Trust looks to prevent kidney ailments Calls on Govt, NGOs to target groups

THE Kidney Help Trust, which has been running a programme to prevent chronic renal failure by regular screening in a specific area, is hoping that the government or small groups or non-governmental organisations will take up similar programmes to cover targeted populations. The trust will share its experience of running the programme for eight years now, according to Dr M.K. Mani, Chief Nephrologist, Apollo Hospital, and Managing Trustee, Kidney Help Trust.

At a press conference here on Sunday, Dr Mani said taking up screening programmes was the only alternative as it would not be possible to fund a long-term dialysis programme for those with kidney ailments. Renal transplants and follow-up medication were prohibitively expensive; a transplant could cost about Rs 3.50 lakh and medication anything between Rs 10,000 and Rs 1 lakh a year.

Dr Mani said the trust had been running the programme for eight years covering a population of 23,000 and treating diabetes and hypertension with the cheapest available drugs. The cost amounts to Rs 14.23 per capita of the population a year, excluding the cost of the tests that were done free at Apollo Hospital, he said and added that the programme was recently expanded to cover the adjacent area with a population of 21,000. There were 33 persons with kidney function below normal per 1,000 of the new population taken up, while the population covered under the project for eight years had only eight per 1,000 with kidney function below normal, he said.
Referring to the "lopsided cost equation," he said while dialysis and transplants had to continue, the bulk of India could not afford it. Given the high cost of dialysis, renal transplants and medication and considering that government expenditure on health worked out to just Rs 400 per capita per year, the only feasible option was to prevent renal failure.

Dr Mani said diabetes accounted for around 30 per cent of all chronic renal failure in India and hypertension another 10 per cent. Control of these two conditions would protect against damage to the blood vessels and, therefore, to the kidneys. The trust took up the screening programme in 26 villages in Sriperumbudur taluk, involving girls who were from the area. Each family had been covered and every member of the population screened once in 18 months. While 90 per cent of the population covered co-operated with the survey, only 30 per cent of the patients were aware of their disease. Among those who co-operated with the trust for the treatment, blood pressure was controlled to ideal levels in 96 per cent, glycated haemoglobin to normal in 52 per cent and significantly improved though not to completely normal in another 25 per cent.
"This is something which can fit easily into a government programme," Dr Mani said referring to the per capita cost. The project had a simple protocol, easy tests, involved social workers from the area, and cheap and effective drugs were prescribed. The most significant aspect of the programme was that the social workers visited every home in the area.
 
Dr Jan J. Weening, President, International Society of Nephrology, who saw the project with Dr John Dirks, Chairman of the society's Commission for the Global Advancement of Nephrology, said there was a tremendous increase in diabetes and hypertension and preventive healthcare was important. He said the Kidney Help Trust's programme was a paradigm for the rest of the world as it showed that kidney diseases could be prevented at low cost. Dr Dirks described Dr Mani as an "inspirational leader" as he had shown what could be done.

Link : http://www.blonnet.com/2005/02/21/stories/2005022102270500.htm

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