SUBSIDISED DIALYSIS PROGRAMME
Haemodialysis is a process by which excess waste products and water are removed from the blood. This process requires an access to the patient's blood stream and the use of a haemodialysis machine. An access is a specially created vein in the arm known as arterio-venous (AV) fistula.
In haemodialysis, the blood channels through plastic tubings (blood lines) to the dialyser which is a bundle of hollow fibres made up from semi-permeable membrane. Here the exchange (diffusion) takes place from blood to the dialysis solution (dialysate) and vice versa. The dialysate has a salt composition similar to blood but without any waste products. Usually one dialysis session takes about four hours to complete and patient requires dialysis three times a week.
Patients admitted into our subsidised haemodialysis programme will dialyse at the dialysis centre located nearer to their homes, depending on availability of dialysis equipment at the centre.
Peritoneal dialysis is a form of dialysis that occurs inside the body.
Dialysis solution will flow into the peritoneal (abdominal) cavity through a silastic catheter. The peritoneal membrane (petrionuem) acts as a filter. Waste products and excess water pass from the body through the membrane into the dialysis solution. When the filtering process is completed, the waste filled solution is to be drained from the peritoneal cavity into a bag and is then discarded.
Fresh dialysis solution is drained into the abdominal cavity through the catheter again. Each exchange takes about 45 minutes.
There are two forms of peritoneal dialysis:
- CAPD or Continuous Ambulatory Peritoneal Dialysis - The patient will perform four exchanges during the day.
- APD or Automated Peritoneal Dialysis - The exchanges are performed by the machine during the night while the patient is asleep.
SUBSIDISED MEDICATIONS PROGRAMME
KDF’s subsidised medications programme offers subsidies for four medications:
d) Lanthanum Carbonate
As part of KDF’s efforts to provide holistic care to the patients, it initiated the ‘Subsidised Erythropoietin Injection Programme.’ This programme helps alleviate the associated problems of anaemia such as fatigue, poor appetite and insomnia, enabling patients to lead a normal lifestyle. To date, over 70% of KDF’s patients have benefited from the programme.
In 2005, KDF introduced two more medicines into its subsidized medications programme – Calcijex and Venofer. In chronic renal failure, the kidneys produce insufficient Vitamin D. Calcitriol (Calcijex) is a man-made form of vitamin D. Vitamin D is necessary to maintain the right calcium level in the blood for strong bones. Venofer is a type of iron sucrose used in the treatment of iron deficiency in dialysis patients.
KDF started providing financial assistance in January 2010 for patients who have been prescribed with Lanthanum Carbonate by their primary physician in the restructured hospital. Prevalent in patients with chronic kidney disease is an increased level of phosphate retention. Calcium levels are low due to precipitation of phosphate with the calcium in the tissues. This condition is treated with the prescription of Lanthanum Carbonate. The medicine helps to bind the dietary phosphate, thus preventing the phosphate from being absorbed by the intestine.
SHARE A LIFE PROGRAMME
With the support of the Ministry of Health, the Share a Life initiative was launched jointly by the Society of Transplantation, Kidney Dialysis Foundation and the Khoo Foundation on 12 November 2005. Share a Life aims to build support for live donor kidney transplantation by educating the public on the needs and benefits of live donor transplants.
In the programme, KDF has committed to provide funds for
a) Grant for donors’ surgery
b) Bridge to Transplant programme
c) Publicity and Education.
KDF contributes to help donors pay for their hospitalisation for the donor surgery. In the Bridge to Transplant programme, KDF provides interim care for patients who are waiting for kidney transplant from a living relation to ensure that proper dialysis treatment is given to them in preparation for transplant. The Foundation will provide fast track subsidised dialysis to these patients from restructured hospitals.
HIGH-DEPENDENCY DIALYSIS PROGRAMME
To further help its needy kidney patients, KDF introduced a new programme called the Portable Subsidy Programme. This programme is specially created to help patients that require more medical attention and services that KDF is unable to provide. This group of patients is generally known as high dependency dialysis patients.
Under the Portable Subsidy Programme, KDF's high dependency dialysis patients can apply for financial assistance for their dialysis treatment at a dialysis provider recommended by their medical social worker and primary physician from the Restructured Hospitals.