CEBU CITY-- Incidence of kidney diseases is on the rise in Central Visayas, and medical renal experts here claim that data on renal cases in the region are underreported.

Dr. John Li, a private nephrologist, said the data given by the Department of Health 7 of 514 patients undergoing dialysis treatment in 2010 taken from the Primary Renal Disease is "too low."

Li said the data perhaps only reflected those patients with permanent residence and does not include transient dialysis patients.

“I receive an average of 10 to 20 patients a day and half of them really have renal problems. And more than 50 percent cannot afford regular dialysis treatment,” Li said at the Kapihan sa PIA that featured the observance of June as National Kidney Month.

Dialysis treatment in a private hospital is said to cost between P3,000 to P4,000 per session while a patient with end-stage renal disease requires three times a week treatment, he said.

“Lack of money is basically the reason why renal patients do not seek dialysis or drop out from regular dialysis sessions or dialyze only one to two times instead of three times a week,” Li said.

Renal transplant surgeon Dr. Alvin Roxas of the Vicente Sotto Memorial Medical Center also said he believes the data is under-reported.

“When I started five to six years ago, there were already 4,000 new dialysis patients then. Year in, year out the number of patients needing dialysis is growing. In fact, at VSMMC we do four shifts instead of the usual two shifts because of the growing number of patients,” disclosed Roxas.

Roxas also said one indicator of rising renal cases is the sprouting dialysis centers in Cebu City.

DOH 7 Regional Director Asuncion Anden said in the same forum that there were 514 dialysis patients in Central Visayas in 2010. Of the figure, 290 patients were from Cebu, 108 from Bohol, 37 from Negros Oriental and two from Siquijor, with a total of 329 patients from Region 7 while 185 patients were from other provinces.

Anden said the same number have more or less been recorded for 2009 while they do not have the data yet for 2011.

He admitted that there is no system-based data on the exact figure of patients undergoing dialysis and that this needs to be addressed to have a real situationer on incidence of renal diseases in Central Visayas.

“We should focus more on how to prevent developing kidney disease rather than the correct data because we want to promote quality and productive life,” Li said.

Roxas, urged the public to undergo annual urinalysis for early detection of kidney dysfunction. This should be done at least once a year. he said. "Do it as a birthday gift to yourself,” said Roxas. Urinalysis costs around P60 here, he said.

The DOH-7 meanwhile, has lined up several forums this month on kidney disease prevention, particularly to public health workers in celebration of June as National Kidney Month.*PIA Cebu

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Newswise — Washington, DC (June 14, 2012) — Among patients with moderate to advanced chronic kidney disease (CKD), homeless people experience higher rates of premature death and kidney failure, and they use emergency services much more often than impoverished peers with stable housing, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN). The findings indicate that greater efforts are needed to address the unmet needs of homeless patients with CKD and other chronic conditions to improve their health and reduce public costs.

Approximately 3.5 million people are homeless each year in the United States. Like many disadvantaged and vulnerable groups, homeless people experience numerous barriers to obtaining appropriate and effective medical care.

While homeless people’s elusive nature can make it difficult to get an accurate look at their health, Yoshio Hall, MD (University of Washington, Seattle) and his colleagues now provide a rare glimpse. The researchers analyzed the medical records of 15,343 adults with moderate to advanced CKD who received outpatient care from 1996 to 2005 from the Community Health Network, a large safety net healthcare provider run by the City and County of San Francisco; 858 of these (6%) were homeless.

Compared with poor adult patients with stable housing:
• Homeless adult patients were younger, disproportionately male and uninsured, and they suffered from much higher rates of depression and substance abuse.
• Over an average follow-up of more than two-and-a-half years, homeless adult patients had an 82% increased risk of developing kidney failure or dying. After demographic factors, substance abuse, and other medical conditions were taken into account, they had a 28% increased risk of developing kidney failure or dying.
• Also during follow-up, half of homeless adult patients visited the emergency department more than nine times and experienced more than five hospitalizations. Most housed patients experienced one or no emergency department visits or hospitalizations.

“Sadly, for most homeless persons, securing adequate shelter, food, and clothing often competes with regular healthcare and results in more frequent use of costly acute care services to manage chronic conditions,” said Dr. Hall. “Use of these acute care services might actually decline among the homeless when services such as transportation, social work, nutrition, and healthcare provider access become available following dialysis initiation.” Additional research is needed to see if such support services actually help homeless people receive appropriate and effective medical care, improve their health, and ultimately reduce public costs.

Study co-authors include Andy Choi, MD (University of California San Francisco); Jonathan Himmelfarb, MD (University of Washington, Seattle); Glenn Chertow, MD (Stanford University School of Medicine); and Andrew Bindman, MD (University of California San Francisco and San Francisco General Hospital).

Disclosures: Dr. Hall receives research support from Satellite Healthcare’s Norman Coplon extramural grant program. Dr. Chertow is a member of the Board of Directors of Satellite Healthcare and the Scientific Advisory Board of DaVita, Inc. and has consulted for Amgen, Inc. The authors dedicate their manuscript to their late colleague, Dr. Andy Choi, who devoted his research to improving the health of society’s most vulnerable populations.

The article, entitled “Homelessness and Chronic Kidney Disease: A cohort Study,” will appear online at http://cjasn.asnjournals.org/ on June 14, 2012, doi: 10.2215/CJN.00060112.

The content of these articles does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Founded in 1966, and with more than 13,500 members, the American Society of Nephrology (ASN) leads the fight against kidney disease by educating health professionals, sharing new knowledge, advancing research, and advocating the highest quality care for patients.
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Approximately 3.5 million people are homeless each year in the United States. Like many disadvantaged and vulnerable groups, homeless people experience numerous barriers to obtaining appropriate and effective medical care.

While homeless people's elusive nature can make it difficult to get an accurate look at their health, Yoshio Hall, MD (University of Washington, Seattle) and his colleagues now provide a rare glimpse. The researchers analyzed the medical records of 15,343 adults with moderate to advanced CKD who received outpatient care from 1996 to 2005 from the Community Health Network, a large safety net healthcare provider run by the City and County of San Francisco; 858 of these (6%) were homeless.

Compared with poor adult patients with stable housing:

• Homeless adult patients were younger, disproportionately male and uninsured, and they suffered from much higher rates of depression and substance abuse.
• Over an average follow-up of more than two-and-a-half years, homeless adult patients had an 82% increased risk of developing kidney failure or dying. After demographic factors, substance abuse, and other medical conditions were taken into account, they had a 28% increased risk of developing kidney failure or dying.
• Also during follow-up, half of homeless adult patients visited the emergency department more than nine times and experienced more than five hospitalizations. Most housed patients experienced one or no emergency department visits or hospitalizations.

More information: The article, entitled "Homelessness and Chronic Kidney Disease: A cohort Study," will appear online on June 14, 2012, doi: 10.2215/CJN.00060112

Journal reference: Clinical Journal of the American Society of Nephrology

Provided by American Society of Nephrology

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