HSE renal services reshaping the lives of patients with chronic kidney disease

• Kidney health for all: advancing equitable access to care and the best medications
• Home dialysis patients avoiding up to 150 hospital visits a year

Renal services across the country are transforming the lives of patients with chronic kidney disease, improving quality of life through effective care and treatment that fits around people’s lives.

This World Kidney Day 2024 (Thursday, 14 March 2024), the HSE is highlighting how patient health and wellbeing is improving with increased access to home dialysis services.

Last year:

• 100,000 home dialysis therapy treatments were delivered to patients
• over 45,000 hospital visits avoided
• up to 300,000 hours saved of patients’ time

Professor George Mellotte, HSE National Clinical Lead for Renal Services, and Consultant Renal Physician, Tallaght University Hospital says:

“There were 5,257 people with chronic kidney disease or failure treated by dialysis or kidney transplantation in Ireland in 2023, an increase of 109 from the previous year. More than 440,000 dialysis treatments took place, with the majority of patients having to travel three times per week to one of 24 dialysis centres across the country for treatment.

This is why we have developed and funded a modernised care pathway for home dialysis, which can significantly improve the patients’ quality of life, meaning each patient on this type of dialysis can avoid 150 hospital visits a year. Our patients tell us it provides great flexibility as they can manage their treatment in the comfort of their own homes, at a time that suits them and their family.

This care pathway provides pre-dialysis education and enhanced community support to enable patients to take on this treatment choice.”

The number of patients with chronic kidney disease in Ireland is increasing. This is likely related to the ageing population, as well as newer treatment strategies that support people to live longer. Chronic kidney disease is more common as people age, leaving patients vulnerable to other medical complications. A diagnosis is often unexpected as it is a silent disease, but is easily confirmed with simple blood and urine tests.

Dr Colm Henry, Chief Clinical Officer, HSE, says:

“The number of patients who need treatment by either dialysis or a kidney transplant has increased by 30% over the past 10 years. For those on dialysis, the implementation of the modernised care pathway for home dialysis provides increased supports for eligible patients so that they can get treated at home. There were also 191 kidney transplants in 2023, transforming the lives of recipients by improving their health and quality of life, supporting them to return to normal activities. The recent Human Tissue Act should lead to more transplants through the introduction of a soft opt-out donation system as well as facilitating living donation.”

The HSE’s National Renal Office has also produced Medication Sick Day Guidance to support renal patients when they are unwell. Patients with chronic kidney disease are more susceptible to the effects of dehydration, with increased risk of developing acute kidney injury or damage. Specific medicines can impact this further and patients are often advised to stop certain medicines. The sick day guidance was developed to help renal patients recognise the signs of dehydration and to explain which medicines need to be stopped, and when to restart them. The leaflet also allows the healthcare professional to set out what medicines the patient is on and what they’re for.

Nationally, key overall figures for renal services include:

• In 2023, the HSE provided over 440,000 dialysis treatments, 100,000 of which are home dialysis
• The number of patients requiring treatment by dialysis or kidney transplantation in Ireland increased to 5,190 adults and 67 children in 2023
• The number of patients in Ireland with the functioning kidney transplant is 2,755
• The number of patients treated by dialysis now stands at 2,502 (1,461 receive haemodialysis treatment in a HSE hospital based dialysis units, and 736 in HSE contracted dialysis units. 305 patients carry out dialysis in their own home).