Cross-infections from dialysis centres

NST: They walked in with chronic kidney trouble and left with the added burden of liver problems for life.
This was the fate of a group of kidney patients who went to a privately-run dialysis centre for treatment and were infected with the hepatitis C virus.
The cross-infection is believed to have occurred because of poor adherence to guidelines on dialysis.
Health Minister Datuk Dr Chua Soi Lek said the cross-infection may not have occurred had the centre followed the ministry’s "Guidelines on Standards for Haemodialysis Treatment".
"It’s important trained and qualified staff are engaged in dialysis centres to ensure kidney patients get quality and safe treatment and do not fall victim to cross-infections," he said.
It is understood that all dialysis centres run by non-governmental organisations and individuals would be audited to ensure they met ministry standards.
Hepatitis C is a liver disease, passed on intravenously, which can lead to cirrhosis and cancer of the liver.
Dialysis, both haemodialysis and peritoneal, involves treatment to remove wastes and excess water from the bodies of people in the later stages of chronic kidney disease.
National Kidney Foundation vice-chairman Datuk Dr Zaki Morad Zaher said cross-infections could be averted if the managements of dialysis centres adhered strictly to ministry guidelines and standards.
"We are concerned about this problem as we find that many privately-run centres are not adhering to the guidelines and standards," the consultant nephrologist told the New Straits Times.
The National Renal Registry report, he said, indicated a wide variation in practice among centres run by the Government, NGOs, individuals, the armed forces and universities.
"Dialysis is a fairly standard treatment and there should not be too much variation. When there are variations, we worry about the outcome. Centres with poorer standards may have higher morbidity and mortality. This is what we are trying to address now," he said.
Dr Zaki said private dialysis centres, which were mushrooming, may not have the resources to administer quality treatment.
He said many were of the opinion dialysis was very easy and all that was needed was capital and machines.
"This is what is really worrying, because they do not realise they are doing major treatment and need properly trained staff and doctors," Dr Zaki said, adding there had been cases of nurses and medical assistants opening such centres.
There are some 12,000 kidney patients on dialysis, with the Government spending almost RM300 million annually on them. The number of haemodialysis patients may increase to 20,000 by 2008.
As of Dec 31, last year, there were 117 privately-run dialysis centres, 92 run by NGOs, 97 by the Health Ministry, seven by the armed forces and five by universities.
An average of 4.5 private haemodialysis centres have opened every month this year.
Dr Zaki said 54 per cent of the elderly on dialysis were diabetics, with this trend growing over the years.