Clinical outcomes of dialysis have today become more positive for patients which has been attributed to the transformation the dialysis sector has seen in recent times. The state-of-the-art machinery, skilled professionals, a patient-centric approach and a focus on equitable and efficient healthcare have fuelled the advancement of renal care in India .Mr. Kamal D Shah, Co-founder, NephroPlus, sheds light on the safety standards in dialysis protocols and how quality of care is deemed with utmost importance to ensure patient safety.

India is home to some of the best-in-class nephrology units with state -of-the-art dialysis centres, in what ways do your clinics stand apart?

In our clinics, the protocols of dialysis are taken extremely seriously. These protocols ensure that patients who come for their dialysis, receive the best quality possible during the hours they spend on the machine. This enables them to get back to a normal life, allowing them to work, travel, exercise, play a sport, and do things that healthy individuals do. The entire atmosphere in our clinics is one of cheer and positivity, which helps our patients return to a normal life.

As per a recent study, it was found that the mortality rate of patients undergoing dialysis stands at  28 per cent. What efforts are you currently making at NephroPlus to reduce patient mortality rates?

At NephroPlus, we take clinical outcomes very seriously. The entire process of dialysis is extremely protocol-driven at NephroPlus, ensuring that the patient gets the best clearance possible during those hours of treatment they spend on the machine. Furthermore, we ensure that the water treatment plant is maintained in a clinically sound manner and all limits are adhered to. This plays a significant role in ensuring that our patients receive the best quality possible, enabling them to lead longer lives and reducing mortality within our clinics.

We also place great emphasis on education because one of the largest reasons for mortality among dialysis patients is fluid overload. By ensuring that patients adhere to their prescribed fluid intake limits and making sure that the sodium level in the machine is not beyond what it should be—which could increase thirst and worsen fluid overload among dialysis patients—we help keep this within limits. This also contributes to reducing mortality among dialysis patients.

On the mortality front, we are also undertaking several clinical initiatives, a couple of which I'd like to mention. It is a fact that patients with access like an arteriovenous fistula or an arteriovenous graft have lower mortality rates compared to those with a catheter as their dialysis access. In many clinics, especially in low-resource settings, we are intervening proactively by identifying patients with catheters and setting them up for fistula surgeries at nearby healthcare facilities where they can get this access free of cost through the government's program. This way, their mortality risk could go down significantly.

Another initiative we've undertaken is treating patients affected by hepatitis C completely free of cost at our expense. This also helps reduce mortality. It is well-known that dialysis patients infected with the hepatitis C virus are at an increased risk of mortality. These are some steps we are taking to reduce mortality in our clinics.

Affordability plays a critical factor in dialysis and is considered an out-of-pocket expense. Could you shed some light on the cost-effectiveness of dialysis services at NephroPlus?

Dialysis services are very affordably priced at all NephroPlus clinics. We take great pride in offering good quality dialysis at affordable prices because we believe that anybody can provide good quality dialysis at very high prices, but the challenge is to provide that same quality at affordable rates. How many people in India can afford to pay large amounts for dialysis, which is a chronic therapy that needs to be done for several years, often lifelong? So, we ensure that we price our services below some of the corporate hospitals in each city, making the entire dialysis service very affordable. We also ensure that other necessities like injections, blood tests, and so on, which are often needed for dialysis patients, are also priced reasonably. This ensures that the overall treatment cost for a patient is well within the reach of the common man.

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Great emphasis on education must be laid because one of the largest reasons for mortality among dialysis patients is fluid overload.

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What are your growth plans for FY 25? Do you intend to acquire companies in a similar space and go the organic route or expand through parallel business lines and go the inorganic way?

In the coming fiscal year, in India, we plan to expand at the rate of three to four clinics every month. Typically, we acquire existing operations of dialysis clinics within hospitals. In countries like the Philippines and other nations where we might expand, there could be potential acquisition opportunities.

In fact, in the Philippines, if you look at our history, our growth has primarily come from acquiring existing dialysis clinics or chains of dialysis clinics. So in the Philippines, we see that remaining our primary method of expansion. In India, apart from taking over existing clinics within hospitals, we will also focus on some greenfield clinics in the coming months.