Costly dialysis forces 80% patients to quit

Water has accumulated in her body and the patient cannot move properly. Her agony is evident on her face. Fifty-year-old Mamataz Begum of Mirpur is suffering from this condition because she could not have dialysis done for two weeks because of a lack of money. Unable to bear the pain any longer, she borrowed some money from a relative and went to the Kidney Foundation and Research Institute on Tuesday. 

Since she was diagnosed with kidney disease six years ago, Mamataz has to have dialysis done three times a week. But she has it done only once or twice a week because of the cost. Sometimes she has to discontinue dialysis even for two or three weeks at a stretch. Water accumulates in her body whenever she stops treatment. She usually pays for the treatment by borrowing money, but she is not sure how long she will be able to continue this way. 

A resident of Monipuripara, she used to teach at a kindergarten school in the city. She left her job because of this sickness. She is a registered patient at the Kidney Foundation and she has to spend Tk2,350 for every dialysis procedure. She also has to bear the cost of medicine and travel.  

Like Mamataz, about 80 percent of the kidney patients in the country cannot complete their treatment. According to the Kidney Foundation, 75 percent of patients are compelled to discontinue treatment just six months after commencing dialysis because of money issues. Physicians at other hospitals said the same thing. 

Dr Muhib Ullah Khandker, vice-principal at the Gonoshasthaya Community-based Medical College, told The Business Standard, "We get patients who frequently do not show up for dialysis. On enquiry, we learnt that they cannot come due to financial constraints. They are unable to pay Tk1,200 for each dialysis session. Kidney ailment is the worst among the diseases that make people poorer." 

Professor M Mohibur Rahman, former head of the department of Nephrology at Sir Salimullah Medical College and Mitford Hospital, said, "12-14 percent patients in the country suffer from some kind of kidney ailment. When a kidney becomes dysfunctional, it requires dialysis or transplantation. Both processes are expensive. We have found from a good number of researches that just a few patients are able to bear the cost of treatment." 

"Most of the patients cannot afford the dialysis cost of Tk4,000 to 5,000 a week at private facilities. Many patients cannot even afford the Tk1,200 cost per week at government hospitals. As a result, many patients have no option but to lead an unbearable life without treatment," he added.   

Kidney patients on the rise  

Around two crore people are suffering from some kind of kidney diseases in Bangladesh. Of them, about 40,000 suffer from long-term kidney ailments. At one stage, their kidneys become completely damaged, and then they have no other way but dialysis or transplantation. According to the Bangladesh Renal Association, 80 percent of kidney patients die after short-term treatment or without any treatment. 

Kidney diseases are spreading due to diabetes, high blood pressure, pain in kidney, taking painkillers, excessive use of antibiotics, taking herbal medicines, drinking contaminated water and eating adulterated food.  
Professor Harun Ar Rashid, founder president of the Kidney Foundation, said, "Diabetes and high blood pressure are closely linked to kidney diseases. Currently, around 80 lakh people are suffering from diabetes and two crore people are suffering from high blood pressure in the country. Treatment and awareness are necessary for those who have been suffering from diabetes and high blood pressure." 

Dr Muhib Ullah Khandker said diabetes and hypertension are the main causes for the increasing number of kidney patients. Adulterated food and pollution are also responsible for spreading the disease. 

Treatment not easily accessible 

Kidney treatment in the country is not easily available. It has not yet reached the village level. The number of kidney transplants is still very low because of the absence of kidney donors and the legal complications. 

In addition, just a few hospitals can transplant kidneys, and a kidney transplant operation costs between Tk2.6 lakh and Tk3.5 lakh. On top of that, one also has to pay the person who gives the kidney. 

Under the circumstances, dialysis is the only option when a kidney becomes dysfunctional. At private facilities, patients have to spend Tk12,000 to Tk15,000 per week for dialysis. Patients are compelled to go to private hospitals because of the shortage of machines at government hospitals. 

However, the government has taken-up a project to set up a 50-bed dialysis unit at every government medical college hospital, and a 10-bed unit at every district hospital. 

Kidney patients need health insurance coverage 

Kidney patients are unable to carry on with the expensive treatment individually. So, experts have called for health insurance coverage for kidney patients. 

Dr Muhib Ullah Khandker said Gonoshasthaya Dialysis Centre gives treatment at low cost. This is possible because of donor assistance and zakat funds (Islamic charity). 

"Still, the assistance we provide to the patients is merely one third of their total treatment costs. We have insurance coverage for our patients. Such an arrangement has to be made at the government level," he added. 

Physicians have also called for government subsidy for expensive kidney treatment.

Stem cell not recognised in kidney treatment  

Physicians said nowadays stem cell therapy is talked-about for kidney treatment. But this method is not recognised in any country. 

They made the statements at a press conference jointly organised by the Kidney Foundation, the Bangladesh Renal Association and the Kidney Awareness Monitoring and Prevention Society in the city yesterday. 

The physicians called on patients not be misled by any propaganda about stem cell therapy. 

Today is Kidney Day. The theme this year is 'Kidney Health for Everyone Everywhere-from prevention to Detection and Equitable access to care.'