HCMC patients struggle to find dialysis spots at overloaded hospitals

By Le Phuong   October 14, 2024 | 03:09 pm PT
HCMC patients struggle to find dialysis spots at overloaded hospitals
A doctor checks on Cao Thi Kieu, 61, who suffers from kidney failure after having a stroke over two years ago, at Thong Nhat Hospital in Ho Chi Minh City, Sept. 25, 2024. Photo by VnExpress/Le Phuong
Dialysis machines are in dire short supply at HCMC hospitals, which struggle to meet the growing demand for life-saving care, forcing many patients to rely on emergency treatment.

Trong Thuc, 43, is dealing with the challenge of caring for his mother, who is in the final stage of kidney failure, frantically contacting several hospitals to get her a spot for dialysis.

But he has been trying in vain for a month, with no hospital being able to accommodate her.

Thuc laments, standing in the hospital corridor as he waits for her dialysis session: "Thong Nhat Hospital arranged emergency dialysis for her for one month. Now that time is almost up, and we still haven’t found a place for her to continue treatment. I have no idea what we’ll do next."

His mother, Le Thi Hong, 70, from Quang Ngai Province, was diagnosed with kidney failure seven years ago along with other underlying conditions such as heart disease, hypertension and diabetes, treatment for which was beyond the capabilities of her local hospital.

She was sent to HCMC, where she has been admitted to several hospitals for emergency dialysis.

When her condition stabilized, she received treatment at Binh Tan District Hospital, which is near their rented room.

Over a month ago her condition worsened, and she was transferred to Thong Nhat, one of the largest public hosptials in HCMC. Once her health stabilized, Thuc returned to Binh Tan to schedule her next dialysis session but was told there were no machines available.

"I went to Binh Tan District Hospital three times and was told to wait for scheduling. Then I went to Nguyen Tri Phuong, Cho Ray and Binh Dan hospitals, but none had machines available."

His mother’s health is deteriorating, and Thuc says: "If she has to go without dialysis for a week, she may not survive."

Le Van Long, 60, of HCMC's Hoc Mon District is also struggling to find a dialysis spot. His wife and children have reached out to district hospitals in Hoc Mon, Cu Chi and District 12, but only managed to get his name on waiting lists.

Diagnosed with diabetes and high blood pressure over 10 years ago, Long discovered he had end-stage kidney failure just over a month ago. Surgery has been performed to create vascular access for dialysis, but he hasn’t found a hospital for regular treatment. For now he has returned to Thong Nhat Hospital for emergency dialysis, and completed two sessions.

He says: "I am a war veteran, my wife is the primary breadwinner and is still raising young children. We can’t afford the cost of dialysis at private hospitals, and the district hospitals are too far for my wife to take me regularly."

Nguyen Van Thanh, 50, had swelling and blurred vision while waiting for a dialysis slot, forcing him to seek emergency hospitalization.

His wife, Nguyen Thi Hong, says they and their two children have contacted several hospitals, including Buu Dien, Nhan Dan 115 and Cho Ray, without success.

A worried Hong says: "If he misses dialysis for just one week his condition worsens immediately. He is the primary financial provider for our family, and I fear that if his treatment keeps getting interrupted, his health will deteriorate quickly."

She adds that the financial burden of treatment and the inability to find dialysis machines have left the family "exhausted and worn out."

Patients stay in line to get kidney dialysis at Thong Nhat Hospital, April 2024. Photo by VnExpress/Phung Tien

Patients stay in line to get kidney dialysis at Thong Nhat Hospital in HCMC, April 2024. Photo by VnExpress/Phung Tien

Nguyen Bach, head of the hemodialysis department at Thong Nhat Hospital, says the hospital is under immense pressure due to the influx of dialysis patients.

Despite its efforts to accommodate everyone, the number of patients has surged recently, far exceeding its capacity, he says.

Thong Nhat Hospital has 45 working dialysis machines, and some 200 patients require regular dialysis.

The department’s 30-odd employees work around the clock, and the machines run for up to 20 hours a day with four hours needed for maintenance.

In developed countries, dialysis machines typically operate for just eight hours a day.

"We keep five machines exclusively for emergency cases, but even that is not enough."

Patients who cannot find spots elsewhere often return in deteriorating condition.

Emergency dialysis is considered a temporary solution for patients unable to secure regular appointments. Typically, patients requiring dialysis need three sessions a week. Interruptions can lead to severe complications and rapidly worsen their condition, putting their life at risk.

At a recent kidney disease conference, Dr. Nguyen Huu Tu, vice president of the Vietnam Young Physicians Association, estimated that over 8.7 million adults in Vietnam, or 12.8% of the population, suffer from chronic kidney disease.

There are over 400 dialysis units serving around 30,000 patients with end-stage kidney disease, which means they treat only 30% of those needing it.

Dr. Bach says there are three main issues that need addressing. First, more investment in dialysis centers is essential to improve patient access to treatment. For people with end-stage kidney disease, treatment options include hemodialysis, peritoneal dialysis and kidney transplantation.

Second, suitable patients should consider peritoneal dialysis, which can be done at home and does not require trips to the hospital three times a week. However, patients need a separate room for the treatment, and doctors must carefully assess their suitability. The machine costs around VND200 million (US$8,000), but monthly costs are covered by health insurance.

Lastly, Vietnam needs to increase the rate of kidney transplants, the most effective solution. The lack of donated organs and high transplant costs, which can run into hundreds of millions of dong, are major obstacles. Currently the transplant rate is just 1% for end-stage kidney patients.

"If we can increase the kidney transplant rate to 5% and the peritoneal dialysis rate to 10%, the burden on hemodialysis centers will be significantly reduced," Bach says.

He also calls for raising awareness of kidney disease prevention and early detection.

Early detection can prevent the progression to end-stage kidney failure, which often occurs silently until it is too late.

Bach recommends annual health checkups and seeking medical advice for unusual health issues.

Drinking plenty of water, maintaining a healthy diet, exercising regularly, and managing underlying conditions like hypertension and diabetes are critical preventive measures.

Bach also cautions against the misuse of drugs, including pain relievers and unregulated supplements, pointing out that some patients in their 20s have suffered irreversible kidney damage from weight-loss drugs bought online.

 
 
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