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Justice K Chandru made the observation while passing orders on a petition filed by a Tasmac employee who suffered renal failure. Though he needed at least 5 lakh for a kidney transplant, Tasmac quoted rules and said he could claim a maximum of only 1 lakh as reimbursement, or else he should go to a government hospital for a free treatment.

Rejecting the submissions, Justice Chandru said: "The ceiling fixed by Tasmac that the employee can get only 1 lakh is unrealistic. It goes without saying that the renal surgery procedure costs much more. Tasmac is responsible for selling liquor to the citizens, which indirectly may cause both liver and renal failure. It is for Tasmac to provide funds for their own employees. They cannot plead resource crunch or hide themselves behind rules."

A Balamurugan suffered kidney failure and doctors said he needed to undergo renal transplantation, which would cost around 5 lakh. K Balu, counsel for Balamurugan, submitted that his monthly salary was just 5,000 and he paid 80 a month to become a member of the state government-stipulated health fund.

In its reply, Tasmac submitted that Balamurugan could have availed himself of renal transplantation in a government hospital without paying any fee. Or else, he could take treatment in a private hospital and claim reimbursement of his medical expenses to the extent of 1 lakh.

Rejecting the contention that the employee should take free treatment in a government hospital, Justice Chandru said it is not for Tasmac to suggest as to which hospital he should approach for treatment.

The judge then directed Tasmac to give a letter to Shri Ramachandra Medical Centre, where Balamurugan wanted to go for treatment, authorizing him to undergo renal transplantation and giving an undertaking that the entire expenses would be reimbursed subject to the scrutiny of bills.

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Like tens of thousands of New Yorkers with kidney disease, Adlei Scarlett lives only by the grace of dialysis, with three treatments a week to clean his blood of toxins. The only other way to keep Scarlett alive would be a kidney transplant.

“God willing, if I’m to get a kidney, I’m going to get it.  That’s the way I look at it,” Scarlett said.

He may be optimistic, but in New York, not every patient has an equal chance of getting a kidney. An analysis of federal health data by NBC 4 New York's I-Team and ProPublica found patients at some dialysis centers are less likely to get organ donations than those at others. 

Often times, the disparity mirrors income gaps.

At Upper East Side Dialysis Center in Manhattan, eight out of 134 eligible patients got donated kidneys in 2010.

In Crown Heights, the Central Brooklyn Dialysis Center had three transplants in a population of 188 patients. 

Dialysis centers in poor and minority communities often have the worst kidney transplant outcomes. According to a study in the Journal of the American Society of Nephrology, "kidney transplantation is the preferred method of treatment" and yet "black patients were [57 percent] less likely than whites to be placed on the kidney transplant waitlist."

Dr. Jubil Malieckal, a nephrologist who works at Central Brooklyn Dialysis, said the center is working to improve health outcomes, but stressed patients in less wealthy communities often have more complex medical issues.

"I don't think that you can compare this facility to all the other facilities," Malieckal said.  "I think it's the patient's mindset. We always offer each and every patient who comes in the option of going on a transplant list." 

Even some dialysis patients admit they are often the ones to blame for low kidney transplant rates. Sometimes they're leery or afraid of surgery

Mercedine Samuel, who gets her treatment from Central Brooklyn Dialysis, says the center does the best it can with some very sick clients.

“You can’t blame the center when people come in the last minute and haven’t taken care of themselves and expect a miracle,” Samuel said.

Some of the under-performing dialysis centers insist transplant statistics are an unfair way to measure their quality of care. Complicated decisions about who actually gets a donated kidney are made in part by organ donation networks. 

Jack Meisels, a spokesman for Gateway Dialysis in Canarsie, which had one patient transplant in 2010, said his facility actually over-performs when it comes to signing patients up for transplant wait lists.

"According to our 2011 Dialysis Facility Report, Gateway had 35 percent of our patients on a kidney transplant wait list as compared to 24 percent nationally," Meisels wrote in a statement to NBC 4 New York.

Dialysis centers that accept federal health dollars are required to offer patients a chance to sign up for a transplant wait list.

Dr. Joe Vassalotti, chief medical officer for the National Kidney Foundation, says the key to achieving more transplants is not just to offer the wait list to patients, but to teach them about organ donation and encourage them to seek transplants.

"For the health care professionals who work in a dialysis center, it's their responsibility to do the right thing and educate the patient about kidney transplant, which for many patients is the best treatment option that offers them the best quality of life and the longest life," Vassalotti said.

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Hyderabad, April 27 (IANS) NephroPlus, a leading kidney care clinic group, Friday said it plans to set up 100 dialysis centres across India over the next three years.

The company also announced eminent nephrologist Brian J.G. Pereira will join its board as a director.

"We hope to leverage his expertise as we work to build the NephroPlus brand and provide the best kidney care and dialysis treatment to patients in India," said NephroPlus CEO Vikram Vuppala.

"I look forward to working with the enterprising team of NephroPlus as we actively strive to raise the level of kidney care and dialysis treatment in the country," said Pereira, an adjunct professor of medicine at Tufts University School of Medicine, the Sackler School of Graduate Biomedical Sciences, and the Tufts Clinical and Translational Science Institute (CTSI).

He also served as president of the National Kidney Foundation in the US.

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