Case Report on Patient with Regular Hemodialysis and Its Impact on Economic Status

Abstract

Mr. D, 37-year-old diagnosed with stage chronic kidney disease (CKD) on hemodialysis,
secondary health problems, severe hyperparathyroidism, known case of hypertension, anaemia
due to chronic disease. He was on hemodialysis for past five years in different private and
specialty hospital. He had history of fall from bike followed with the history of left fracture of
femur neck and pain in the shoulder for the one month. At present, he got admitted in the
hospital for the present problems with history of cough with sputum for past one month,
breathlessness for the past 5 days which is aggravated by physical activity. On the recent
admission to the private hospital, he was currently diagnosed with end-stage renal disease
(ESRD), renal osteodystrophy, and miliary tuberculosis. He was on conservative treatment for
past 5 years which is on continuously hemodialysis. Approximately after 60 months, he was
diagnosed with irreversible ESRD of uncertain aetiology. He has AV fistula in position in left
arm for the hemodialysis. He was referred to the Nephrology Unit in multispecialty hospital
and again followed with hemodialysis. In meantime, actually for about 1 month, he
discontinued the treatment from private hospital due to the poor financial support where the
patient’s condition developed lots of complications associated with renal failure. In the due
course, he tried to approach the government hospital, got admitted to continue the dialysis.
Moreover, he had around 2 to 3 cycles in GH. During this time, his clinical status improved on
dialysis, but socioeconomic, poor financial status and psychological challenges were always
triggering factors for the patient and his family. During the period of treatment from
government hospital, unfortunately, waiting time for the dialysis patient to get in turn was very
high. Later again he had gotten admission into private hospital due to the ERSD related
complications.