CANADA: No plan for home dialysis; Health minister says

No plan for home dialysis; Health minister says superior treatment for kidney patients not coming North

Carol Mulligan
Local News - Friday, June 22, 2007 @ 09:00

Nocturnal home hemodialysis is a "fantastic example" of health care better delivered at home than in hospital, says Ontario's health minister.

But while George Smitherman supports people receiving the blood-filtering treatment at home, he isn't about to fund it in Sudbury any time soon.

"I'm very, very aware of this initiative," Smitherman said in a telephone interview Thursday with The Star.

"But I would not want to pretend ... that this is something that is a pending announcement."

Smitherman was asked to respond to a letter from Sudbury's Homer Seguin asking why the progressive form of treatment for patients whose kidneys have failed isn't available in the North.

The retired workplace health and safety activist attached a 65-name petition to his letter, in which he called on the minister to implement a pilot project in nocturnal home hemodialysis at Sudbury Regional Hospital.

Seguin, 73, asked the minister why the only two hospitals offering the treatment are in southern Ontario.

Nocturnal home hemodialysis allows patients whose kidneys no longer function to receive a slower, gentler form of blood-filtering at home, while they sleep.

Conventional hemodialysis is offered in hospital, and patients must travel there three days a week to undergo four-hour treatments.

Aside from the convenience of being treated at home, nocturnal home hemodialysis has tremendous health advantages for patients. It can reduce the need for medications, eliminate cramping and other pain associated with conventional dialysis, and return lost sexual function.

Even more importantly, it can extend kidney patients' lives.

The Health Ministry has yet to approve HMMD for widespread use, although it has funded pilot programs in Toronto for more than a decade.

Smitherman said establishing a pilot project in Sudbury "is not going to bring fairness" to the North. There are pilot projects and then there are "genuine pilots," he said.

Genuine pilot programs are offered for a limited time to find out how a new treatment works.

"There's another kind of pilot that's a health-care pilot. That's where one community gets what it wants, even if you can't do it for everybody," he said.

Smitherman addressed the issue during a teleconference with Ontario reporters about his government's progress in addressing the physician shortage in Ontario.

Smitherman said the resources required to move the project forward throughout Ontario would be "very, very extraordinary on a one-time basis."

Joe Pilon, Sudbury Regional Hospital senior vice-president, told The Star this week the hospital is eager to offer a pilot program in nocturnal home hemodialysis. At least half a dozen of the almost 600 dialysis patients the hospital treats would qualify for the procedure, he said.

Experts say at least 20 per cent of traditional dialysis patients - and as many as 30 or more per cent - would benefit from the home-based treatment.

Seguin receives a form of blood filtering called peritoneal dialysis at home, but many people believe it to be less effective than hemodialysis.

Even though he may never benefit if the treatment is offered in Sudbury, Seguin is determined to gain access to it for people in the North.

Nickel Belt MPP Shelley Martel, the New Democrats' health critic, is supporting Seguin.

"For those who qualify medically for such a program, its creation would improve their health and well-being, and it would also save the health care system money," Martel said in a letter to Smitherman.

cmulligan@thesudburystar.com

http://www.thesudburystar.com/webapp/sitepages/content.asp?contentid=581390&catname=Local+News&classif=