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COVER STORY
more expensive HaemoDiaFiltration (HDF)
is an emerging trend in developed world
especially western Europe. Anaemia man-
agement is a baseline protocol that is fully
funded in the west to improve the quality
of life but it is not funded in India due to
budget constraints.What should the Government do to im-
prove dialysis care in India?
The Government should introduce strin-
gent regulations for opening a dialysis
centre to ensure baseline quality and pre-
vention of cross infections. In many cases,
a dialysis centre is started and managed by
a technician who just sets up operations
with refurbished dialysis machines and no
clinical protocols whatsoever. Having a ne-
phrologist associated with a dialysis centre
is mandatory to ensure proper clinical over-
sight and also reduce chances of cross infec-
tions that are rampant in dialysis in India.
There are talks to introduce accreditation
for dialysis centres and this might ensure
that more patients get dialysis treatment
in standalone centres as CGHS and other
panel patients would be able to get dialy-
sis. The country has only 1,300 practising
nephrologists and the dialysis centres are
over 5,000. So while having a nephrologist
associated with a centre is a must, one ne-
phrologist can man over 5 to 10 centres atthe same time. The Government should also
know the ground reality about the difficul-
ties associated of getting a full time MBBS
doctor or a nephrologist in a tier II, III or IV
city in India.
The Government should moot more sus-
tainable business models for PPPs in dialy-
sis. Recently, one state Government invited
proposal for 39 five-bed dialysis centres
across various districts with requirement of
full-time doctors. Another major issue with
Government projects is timely payments.
When payments from Government are
delayed, how can services be sustainable in
the long-term?NephroPlus has zero infection rate in dialy-
sis. How do you achieve that?
Patients in India who get dialysis for over
two years have a 30% chance of getting in-
fected by Hepatitis B or C or HIV infection.
The cross infection happens due to sharing
of contaminated consumables and due to
improper disinfection of equipment and
machine surfaces. To prevent cross infec-
tion from consumables, we have a ZIP Kit
(Zero Infection Point kit) that is uniquely
created for each patient. And for the sec-
ond reason, we have a comprehensive 56-
step dialysis process to prevent infections
transmission from bed and equipment
surfaces to the patients.4
- In the next few
years, Nephroplus
would look at global
presence and more
acquisitions in India.