Dialysis services at breaking point as kidney patients face harmful care restrictions

Australia and New Zealand’s kidney care services are under unprecedented strain, with many nephrology units warning they can no longer provide timely or adequate dialysis to patients.

The findings come from a new report by the Australian and New Zealand Dialysis and Transplant Registry (ANZDATA), housed at SAHMRI, and the Australian and New Zealand Society of Nephrology (ANZSN).

The report reveals dialysis chairs are full, waiting lists are growing, and restrictions on patient care are becoming unavoidable. In some cases, these restrictions have already led to patient harm.

Surveying almost every public nephrology unit across both countries, the report paints a confronting picture of clinicians struggling to keep up with rising demand.

Heads of unit describe patients travelling long distances for treatment because local facilities have no space, others missing out on their preferred therapy, and some having their dialysis sessions cut short.

Many units also reported that patients hoping to manage their condition through home dialysis faced lengthy delays before training could begin.

Director of ANZDATA, Professor Stephen McDonald, says the survey findings highlight the urgent need for action.

“This is evidence from the frontline that dialysis services are stretched beyond safe limits,“ Prof McDonald said.

“Units are being forced into decisions that compromise recommended care, and in some cases, this is directly impacting patients’ health.”

The survey also shows the workforce that underpins kidney care is under immense pressure.

Nephrologists, trainees and allied health professionals are working with increasing patient loads, with many units struggling to recruit and retain staff.

Lead investigator Dr Dana Forcey says the message from clinicians is clear.

“The people providing this care are deeply committed, but they are telling us the system is at breaking point,” Dr Forcey said.

We need investment in infrastructure, staffing and service planning now, otherwise the gap between what patients need and what the system can provide will only widen.”

ANZDATA provides the most complete and independent picture of kidney care across Australia and New Zealand. This report provides health services and governments with crucial evidence to inform future planning and reform.