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Last Updated: Tuesday, 31 January 2006, 10:49 GMT
Key dialysis target being missed
Dialysis machine
Around 19.000 people in the UK receive dialysis treatment
Most UK kidney disease care centres are failing to meet a key standard for dialysis treatment, a report has found.

The study by the UK Renal Registry for the Renal Association, and Kidney Research UK surveyed 62 out of the 72 centres.

It found infection rates were high, and many were insufficiently prepared for treatment.

And patients treated in these centres made up a significant proportion of those infected with the superbug MRSA.

The survey found that only 43% of patients starting treatment for kidney failure did so in an ideal manner - including those receiving kidney transplants.

The report also highlights delay such as late diagnosis of kidney disease which leads to late referrals, and delays in operations being carried out.

Superbug risk

Three quarters of the UK's 19,000 dialysis patients receive haemodialysis - a blood purifying treatment.

Too many patients are starting haemodialysis without definitive vascular access
Professor Charles Pusey, Kidney Research UK

The report looked at vascular access - the way in which patients are connected to a dialysis machine.

Vascular access is either through a surgically formed fistula or by a plastic tube (catheter).

A fistula is recommended as the best way to receive haemodialysis, because it leads to improved efficiency and reduced infection rates.

But the survey found that only a third of dialysis patients overall were given a fistula.

However this figure varied widely in individual centres, with the proportion of patients given a fistula ranging from 44% to 94%.

The study also found that patients receiving haemodialysis may account for up to 10% of all hospital MRSA (methicillin-resistant Staphylococcus aureus) infections.

In 2004, serious MRSA infections were recorded in 4% of haemodialysis patients.

When compared to the total number of MRSA infections in the UK in 2004, the study authors say this suggests that patients on haemodialysis potentially contribute up to 10% of cases.

One in twenty haemodialysis patients were also occupying a hospital bed - equating to over 320,000 bed days a year in this group.

One third of hospital stays were due to problems with vascular access.

Variability

Professor John Feehally, a leading nephrologist, and President of the Renal Association says: "These results highlight the need for improvements in treatment for kidney patients on dialysis.

"We already know some of the changes that are needed in the complex care pathway for kidney patients - and we are all committed to working together to make them happen."

Professor Charles Pusey, Chairman of Kidney Research UK says: "These results show that too many patients are starting haemodialysis without definitive vascular access.

"This is contributing to a high incidence of infection and to additional hospital stays.

"There is wide variability between different renal units, and there is clearly a need to improve performance nationally."

Professor Dame Carol Black, President of the Royal College of Physicians, said: "The evidence collected by this survey is vital to the future well-being of patients on dialysis.

"Now that we know the difficulties faced in gaining vascular access and the reasons why, we can work together to spread good practice across the NHS to ensure patients will not in future suffer from infections and increased stays in hospital."




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