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Help Treat Chronic Renal Failure in Sri-Lanka

Help Treat Chronic Renal Failure in Sri-Lanka. An Appeal by Sri-Lankan Physicians. Chronic Renal Failure. An endemic form of chronic renal failure emerged in epidemic proportions in North Central, North Western, Eastern and Uva provinces in Sri Lanka

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Help Treat Chronic Renal Failure in Sri-Lanka

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  1. Help Treat Chronic Renal Failurein Sri-Lanka An Appeal by Sri-Lankan Physicians Dr. Ananda Gunewardena

  2. Chronic Renal Failure • An endemic form of chronic renal failure emerged in epidemic proportions in North Central, North Western, Eastern and Uva provinces in Sri Lanka • Unknown etiology. Ongoing clinically investigation with the financial support from the WHO. Dr. Ananda Gunewardena

  3. Chronic Renal Failure - 2 • 2 – 3% Prevalence in all affected provinces • Very high prevalence (10%) in some areas • Padaviya (NCP) • Madavachchiya (NCP) • Polpethigama (NWP) • Approximately 2000 patients are being added annually to the disease burden Dr. Ananda Gunewardena

  4. Affects • Approximately 300-600 deaths occur in hospitals due to CKD Annually • Mortality rate could be higher because home deaths are not included in death registries. • Approximately 1400 deaths occur nation wide • 50 to 60 deaths in Kurunegala Dr. Ananda Gunewardena

  5. Socioeconomic Impact • Young people are predominantly affected. • Common among patients residing in paddy cultivating areas • Male to female ratio = 4: 1 Dr. Ananda Gunewardena

  6. Etiology • Unknown Primary cause • Possible causes: • Chronic exposure to heavy metals such • Cadmium • Fluoride Dr. Ananda Gunewardena

  7. Diagnosis and Treatment • Diagnosis • Urine Albumin test • Blood Creatinine test • US scanning of kidney • Treatment • Kidney replacement treated by using dialysis • Medical management of metabolic abnormalities Dr. Ananda Gunewardena

  8. Financial Needs • Chronic kidney disease clinics for identification and management of patients • (approximately 3000 patients are being treated) • Pharmaceuticals • Maintenance dialysis for end stage renal disease • Kidney transplantation for eligible patients Dr. Ananda Gunewardena

  9. Hemodialysis Units in Sri-Lanka Dr. Ananda Gunewardena

  10. Special Burdens • High disease burden in Kurunegala and Anuradhapura districts • Being in the most affected provinces, these hospitals have to care for more patients • Results in high cost of care and shortage of resources Dr. Ananda Gunewardena

  11. Related Issues • Acute renal failure is prevalent in this region mainly due to • Snake bites • Leptospirosis etc. Dr. Ananda Gunewardena

  12. Statistics - 2007 Dr. Ananda Gunewardena

  13. Current Status • Dialysis unit • Three Hemodialysis machines and • A peritoneal dialysis section. • Current dialysis unit serves only a small proportion of patients • Grossly inadequate to meet the demand. Dr. Ananda Gunewardena

  14. Estimated Needs • Hemodialysis unit with 25 dialysis machines and chairs. • Ten-bed Peritoneal dialysis section • Male and female wards Dr. Ananda Gunewardena

  15. Existing Facilities • Twenty five peritoneal dialysis section • 16-bed male and female wards • Water purification plant for hemodialysis • Consultant MOO, nurse manager and clinic nurses with nursing station • Restrooms for MOO, nurses and non-medical staff • Supply, storage, linen and sterilization areas • Academic areas Dr. Ananda Gunewardena

  16. Costs • Machine costs • Rs. 30 million / 15 hemodialyis machines • Rs. 5 million for a water purification plant • Cost of consumables • Hemodialysis: RS. 2.4 million • Peritoneal dialysis : Rs. 1.5 million • Intensive care hemodialysis: Rs. 0.6 million • Rs. 33.5 million building (CECB estimate) Dr. Ananda Gunewardena

  17. Wish List • Dialysis machines of following brands • Dialog, B’Braun, Fresenius, Gambro • Consumables • Diacaps • Blood line set • Concentrate can (bicarbonate & acetate) • Transducer protector (two per dialysis) Dr. Ananda Gunewardena

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