD), even though it is one of the top 10 individual causes of death in our country.

Thankfully, CKD is one ailment that can be managed by slowing the pace of impairment or stopping the condition from getting worse. Over time, the mainstay of treatment for CKD has been dialysis – hemodialysis (HD) and peritoneal dialysis (PD) — and kidney transplant or renal replacement therapy for patients who are in the fifth stage of chronic kidney disease.

In simple terms, chronic kidney disease is a condition of gradual loss of kidney function over a period of time — months or sometimes years. It has two primary causes — diabetes and high blood pressure, and these contribute to one-third of total CKD cases.

In present times, it has been estimated that almost 10% of the global population is suffering from chronic kidney disease — with one out of five men and one out of four women falling victim to the disease. Our country has a poor record with chronic kidney disease, with 150 out of every 1,00,000 affected by it.

Though, the disorder is not necessarily a gender-specific disease, but some studies show that the burden of chronic kidney disease is marginally more on women.

Owing to anatomical differences, chronic kidney disease has become a graver concern for women in India, and thus the disorder leads to more health complications among women.

Women suffering from the disease are more susceptible to face problems during their pregnancy, and the disease can also cause menstrual irregularities. Moreover, accessibility of proper treatment for women living with the condition is a major issue in India.

Nevertheless, managing chronic kidney disease is becoming hassle-free with peritoneal dialysis gaining predominance as the treatment option. In this procedure, the abdominal lining of the patient is used to filter waste products from the blood.

A soft tube is placed inside the patient’s belly, a few weeks prior to the treatment, and a dialysis solution is poured in this tube. The process is repeated for the next cleansing session.

Go-to treatment

There are multiple compelling reasons why peritoneal dialysis is becoming the go-to treatment option to deal with chronic kidney disease. Greater lifestyle flexibility and the ability to administer it from the comfort of home, work, or even while travelling adds to its benefits.

Further, it results in lesser buildup of potassium, sodium and other fluids, thereby reducing the stress on heart and blood vessels. Furthermore, peritoneal dialysis provides more stable blood chemistry and body hydration which is good for maintaining the overall health.

The most beneficial advantage of this treatment mode is that the process can be carried out by patients themselves with proper training. The entire process does not take more than 25-30 minutes per usage which significantly brings down the number of hospital visits for women. Thereby, it provides ample convenience for women dealing with this condition. Peritoneal dialysis has the potential to make lives easier for women as it does not hamper a patient’s productivity and lifestyle.

Lastly, I would like to emphasise that chronic kidney disease constitutes a significant part of the burden from NCDs, and it is only spiralling up. Given this, it has become important to recognise the potential impact of this condition and adopt measures to counter it. There needs to be a shift in the social behaviour of people wherein they will have to adopt a healthy lifestyle and go for regular screening.

As far as the treatment is concerned, it is crucial that the right modality is opted for, which can result in a quality outcome. The onus lies on us healthcare professionals and, also on the patients to decrease the burden of this condition by opting for treatments like peritoneal dialysis for managing this condition. As an expert, who has been concerned with promoting good health for all, I believe that concerted efforts will have to be made by all to fight the battle against chronic kidney disease.

(The writer is Head of nephrology and Superintendent, Institute of Nephro Urology, Senior consultant, Apollo Hospital, Bengaluru)