Patients can now opt for dialysis at night

NST: Rajeswari Mathavanam’s body was swollen and her kidneys were failing when she was rushed to Kuantan Hospital three years ago.
She was only five and suffering from end-stage renal disease (ESRD).
Today, the vivacious eight-year-old is alive and healthy for a child who has been undergoing dialysis for the last three years.
This is largely due to the National Kidney Foundation of Malaysia’s Children Dialysis Programme.
Rajeswari is among 410 children nationwide undergoing dialysis for ESRD using the Continuous Ambulatory Peritoneal Dialysis (CAPD) method, which is time-consuming and uses non-portable equipment.
But there is good news for her and four others who may soon be receiving treatment using the Automated Peritoneal Dialysis (APD) method, where dialysis can be done at night while they sleep.
However, there is the extra cost of fluid, tubing and cartridges as well as the monthly machine rental of RM300.
Those interested in switching to APD will have to pay the difference of between RM70 and RM395.
"With APD, the children can attend classes and participate in co-curricular activities without disruption and parents can go to work," said Kuala Lumpur Hospital consultant paediatric nephrologist Dr Lim Yam Ngo.
Rajeswari, Wong Foong Mei, 17, from Kajang, Mohamad Nor Akram Azam, 8, and Alina Ann, 15, both from Klang, and Tamilselvam Vijian, 11, from Perak, are undergoing regular treatment and checks at KLH.
They will be placed on APD once the equipment arrives from abroad.
The machine, known as a "cycler", is slightly bigger than a fax machine and is convenient for travelling.
Dr Lim said ESRD in children below five was largely congenital or inherited.
She added that children born with posterior urethral valves, the most common cause of obstruction of the lower urinary tract, also progressed to ESRD.
Dr Lim, who is on the NKF Board of Managers and the brains behind the Children’s Dialysis Programme, aims to offer APD treatment to students.
NKF chief executive officer Goh Seng Chuan said APD was convenient and should be the preferred form of treatment for kidney patients.
"It’s portable and can be placed at the bedside. One unit can follow a paediatric patient through treatment, even as fill volumes increase, with minor programming changes. It’s easy-to-use software," he said.
Working adults on CAPD can also opt for APD.
He said APD exchanges were performed while children slept with the machine warming, filling, draining and weighing the blood solution at timed intervals.
Goh said there were nearly 12,000 patients, including children, on dialysis in the country.
"Many of them are young and can be productive if not for this disease.
"With proper treatment and rehabilitation, adults can return to work and students to school."