Rising kidney disease a worry – home dialysis may solve some problems

By Dr. Ananya Mandal, MDNov 5 2010

Kidney Health Australia (KHA) has released a report that predicts that the number of people needing treatment for serious kidney disease will triple to 30,000 by 2020 and treating serious kidney disease will cost the health system $12 billion over the next decade. The report, by the George Institute for Global Health, also found the annual cost of providing dialysis treatment was just over $79,000 per patient. This was compared to just over $49,000 per person taking part in a program which delivers the treatment not in a hospital but in the patient’s home.

Dialysis at home would be the best option for reduction of costs. KHA chief executive Anne Wilson says home dialysis saves the health system about $30,000 a year per patient. She said, “[People can] dialyse more frequently, maybe dialyse at night time so that people can have the day to go to work or to be able to do what they need to do, which normal in-hospital dialysis really interrupts.”

Specialist Dr Tim Matthew agreed that home dialysis can save lives. “Dialysis survival is not good. Some 10, 12 per cent of people on dialysis programs die each year… That mortality has not improved over the years and the only breakthrough that has occurred is the demonstration in recent years that doing more hours on dialysis is associated with a very significant improvement… So instead of living for five years, you’ll live for 10 years. A slow dialysis done all through the night is the future of dialysis I believe,” he explained.

KHA also revealed that not enough Australians are being given the option of home dialysis and people in rural and regional Australia and Aboriginal communities are particularly disadvantaged. Most of it is due to difficulties in training for home dialysis feels Ms Wilson. She said, “We know that there are limitations to home dialysis training facilities…We also know that it is actually easier to refer someone to an empty dialysis chair in a satellite than it is to put them through the whole training rigmarole of trying to send them home to be able to self-manage and dialyse at home.”

She added that home dialysis did no have enough government support. “I don't think our Federal Government is very receptive to home dialysis and I think we have to say that neither our federal or state governments really around the country are all that receptive to the needs of kidney patients…It really just doesn’t count an awful lot compared to other diseases,” she said.