Kidney patients lose out on home dialysis

Kidney patients lose out on home dialysis

Patients suffering from kidney failure are not being routinely offered the chance to receive treatment at home, a leading charity has warned.

The National Kidney Federation claims hundreds of patients have to travel long distances several times a week to receive dialysis in hospital when they could be trained to perform the procedure themselves in their homes.

According to the latest figures from the Scottish Renal Registry, 2159 people in Scotland received some form of dialysis to remove toxins from the blood but only 426 carried out dialysis at home in 2007. Timothy Statham, chief executive of the National Kidney Federation, said that many renal units do not explain to patients that home dialysis is an option, even if they are medically suitable for the procedure.

He added that home dialysis could "transform" a patient's life. "A patient's life disappears when they are on dialysis and home dialysis allows them to have their life back," he said.

"If they are suitable candidates they should be given the choice to do it at home, but currently that is not happening.

"Renal units sometimes prefer to have all the patients in the centre and do dialysis under a doctor's supervision and control. It is a question of changing the culture and getting the kidney unit to agree that the patient's lifestyle, and preference is a crucial part of the decision."

More than 82% of the total number of people on dialysis in Scotland receive haemodialysis (HD), when the blood is pumped into a machine, cleaned and pumped back into the body.

Only 2% of dialysis patients in Scotland receive HD at home, with the vast majority of people attending a renal unit.

Mr Statham said that there was a "cost issue" in making home haemodialysis available but patients given this option benefited from a "huge improvement" in their lifestyle.

The most common form of home dialysis is peritoneal dialysis (PD) when patients undergo an operation to have a tube inserted into the abdomen and fluid can then be drained into the body to clean the blood and then drained out again. It allows patients to carry out the procedure themselves, either several times throughout the day or overnight.

Some 382 people in Scotland receive PD, which can be used for between five and 10 years before further hospital treatment normally becomes necessary.

Mr Statham admitted that the procedure was not appropriate for every patient. "Some people are not well enough to have home dialysis," he said. "It is not a simple thing and not everybody can be trained to do it. But we are asking for the choice. People can carry on their lives with PD."

A report on the travelling time between patients' homes and their nearest dialysis unit, using data from 1982 until 2002, found that 10% of Scottish patients live more than 30 minutes' drive from a dialysis unit.

Since then the number of "satellite" dialysis units has been on the increase and Mr Statham said that offered a "better option" for some patients instead of having to travel hundreds of miles to a larger hospital. But he warned that too many patients still faced a regular drive of at least 30 minutes each way to receive treatment.

A Scottish Government spokeswoman said: "This government is committed to providing care as close to home as possible with ready access to specialist care when necessary, and that includes providing home dialysis for suitable patients who have chronic kidney disease.

"Patients and clinicians should discuss this as an option, with the safety of the person needing dialysis always being the paramount consideration.

"Health boards are developing increasing numbers of satellite' dialysis units so that even where home dialysis is not an option patients can be dialysed as near as possible to home or work."

12:04am Monday 23rd March 2009

Exclusive By CAROLYN CHURCHILL

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