Pradhan Mantri National Dialysis Programme (PM-NDP) - The government may soon establish peritoneal dialysis services across states to provide door-step dialysis services for kidney patients. Ministry of Health and Family Welfare Guideline
- The Union ministry of health and family welfare has set guidelines under the Pradhan Mantri National Dialysis Programme (PMNDP), asking states to include the services to implement the program.
- If the proposal is implemented by the states, patients can avail of dialysis, along with several other services, at home.
- The guidelines will serve as a comprehensive manual for best practice for states intending to set up peritoneal dialysis centers.
- This will ensure the delivery of high-quality and cost-effective services and develop a clinically-safe and effective program.
The implication of the Guideline:
- The move will benefit about 200,000 people who develop end-stage kidney failure every year in India.
- They now have another treatment option that allows them to do dialysis at home with potential flexibility in lifestyle.
- Mass-based peritoneal dialysis programs also have the potential to substantially bring down the cost of treatment.
- Peritoneal dialysis does away with the substantial costs of infrastructure, maintenance and staffing reduces the demand on the healthcare system and offers patient autonomy.
- The guidelines also address problems faced by pediatric patients.
About Pradhan Mantri National Dialysis Programme(PMNDP)
- The Pradhan Mantri National Dialysis Programme was rolled out in 2016 as part of the National Health Mission (NHM) for the provision of free dialysis services to the poor.
- The first phase envisaged setting up centers for hemodialysis.
- The Guidelines for Pradhan Mantri National Dialysis Programme envisage the provision of dialysis services under NHM in PPP (Public-Private Partnership) model.
Solution Strategy There are two main types of dialysis, which are hemodialysis and peritoneal dialysis.
- Hemodialysis (HD): commonly known as blood dialysis. In HD, the blood is filtered through a machine that acts like an artificial kidney and is returned back into the body. HD needs to be performed in a designated dialysis center. It is usually needed about 3 times per week, with each episode taking about 3-4 hours.
- Peritoneal dialysis (PD): commonly known as water dialysis. In PD, the blood is cleaned without being removed from the body. The abdomen sac (lining) acts as a natural filter. A solution (mainly made up of salts and sugars) is injected into the abdomen that encourages filtration such that the waste is transferred from the blood to the solution.
There are 2 types of PD -
- Continuous ambulatory peritoneal dialysis (CAPD)-CAPD needs to be done 3 to 5 times every day but does not require a machine.
- Automated peritoneal dialysis (APD)-APD uses an automated cycler machine to perform 3 to 5 exchanges during the night while the patient is asleep.