PETALING JAYA: Hospital Kuala Lumpur (HKL) has seen a rise in the number of new kidney failure patients choosing home-based dialysis over in-centre hemodialysis, in part because of the Covid-19 pandemic as such patients are at increased risk of infection.
Covid-19 has forced the postponement of many surgical procedures, but Dr Sunita Bavanandan, the president of the Malaysian Society of Nephrology, told FMT government hospitals had continued to perform the simple and low-risk peritoneal dialysis (PD) access procedure.
She said it was time for Malaysians to give more thought to the therapy as an option.
PD removes waste products from a person’s blood with a cleansing fluid which flows through a catheter into the patient’s abdomen. The procedure usually takes 20 to 30 minutes and is usually done four times a day.
It can be done at home, at work or while travelling, thus eliminating the need for patients to travel and follow rigid schedules for access to hemodialysis machines located at hospitals and other healthcare settings.
Moreover, the hemodialysis treatment takes four hours and has to be done three times a week.
Sunita, who heads HKL’s Department of Nephrology, said many Malaysians remained unaware of the PD option although it became available in Malaysia in 1981.
She said fewer than 4,500 patients were on PD as of Dec 31, 2018 and this represented only 10% of all patients currently on dialysis.
The recent rise in the number of patients opting for it should be good news to the health ministry, which has long advocated the choice.
“Unlike haemodialysis, where the dialysis schedule has to be fixed to accommodate all other patients, the timing of exchanges in peritoneal dialysis is more flexible for patients’ activities and convenience,” Sunita said.
“There is also accumulating evidence from most developed and some developing countries that PD offers better cost savings than haemodialysis does, including in Malaysia.”
PD preserves remaining kidney function much longer than does hemodialysis, thus giving patients greater freedom in their diet and lifestyle.
Patients on PD have a lower risk of blood-borne infections like hepatitis and HIV because they don’t share machines with other patients. The treatment is also gentler on the heart since its more continuous process reduces the risk of sudden drops in blood pressure, which may occur in hemodialysis.
A patient on PD, Chee See Soon, told FMT he chose the treatment because of the flexibility it allows.
“I think most patients will be taken aback as there are a lot of new things to learn at first,” he said.
“But people should not be skeptical. It offers great flexibility and mobility and it’s very easy in terms of travelling. I have been to the US, London, Paris, Hong Kong, Taiwan, Thailand while on peritoneal dialysis.”