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Is haemodialysis the most feasible dialysis modality for Pakistan?

Salman Imtiaz1, Ashar Alam2

  • 1Department of Nephrology, The Indus Hospital, Karachi, Pakistan.

JPMA. the Journal of the Pakistan Medical Association
|April 5, 2021
PubMed

Insights

Chronic kidney disease (CKD) treatment options like hemodialysis pose environmental and economic challenges. Peritoneal dialysis offers a more eco-friendly and cost-effective alternative for CKD patients.

Area of Science:

  • Nephrology
  • Environmental Health
  • Health Economics

Background:

  • Chronic kidney disease (CKD) prevalence is increasing globally, imposing significant psychosocial and economic burdens.
  • Current CKD treatments include hemodialysis, peritoneal dialysis, and kidney transplantation, each with unique advantages and disadvantages.
  • Hemodialysis, while accessible in Pakistan, presents considerable environmental and economic concerns.

Purpose of the Study:

  • To evaluate the environmental and economic impact of hemodialysis for chronic kidney disease (CKD) patients.
  • To compare the sustainability of hemodialysis versus peritoneal dialysis.
  • To advocate for peritoneal dialysis as a preferred treatment option in Pakistan.

Main Methods:

  • Literature review of CKD treatment modalities.
  • Analysis of resource consumption (water, electricity) for hemodialysis.
  • Assessment of waste generation from hemodialysis procedures.
  • Comparative cost-effectiveness analysis of hemodialysis and peritoneal dialysis.

Main Results:

  • Hemodialysis requires substantial water volumes and generates significant solid waste (disposables) and electricity consumption.
  • These resource demands contribute to a considerable environmental and economic footprint.
  • Peritoneal dialysis demonstrates a more favorable environmental profile and cost-effectiveness.

Conclusions:

  • Hemodialysis for CKD is resource-intensive, impacting the environment and economy.
  • Peritoneal dialysis is a more sustainable and cost-effective alternative for managing CKD.
  • Prioritizing peritoneal dialysis can alleviate the environmental burden and economic strain associated with CKD treatment in Pakistan.

Keywords:
Pakistan, haemodialysis, peritoneal dialysis, chronic kidney disease.

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