Home based dialysis options gain popularity in the pandemic

Dr. Aakash Shingada

Early in the pandemic, several patients on dialysis suffered because of the lack of transportation options and closure of several dialysis units. Patients needing hemodialysis have to visit the dialysis centre 2-3 times a week, for at least 3 to 4 hours, surrounded by numerous other patients and staff. These patients cannot self-isolate, rendering them vulnerable.

Home dialysis, a concept popular in the west, was not opted frequently in our country mainly due to the financial strain it puts on the patient. With better coverage by medical insurance, several patients have started opting for home based options.

62-year-old Hitesh Shah (name changed), resident of Kandivali, who was recently initiated on dialysis, dreaded coming to the dialysis centre. "I had lost my sister, younger to me by 2 years to COVID. Before I was diagnosed with kidney failure, I had not left my house for 6 months. Now I had to go to the hospital and get exposed twice a week," said Shah.

To prevent the spread of virus, patients have to keep wearing the mask at all times and to avoid eating food during sessions. "I had been assured by my doctor, Dr. Aakash Shingada, that dialysis wouldn't be uncomfortable and will help improve my quality of life, but the strict COVID protocols, albeit necessary, made it difficult and distressing," said Shah.

"I discuss home options, both hemodialysis(HD) and Peritoneal Dialysis(PD) with all patients initiating on dialysis. With the excessive load on hospitals to prioritize COVID-19 patients, we must be open to moving towards remote patient management. In case of Mr. Shah, we had decided to initiate dialysis in hospital, and since he wasn't comfortable with the option, we helped him set it up at home," says Dr. Shingada, who has helped several other patients opt for home HD and PD.

"Earlier, to set up hemodialysis at home, one needed to purchase the machine and the onus of establishing the technology at home was mainly on the patient. Now several agencies help set up dialysis at home, with monthly cost of machine rent and sessions ranging from Rs. 40,000 to 65,000," adds Dr. Shingada. These dialysis providers have made this possible, safe and rather easy.

The number of patients on peritoneal dialysis, another mode of dialysis done through a catheter inserted in the abdomen, have also increased. "The number of our patients initiated on PD have almost doubled in last one year. Fewer patients used to opt this wonderful modality earlier, mainly owing to lack of awareness and because this option is not commonly discussed," says Dr Shingada.

"I can now sit in my shorts and t-shirt, sipping my cup of coffee, watching TV, while getting dialysis at home surrounded by my family. It has become a routine now," concludes Mr. Shah.

Dr. Aakash Shingada is a Nephrologist and Transplant Physician practicing in Mumbai suburbs. For queries and appointments: +91-8591679131, 02261236123. Website - www.draakashshingada.com