Fears over soaring kidney disease rate

SURGING obesity and diabetes rates are set to fuel kidney disease at a time when overcrowding at dialysis units is forcing patients to travel excessive distances three times a week for life-saving treatment.

Health Service Executive (HSE) figures show as of December 31, 2007, that:

* 16 patients were travelling from Limerick to Galway for haemodialysis.

* 25 patients were travelling from Tullamore, Co Offaly, to Dublin.

* Two/three patients were travelling from Letterkenny to Omagh, Co Tyrone.

The situation in Tullamore could be alleviated by the opening of five additional dialysis stations, which are “ready to go, but unmanned”, according to chief executive of the Irish Kidney Association (IKA) Mark Murphy. He said staffing was an issue.

A HSE statement said it is “considering proposals to open the remaining stations and a decision will be made shortly”. Tullamore has 10 stations operating with the capacity to treat 60 patients a week.

In the case of one patient travelling from Limerick to Galway in a minibus shared with six others, his “dialysis day” lasts 12 hours, though the treatment lasts just four.

Overcrowding at the country’s dialysis units, which places patients at increased risk of infection, is set to continue for the foreseeable future, according to Dr George Mellotte, president of the Irish Nephrology Society (INS) and renal consultant at Tallaght Hospital and St James’ Hospital.

He said kidney disease — inextricably linked to cardiovascular disease — is to become “the health problem of the 21st century”, fuelled by growing levels of obesity, diabetes and high blood pressure.

“In an effort to address this we need to put into place health prevention strategies immediately,” said Dr Mellotte.

In Britain, GPs are being paid to screen patients for kidney disease where it is recognised as a huge public health issue.

Dr Mellotte said the HSE has still not implemented the recommendations of a National Renal Strategy Review (NRSR), more than a year after its completion. One of its goals is that anyone requiring dialysis be within 30 minutes travelling time of a dialysis unit. It also recommends a doubling in the number of consultant nephrologists (kidney specialists) from 20 to 40.

Last night, the HSE said: “At this stage it is appropriate that the report would be reviewed by an external expert/consultancy working with the NRSR chairman to ensure that the strategy is aligned with the HSE transformation programme”.

Mr Murphy said no funding had been set aside in this year’s health budget for dialysis services.

In 2006, the number on dialysis was 1,500, in 2007 it was 1,540. The transplant list is also growing, 146 transplants were carried out last year, but four were living transplants, short of the target 15. The IKA predicts a doubling in dialysis patients in the next decade. Already units in Beaumont, Limerick, Cork and Waterford operate extended hours including dialysing patients late at night.

“The acceptance here that patients be dialysed in the middle of the night is absolutely unheard of in Europe,” said Mr Murphy.

Today is World Kidney Day and Mr Murphy said the IKA and the INS were encouraging people to take a simple finger-prick blood test to see how well their kidneys are working.

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