With the opening of the new Dialysis Unit at the Cayman Islands Hospital recently, there has already been significant improvements for some patients requiring dialysis. The new unit signalled the start of a new home-based dialysis programme which has led to more flexibility in the timing and administration of dialysis treatments and an overall better quality of life for the patients who are able to use this service.HSA Internist and Nephrologist, Dr Nelson Iheonunekwu gave some background to the new service:The home-based dialysis programme takes the form of continuous ambulatory peritoneal dialysis and automated peritoneal dialysis. This programme offers patients the opportunity to take control of their treatment, giving them far greater flexibility and independence, he said. When they participate in the home-based programme they do not need to then visit the Dialysis Unit at Cayman Islands Hospital three times a week for their treatment.Dr Nelson said that patients who are able to take control of their dialysis do well on the home-based programme.Patients are trained in how to administer their own dialysis treatments and many undertake their exchanges in the comfort of their own bedroom.  Additionally, the home-based unit is portable, making it convenient for the patient. Prior to doing their dialysis treatment, patients are instructed to follow the necessary hygiene procedures; the actual exchange takes about 20 minutes. Some patients have to undertake their dialysis every four hours, some every six. The flexibility with the home-based programme means that patients are often able to go to work and live a more normal life, he said.Dr Nelson advised that studies have shown that there is very little difference in life expectancy of patients who undertake the home-based peritoneal dialysis and those in a hospital-based programme.Ms Lizzette Yearwood, CEO of the Cayman Islands Health Services Authority explained the need for the expansion to the dialysis service offered at the Cayman Islands Hospital.Cayman is unfortunately, like the rest of the Western world, currently seeing an increase in the number of patients suffering from chronic kidney disease.  Our chronic kidney disease and dialysis population has grown exponentially over the years; in 1998 there were 10 dialysis patients compared to 52 patients requiring dialysis in 2012.  This represents a 420% increase over a period of just 15 years, Mrs Yearwood stated.I am pleased to see that a number of our patients are benefiting from this additional service. The Health Services Authority is committed to providing the best possible care to all our patients and stresses the importance of maintaining healthy lifestyles, which is one of the most important tools in the prevention of many chronic diseases. We therefore encourage our patients and the public to adopt healthy habits and lifestyles, thereby reducing their chances of developing chronic illnesses such as chronic kidney disease. In that way the need for dialysis will hopefully be reduced in time. she said.Photo Caption: Dr Nelson Iheonunekwu, HSA Internist and Nephrologist