Need for more preventative care for dialysis patients

by Curlan Campbell, NOW Grenada

  • Island Health Services has capacity to operate 8 dialysis machines
  • 70% of patients referred to the clinic are from the General Hospital
  • March is designated as National Kidney Awareness month

A more patient-centred approach to care for dialysis patients aimed at prevention will be the new thrust for Island Health Services, as more and more people diagnosed with kidney failure mostly consist of those who have reached the late stages of the disease.

The IHS facility which provides haemodialysis treatment is now operational at its new location the Grand Etang Road in St George’s with the capacity to operate 8 dialysis machines.

Managing Director, Trevor Forrester, has observed a slight improvement in some aspects of preventive care in Grenada, and believes this should the primary focus in managing the disease. “Those type of patients who are diabetic and hypotensive and who may have other risks factors, those patients tend to present themselves to the General Hospital very late. There are 5 stages of kidney failure and patients are showing up at the hospital around stage 4 or 5.”

As part of the ongoing refurbishment of the IHS facility that currently runs 4 dialysis machines, upstairs will be used as a resource centre to provide more comprehensive care aimed at managing the disease at an early stage.

Integral to this process, Forrester said is the need for a clinical nutritionist who would be on hand to assist patients once the resource centre is established. “We would like to give patients information on the disease and a lot of it has to do with having proper diet management and knowing your numbers, taking your medication and helping them with reminders. A clinical nutritionist is key to that preventative programme, and also a nephrologist as a resource for primary health doctors.”

Currently, 70% of patients referred to the clinic are from the General Hospital and as many as 60 patients are managed at the pre-dialysis clinic. At present, there are 22 patients receiving dialysis treatment including 6 receiving peritoneal dialysis treatment. The IHS clinic treats around 16 patients and that is expected to increase to between 18 or 19 next week as more patients are added. Forrester believes there may be more patients being treated at other private facilities around the island and outside of Grenada, and looks forward to the General Hospital’s treatment clinic up and running which can help to better manage the dire situation of kidney disease.

Another major huddle in the fight against kidney disease is the cost of treatment. Currently, patients pay out of pocket $450 per treatment, with the Government of Grenada and the Grenada Kidney Foundation contributing $160 per treatment. There are ongoing discussions with government on how they can increase their contributions. Forrester hopes that the National Health Insurance (NHI), will also provide more support for dialysis patients.

The process to have the new facility at its present location was not an easy task. It took a significant amount of time, research and financial resources to have the facility operational at a cost of EC$400,000. The overall developmental cost when the facility first opened at Belmont, St George, and subsequently moved to the St Augustine Medical Services, cost $1.3 million including the cost to acquire the dialysis machines.

Speaking to the current Covid-19 restrictions, Forrester said, “We always have to practice universal infection control. However, we are taking further steps regarding visitors, and have also stopped accepting foreign patients.”

March is designated as National Kidney Awareness month and this year’s theme is “Kidney Health for Everyone Everywhere – from Prevention to Detection and Equitable Access to Care.”

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