Renal Replacement Therapy Practices in India: A Nationwide Survey

Kanwalpreet Sodhi; Atul Phillips; Rajesh C Mishra; Niraj Tyagi; Subhal B Dixit; Dhruva Chaudhary; Manender K Singla; Prakash C Kowdle; Poonam M Kapoor

doi:10.5005/jp-journals-10071-23554

Renal Replacement Therapy Practices in India: A Nationwide Survey

Indian J Crit Care Med. 2020 Sep;24(9):823-831. doi: 10.5005/jp-journals-10071-23554.

Authors

Kanwalpreet Sodhi¹, Atul Phillips², Rajesh C Mishra³, Niraj Tyagi⁴, Subhal B Dixit⁵, Dhruva Chaudhary⁶, Manender K Singla⁷, Prakash C Kowdle⁸, Poonam M Kapoor⁹

Affiliations

¹ Department of Critical Care, Deep Hospital, Ludhiana, Punjab, India.
² Department of Critical Care, Christian Medical College and Hospital, Ludhiana, Punjab, India.
³ Department of Critical Care, Epic Hospitals, Ahmedabad, Gujarat, India.
⁴ Department of Critical Care, Sir Ganga Ram Hospital, New Delhi, India.
⁵ Department of Critical Care, Sanjeevan and MJM Hospital, Pune, Maharashtra, India.
⁶ Department of Pulmonary and Critical Care, Pandit Bhagwat Dayal Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India.
⁷ Department of Cardiac Anesthesia, Hero Heart DMC Institute, Ludhiana, Punjab, India.
⁸ Department of Nephrology, Tamil Nadu, India.
⁹ Department of Cardiac Anaesthesiology, All India Institute of Medical Sciences, New Delhi, India.

Abstract

Introduction: Renal replacement therapy (RRT) is utilized for patients admitted with acute kidney injury and is becoming indispensable for the treatment of critically ill patients. In low middle income and developing country like India, the epidemiological date about the practices of RRT in various hospitals setups in India are lacking. Renal replacement therapy although is being widely practiced in India, however, is not uniform or standardized. Moreover, the use of RRT beyond traditional indications has not only increased but has shifted from the ambit of the nephrologist and has come under the charge of intensivists.

Aims and objectives: The goal of the study was to record perceptions and current practices in RRT management among intensivists across Indian intensive care units (ICUs).

Materials and methods: A questionnaire including questions about hospital and ICU settings, availability of RRT, manpower availability, and RRT management in critically ill patients was formed by an expert panel of ICU physicians. The questionnaire was circulated online to Indian Society of Critical Care Medicine (ISCCM) members in October 2019.

Results: The facilities in government setups are scarce and undersupplied as compared to private or corporate setups in terms of ICU bed strength and availability of RRT. High cost of continuous renal replacement therapy (CRRT) makes their use restricted.

Conclusion: Resources of RRT in our country are limited, more in government setup. Improvement of the existing resources, training of personnel, and making RRT affordable are the challenges that need to be overcome to judiciously utilize these services to benefit critically ill patients.

How to cite this article: Sodhi K, Philips A, Mishra RC, Tyagi N, Dixit SB, Chaudhary D, et al. Renal Replacement Therapy Practices in India: A Nationwide Survey. Indian J Crit Care Med 2020;24(9):823-831.

Keywords: Acute kidney injury; Continuous renal replacement therapy; Renal replacement therapy.