Question

What ethical issues surround the use of kidney dialysis machines? What roles do you think social or economic factors play in decisions? Do the rich and poor have the same access? What criteria would you use to decide who would receive dialysis?

Answer 1

Dialysis is the process of removing excess water, solutes and toxins from the blood in people whose kidney no longer perform these functions naturally. It is also referred as Renal Replacement Therapy.

Dialysis is used as temporary measure in either acute kidney injury or those in awaiting kidney transplant and as a permanent measure in those for whom a transplant is not indicated or not possible .

Treatment for end stage kidney disease is a major economic challenge and public health concern worldwide. In earlier itself kidney transplantation and dialysis have raised ethical questions since their introduction to clinical practice..

Renal Replacement Therapy posses several practical and ethical dilemmas of global relevance for the patients,clinicians and policy makers . These includes how to promote patients best interests, increase the acces to dialysis while maintaining procedural and distributive justice, minimize the influence of financial Incentives and competing interests ensuring quality of care in service delivery and access to non dialytic supportive care when needed, and thus minimize the financial burden of patients and health care systems, and protect the interests of vulnerable groups during crisis situations.

Social and economic factors have a great role in taking decisions for dialysis.. Large proportion of peoples with end stage of kidney disease can be found in low-income and lower-middle income countries ... The socio-economic factors consisting of eduacation, income, employment and funding are important parameters affecting the kidney patient. Dietary counseling of patients on haemodialysis is mandatory.. The intervention on socio-economic situations allow delivering important messages on foods with least amount of phosphorus and adequate protein content . And they may be a successful strategy in targeting patients at higher risk of hyperphosphoremia.

The Poor and Rich have different acces towards dialysis. Poverty is known to be most risk factor for end stage kidney disease. People's in poverty zip areas were threatening eith their life... They don't have enough money to buy the medicines... They were not provided with enough nutrient food and food supplements containing electrolytes and thus poverty were strong risk factor for renal diseases... They were leading to kidney failure.