New pilot study evaluates outcomes in patients on dialysis

A new pilot study conducted by the George Institute for Global Health has revealed that the outcome of dialysis in people with end-stage kidney failure is affected by both clinical as well as economic and social factors. Planning or expansion of dialysis services in the country should keep both these things in mind.    

This prospective cohort study of dialysis outcomes in India was conducted at the Postgraduate Institute of Medical Education, Chandigarh and Medanta Hospital, Gurgaon, on 100 patients who started dialysis in 2015. These patients will be followed up for one year.

Some of the key findings of the pilot study indicate that diabetes and hypertension are two of the major causes of kidney failure among the participants, contributing 27% and 26% cases respectively. The average age of the patients was 47.5 years with the majority being males.

The study also brings forth a huge disparity between the average income and expenditure for people undergoing haemodialysis, thereby indicating that regular treatment has a huge impact on the economic well-being of the families. This is a major factor due to which many patients might be forced to give-up dialysis.

The results of the baseline assessment of these patients were presented at the Indian Society of Nephrology Conference held in Bangalore from December 17 to 20, 2015.  

Professor Vivekanand Jha, Professor of Nephrology at the PGIMER, Chandigarh, who led the team of researchers that did the study said “Though the sample size is small, the information on the economic impact of dialysis on patients and their families is providing insights into this critical aspect of dialysis services. The pilot feasibility study will be followed by a larger study to test the generalizability of some of these findings to the whole of the country.”

The larger study will evaluate if there are any regional or geographic differences, thereby informing and influencing policy makers on what would be the best approach to design strategies for the management of end stage kidney diseases in India.

Dr Oommen John, Senior Research Fellow at the George Institute for Global Health pointed out that approximately 150-200,000 individuals develop end stage kidney failure in India and need dialysis. Evaluation of the patient outcomes through such studies provide data to develop quality benchmarks and design better and affordable modes of treatment which are directed at optimizing outcomes. Healthcare systems that provide dialysis to their patients regularly collect data through registries that help optimize care delivery. Such studies will help develop a framework for setting up a registry in India.