The Union Health Ministry is Planning to offer peritoneal dialysis(PD) facility to kidney patients at their homes. The Health ministry has framed this proposal under Pradhan Mantri National Dialysis Programme (PMNDP).
PMNDP was launched in 2016 to provide free dialysis care to the patients in district hospitals. But PD, which is another form of standard dialysis therapy was not included in this phase.
As per the words of a senior ministry official, the main aim of this move is to achieve equity in patient access to home-based peritoneal dialysis and reduce the overall cost of care to the system by focusing on efficient leveraging of resources. According to the draft proposal, the ministry will provide peritoneal dialysis (PD) facility to the patients at their homes.
“Once the patient would reach the dialysis centre, nephrologists would confirm whether a patient needs HD or PD. If the patient requires PD, a doctor will insert a catheter tube inside the patient’s body. Nephrologists will train the patient and his relative the technique to perform PD. The patients would be provided with drug, diagnostics and equipment related to PD kit to conduct dialysis at home,” said one official. “Given that peritoneal dialysis avoids the substantial cost of infrastructure set up and maintenance and staffing, reduces the demand on the healthcare system and offers patient autonomy, the inclusion of peritoneal dialysis in the ambit of the National Dialysis Program is being considered,” he added.
The Centre announced the National Dialysis Program in the 2016 budget.
The first phase of this program envisaged setting up of haemodialysis (HD) centres in all districts, which is being implemented.
PD allows therapeutic intervention at home (or nearest to the community) which in turns reduces overall out-of-pocket expenditure by saving the wage loss of the patient and his attendant, which was not possible in HD patients requiring to travel to the district level twice/thrice weekly.
Moreover, young children especially those below five years are often unsuitable for HD.
Such patients are preferably initiated on PD, home-based PD is better suited to their flexible lifestyle, including education, schooling and other childhood activities, the official explained.

Source: The Hindu, India Today

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