BMC’s dashboard for Covid-hit kidney patients worked wonders: Study

Mumbai has an estimated 10,000 chronic patients on maintenance hemodialysis

A dashboard maintained by the BMC for Coronavirus-infected kidney patients helped scores of them immediately secure a dialysis slot. The dashboard also evolved into a valuable tool to track patient outcomes in real-time, generating data for informed decision-making, says a study published in the latest edition of the medical journal Indian Journal of Nephrology. The dashboard was launched in May 2020.

As part of the study, the doctors analysed the Covid-19 patients enrolled via the portal run by the civic body. It was a citywide dashboard for allocation and scheduling of dialysis for Covid-19 patients on maintenance hemodialysis.

"Project victory is an inspirational, one of its kind collaborative initiative of BMC, IIT-Bombay, Mumbai Nephrology Group and Apex Kidney Foundation that carried out in these difficult pandemic times all across Mumbai for Covid-19 positive patients on haemodialysis for the last 18 months. This effort was recently published in the prestigious Indian journal of Nephrology and was lauded by experts in the field all across India and abroad," said Dr Jatin Kothari, director of nephrology, Nanavati Hospital and one of the co-authors.

The study analysed 1,418 Covid-positive end-stage kidney disease patients enrolled by the portal over the seven months. It showed that the portal helped in the timely and smooth transfer of these patients to designated facilities and cut mortality arising from delayed or denied dialysis. The portal also documented the natural history of the pandemic in the city and provided information on the overall incidences and outcomes.

"This aided the city administration in the projected resource needs to handle the pandemic. The portal's primary objective was to allocate a Covid-19 (positive) hemodialysis slot to every enrolled patient. About 97 per cent of patients got a dialysis slot within 48 hours of registering on the website with comparable outcomes with all developed countries and cities in the world," said Dr Vishwanath Billa, nephrologist, Apex Kidney Foundation, another co-author. Mumbai has an estimated 10,000 chronic patients on maintenance hemodialysis.

As per the study, the Covid-infected kidney patients originated from 106 of the 174 hemodialysis facilities across Mumbai and were transferred to 23 designated Covid centres. Those patients who had one or more comorbidities - hypertension, diabetes, or heart ailments - had a mortality of 51 per cent as against 17 per cent in those without comorbidities.

Dr Shrirang Bichu, a nephrologist from Bombay Hospital and a co-author, said when the pandemic began, the entire nephrology community faced twin problems - high mortality associated with the infection and the inability to manage dialysis needs of an infected patient at the existing dialysis centres. "The national lockdown in India initially resulted in the shutting down of some hospitals and lack of clear guidance to balance infection containment while maintaining life-saving treatments such as dialysis. This was the stimulus to develop a solution to meet this unprecedented challenge. This project has helped health care providers and administrators guide patients to access chronic MHD services efficiently," he said.

1,418
No. of patients analysed for the study