Chronic Renal Failure is the condition where kidneys stop
functioning because of a variety of conditions. At some stage these patients require
to undergo dialysis which is a procedure where the blood is purified of the
wastes products. Simply put, the job of the kidney is to be done by some
artificial means, which is known as dialysis. Haemodialysis is a form of dialysis where blood is purified by
machines. In order to do this, one requires to take the blood out of the arteries,
which goes to the dialysis machine, purified and sent back to the body via
veins. With the repeated puncture of veins for dialysis, blood
clot forms in the vein (thrombosis) and vein becomes unsuitable for further
procedures. Due to this, before commencing on dialysis, one makes an arterio
venous (AV) fistule(connecting the artery with the vein), which increases the
flow in the vein and makes it amenable to be repeatedly used for dialysis without
formation of clots.
photograph - AV fistula performed by me
Very few government hospitals in Delhi provide this facility
for making AV fistule. Many of the lower socio economic strata patients cannot afford to get
the same procedure done at private hospitals, costing around Rs. 15, 000 to 20,000. Around 2 years ago, I started
providing this facility at my hospital for such patients. In the last one year, I have made AV fistule
for 70 odd patients and it has been a successful endeavor. My idea behind this attempt
is to provide some kind of relief to the patients and their families undergoing
dialysis.
For the patients with chronic renal failure,
dialysis has to be done at given intervals which can range from one to three
times in a week. Patient has to be accompanied by atleast one
relative to the hospital for such sessions. So, both the patient and his/her
relative lose valuable time in each visit. Government hospitals in Delhi cannot accommodate all the patients for routine dialysis as the patient load is enormous. Hence after the stabilization of the condition of the patient, they are asked to get it done at private hospitals where each session costs 2000- 5000 Rs. Its results in financial strain to the entire family of the patient, with some patients telling me that they have sold
their property, land and even sometimes cattle (for rural patients) for getting
dialysis at private hospitals.
The only other solution for renal failure is transplant, which
requires a donor (hard to find a match and costly). Plus there is also
recurring cost of Rs. 10,000 per month for medicines post transplant.
On my part, I do this with the thought that I may be alleviating
some of these patients’ agony and contribute to lowering their financial
strain, since this procedure is free of cost my hospital.
