Dialysis Alternatives | if You Don’t Want Dialysis or Transplant

More than 22000 new patients every year develop ESKD in Pakistan who will need dialysis or kidney transplant. Everyone is not a candidate for kidney transplantation and many do no not want dialysis due to social, financial and several other reasons in this resource limited country. That creates a chance to different “mafias” to exploit ignorant and illiterate population of Pakistan, India, China. Here is the brief review of some of these treatment modalities which are prevalent in India, Pakistan and China.
Conservative Care
Out of all the treatment options discussed below, this could be your best bet. Patients have the right to be informed of their options and one of the option foe ESKD is conservative care. If a patient does not want dialysis, he could be managed conservatively with medicines, diet and supportive tender loving care for as long as he/she survives. An experienced nephrologist can adjust your treatment plan, sit with your family to discuss the possible outcomes. For some patients, especially elderly, this is not an unreasonable option. Most people don’t die immediately but could survive for months to years based on several factors, residual kidney functions and management plan. Many experts have recommended the conservative therapy for people with old age, multiple comorbidities, cancers and life expectancy of only few months.
Osmotherapy
As per NKF website when someone asked question about osmotherapy and answer is quoted below
“I had never heard of "Osmotherapy" until your question. The osmotherapy that I have been familiar with was for treatment cerebral edema and not kidney disease. I tried to find any credible scientific studies done on this therapy and I could find none. I have no experience with this therapy” But believe it or not, it is not uncommon in china. Many of my patients from Pakistan and asked about it and have gotten treatment without any benefit. It does not help or cure kidney disease or take you off dialysis. So my expert opinion is that don’t fall into the trap of attractive osmotherapy.
Ayurveda Nephrology
Ayurveda, is the traditional Hindu system of medicine based on natural or herbal & yoga. It will work for body aches, stress, flu or common cold but not for CKD
Below is taken from the website of Dr Puneet Dhawan
“Karma Ayurveda is one of the renowned kidney health care units based out in Delhi. Led by Dr. Puneet (Kidney Expert), Karma Ayurveda has liberated thousands of patients suffering from some sort of kidney problem. Dr. Puneet (Kidney Expert) wants to bring the therapeutically effects of Ayurveda into the everyday while eliminating dialysis."

So what he is saying he can cure any kind of kidney disease. I wonder why US or west has not given him the nationality and invited him there where they are spending more than 50 billion per year just for kidney disease care. None of the nephrology associations or nephrologist recommend this kind of treatment for CKD and dialysis patients.
This is scam on the name of nature or natural treatment so stay away as far as you can, I would say run.

Stem Cell Therapy
Many of my patients has been under the impression that it can cure their CKD and they will not need dialysis. While it may be possible decades later but for now FDA has not approved it and there is no evidence in humans that it can save their kidneys or regenerate kidney cell. Few of my patients has gone to Islamabad and spent 6-8 lacs with no benefit. I would strongly discourage this for any form of kidney disease. It has no role at this point, so stay away from anything related to stem cell therapy.
Heavy Metals
Many heavy metals like GOLD, cadmium, arsenic. Lead, mercury and copper are the most common metals implicated in kidney toxicity. Many Hakeem and others use it in their treatment plans and it can damage your kidneys. The worst thing is sometimes patient are told to stop other vital meds like BP and sugar meds and it can harm them more and more and lead to decline in kidney function rapidly.
Hot Water Immersion
In India, it is becoming very popular and there is a center where it is being performed regularly and there is social media page regarding it. It has no role in modern medicine and nephrology and has no scientific basis so it should not be considered as a form of therapy for CKD or dialysis patients because it will not work.
Herbal Medicine
It is a billion-dollar industry in west and growing in Pakistan. Once you have established kidney disease and especially advanced disease, it has no role. It can improve your sugar or BP little bit but by no means comparable to established treatment options like ACE inhibitors or angiotensin receptor blockers or newer SGLT2 receptor blockers. So don’t fall into the trap of nice adds and promotions. They have actors and actresses saying things for money and you will end up damaging your kidneys.
#hemodialisis #stemcell #ayurveda #hotwater #herbal