Mortality rate in India post dialysis is double the global rate: Study

A recent research paper published by Lancet medical journal and led by George Institute of Global Health has investigated the survival outcomes for patients receiving haemodialysis, and the geographic scope includes India as well. As per the study about 7 of every 10 patients survive dialysis beyond six months in India. This, as per the study, is the benchmark for survival among dialysis patients in India, meaning, of the total sample, 28 per cent patients (6,637 patients) receiving haemodialysis died within 10 months of receiving the treatment. The study titled, ‘Dialysis outcomes and practice patterns,’ suggests that the mortality rate in India is double the global rate in this regard.

“What we need is good infrastructure that is able to supplement the care given to a dialysis patient,” says Dr Ramesh Shah, a treating physician based in Mumbai and who is associated with Bhatia Hospital’s nephrology department. “There is a severe breakdown of basic dialysis infrastructure in most rural health centres and public hospitals in the satellite towns and smaller talukas. How do you think the survival rate will be high then, he asks.

Dialysis is a medical treatment to help individuals with kidney failure filter waste and excess fluid from the blood. As per the Lancet report, globally, India had the highest number of patients receiving the treatment in 2018, with nearly 1,75,000 people.

The researchers looked at 23,601 patients across 193 NephroPlus centres (which is a privately held dialysis centre network in India) in 20 states in India and noted that there was an “inverse relationship between mortality and dialysis vintage, with those receiving dialysis for at least a year prior to joining a centre having a 17 per cent lower rate of mortality than those who started dialysis less than 30 days before joining,” the researchers said.

Additionally, as per the paper published in The Lancet Regional Health-South East Asia, the mortality rate was higher for those who met the expense on their own rather than avail health insurance and government-subsidies. Diabetes and hypertension also contributed to mortality resulting from dialysis in a big way. “We are observing a rising number of diabetic cases that result in kidney failure. Uncontrolled diabetes is one leading cause and must be addressed,” says Shah.

The group examined by the researchers had 31 per cent of patients over the age of 60. “We need to have more data in relation to kidney diseases in India and this is a welcome step in that regard,” he said. “Also, getting supplementary medication and proper nutrition under the supervision of a medical practitioner or a nutritionist alongside dialysis, is equally crucial.”