Policymakers, doctors of private and government hospitals and experts held a closed-door brainstorming session during the Health Conclave at IIC to discuss policy issues related to kidney treatment in the country. Many constructive suggestions emerged out of the meeting. It was suggested that kidney transplantation costs for very poor patients be taken care of under the National Dialysis Programme. The participants said that since transplantation is the most cost-effective treatment for kidney failure, this is the best way to tackle it.
It was also suggested that urine albumin test should be conducted for early detection of kidney diseases. This test should be made a part of the screening process under the National Diabetes Screening Programme. Albumin excretion is an early sign of kidney disease.
To increase awareness about kidney diseases, all modes of mass media—like TV, Newspapers, radio etc—should be used. School children, RWAs, corporate offices and social clubs should also be roped in. The experts also suggested that there should be a transplant registry recording outcome data from all transplant centres across India. It was suggested that it should be started at least in states which have adopted the Clinical Establishment Act.
In order to improve deceased organ donation, it was suggested to get brain death data as well as conversion to organ donation data from all ICUs in India on a regular basis. Non-compliance should be taken seriously and warnings including closure of ICUs can be implemented.
There is a further need to increase awareness about brain death among physicians in general, especially in smaller nursing homes and other smaller health setups. According to the experts, the Tamil Nadu model of deceased organ donation has been a consistently successful model which should be promoted and implemented in other states as well.
Also discussed were various matters related to insurance of transplant and dialysis cases and the problems faced by patients with insurance policies. It was felt that some advocacy work needs to be done with the Insurance Regulatory & Development Authority (IRDA).
Giving Incentives to donor families was also debated. Dr Megha Pravin Khobragade, Director NOTTO, shared that this was under discussion within the ministry but received a lot of flak from international bodies. It was agreed by all present that, while monetary incentive should not be considered, other incentives related to social security, such as educational allowances, insurance etc., should be taken into consideration.
The closed-door session was attended by Dr Vijay Kher, Chairman, Nephrology & Urology, Medanta the Medicity; Dr Sanjeev Bagai, Chairman & Managing Director, Nephron Clinic, Specialist in Paedriatric Nephrology; Dr Dinesh Khullar, Head of Nephrology, Max Saket; Dr Yasir S. Rizwi, Senior Consultant, Nephrology, Dharamshila Narayana; Dr Pranaw K. Jha, Senior Consultant, Nephrology & Urology, Medanta the Medicity; Dr Reetesh Sharma, Director and Head Nephrology and Kidney Transplant Medicine, AIMS; and Pallavi Kumar, Executive Director, Mohan Foundation. The government panel was represented by Dr S. Rajesh, Director Health, NITI Aayog; Dr Promila Gupta, Principal Consultant – DGHS; Dr Megha Pravin Khobragade, Joint Director (NOTTO); Dr Aarti Vij, Professor of Hospital administration and faculty head ORBO, AIIMS.
The writer is Chairman, Nephrology & Urology, Medanta the Medicity