Local renal failure study flawed

A recent study by University of Guyana students, which found that the quality of life in kidney failure patients at the Georgetown Public Hospital Corporation (GPHC) was higher among those who received hemodialysis, as compared to those on peritoneal dialysis, has been questioned as doctors say inferior drugs were being used during the research period.

The study, titled ‘Hemodialysis versus Peritoneal Dialysis: in the context of Guyana’s setting’, was conducted to assess whether hemodialysis was a better option as against peritoneal dialysis for an improved quality of life in adult patients diagnosed with chronic renal failure between the years 2007 and 2014 in Region 4.

The findings of the study were presented on November 24 at Grand Coastal Inn by UG student Garfield Bryan, who conducted the research in collaboration with Rene Sealey.

Their findings are contrary to international standards and doctors present when the results were presented attributed this to the fact that during the time the study was conducted there had been a shortage in the supply of fluid for peritoneal dialysis and those patients were being treated infrequently and with inferior drugs.

“As of recently, somebody decided to buy original Baxter fluid… and there is a big difference currently in the outcome and satisfaction of peritoneal dialysis fluid presently at Georgetown. If you go back and do this research, your research will be comparable with universal statistics. Because what GPHC was doing all the time is that they looked at the inferior quality and just the supply and demand rather than quality,” Dr Kishore Persaud, Transplant Surgeon and Head of the Nephrology Department at GPHC stated.

Persaud explained during his presentation that peritoneal dialysis was cheaper, could be done at home, allowed patients to retain their primary kidney function and required less blood transfusions.

Nevertheless, the findings of the research by Bryan and Sealy showed that hemodialysis patients reported having a better quality of life, feeling better physically and having better social relationships.

“Why is your study so different to the international study?” Dr Joel Joseph questioned after the study had been presented.

Joseph then went on to explain that during the time the study was conducted, April 2015 to July/August 2016, there had been problems with the supply of drugs for patients on peritoneal dialysis.

“…The stark difference in quality of life is because mainly of supply of treatment. Patients with peritoneal dialysis for the longest while were not getting adequate dialysis, they didn’t have the dialysis fluid to instill and exchange the recommended amount of times daily,” Joseph stated.

He further related that many times patients were placed on peritoneal dialysis because they could not afford the hemodialysis sessions, but stated that because the availability of the fluid had been limited, patients on peritoneal dialysis were forced to purchase the fluid themselves, which worked out to be more expensive.

Joseph attributed the cost to an inflation in prices of the fluid being sourced in Guyana, which he stated was more expensive than anywhere else in the world.

The doctor further stated that the GPHC had been working hard to improve the psychosocial environment of the patients, noting that the hospital has had a social worker in residence for more than a year now.

Bryan and Sealy’s study had found that both patients of peritoneal dialysis and hemodialysis indicated that they had little to no money available to them for treatment and depended on friends, overseas relatives and money from NIS and the Ministry of Public Health for support.