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ISN Voices: Nepal

Klara Paudel’s dedication to nephrology is changing kidney patient care and research across Nepal.

“In the developed world, you can rely on someone senior for guidance. Almost all specialists in emerging countries have to work on their own, relying on their own judgment and what they read in literature. 

It was similar for me. Born in Hungary, I studied medicine in Budapest, moved to Nepal with my husband and was immediately assigned to a dialysis unit in Pokhara. I had to learn on my own.

In 2013, I trained as an ISN Fellow for a year at the Royal London Hospital in London, UK. With this training, I gained more knowledge and confidence in practicing nephrology. I wanted to learn more about chronic ambulatory peritoneal dialysis (CAPD), one of the most cost-effective forms of treatment for kidney disease patients in emerging countries.

Returning to Nepal in 2014, I started working as the only nephrologist in the region. I felt a lot more responsibility and set up the first peritoneal dialysis program in Western Nepal. In the first month, eight patients began peritoneal dialysis and this increased to 25 within the first year. The partnership with the Royal London Hospital in London, UK is leading to more peritoneal dialysis training programs, expanding CAPD throughout Nepal.

I wanted to work with all other centers in the city and organize programs. I helped the nurses establish the Dialysis Nurses Association of Pokhara and provide some educational support for them. I also set up social and educational activities for CAPD patients.

An ISN Clinical Research grant will go towards conducting a community intervention study. We have come up with the idea of training local volunteers to take blood pressure and carry out urine tests to detect highrisk patients. With the help of local volunteers as peer educators, we will conduct a study to see if their intervention reduces cardiovascular risks.

I want to raise awareness about kidney disease to local health workers communities through practical nephrology courses and workshops. Humanitarian work is very important in progressing research. Humanitarian grants are neutral with the research becoming genuinely beneficial for patients.”

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