The Pradhan Mantri National Dialysis Programme was rolled out in 2016 as part of the National Health Mission (NHM) for provision of free dialysis serv
Every year about 2.2 Lakh new patients of End Stage Renal Disease (ESRD) get added in India resulting in additional demand for 3.4 Crore dialysis every year. With approximately 4950 dialysis centres, largely in the private sector in India, the demand is less than half met with existing infrastructure. Since every Dialysis has an additional expenditure tag of about Rs.2000, it results in a monthly expenditure for patients to the tune of Rs.3-4 Lakhs annually. Besides, most families have to undertake frequent trips, and often over long distances to access dialysis services incurring heavy travel costs and loss of wages for the patient and family members accompanying the patient. This therefore leads to financial catastrophe for practically all families with such patients. With substantial gain in quality of life and extension of progression free survival for patients, families continue to stretch financially to make large out of pocket spends. It has been felt that both in terms of provision of this important life saving procedure and also for reducing impoverishment on account of out of pocket expenditure for patients, a Dialysis program is required.
There are two main types of dialysis, which are hemodialysis and peritoneal dialysis.
Close medical supervision is not required for most PD cases, thus making it a feasible option for patients who may want to undergo dialysis in the home setting. Each treatment option has its advantages and disadvantages, which vary with the condition of the patient and presence of underlying diseases. It is therefore important for every patient with ESRD to discuss various treatment options in detail with his doctor before starting treatment.
The majority of patients in India receive renal replacement therapy in hemodialysis center. The number of patients on Hemodialysis and the number of hospital based and free standing units is steadily growing. A dialysis unit delivers patient care, and has specific requirements of treated water, electricity, medical gases and waste disposal. It additionally requires accommodating all the workers involved in patient care, allow emergency procedures, permit adequate hygiene and maintenance of specialized equipment. The design and layout of a unit must take into account all the above features in order to function smoothly and prevent development of complications. Proper planning of a dialysis unit is therefore essential.
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