Urgent Need For More Artificial Kidneys

Press, Volume CVIII, Issue 31862, 14 December 1968, Page 14

Urgent Need For More Artificial Kidneys

The provision of more artificial-kidney units in New Zealand was extremely urgent, said Dr P. J. Little, renal physician to the North Canterbury Hospital Board, yesterday. The Auckland unit could no longer cope with all the patients needing treatment, which meant that patients were suffering ilyDr Little has recommended that the board buy four arti-ficial-kidney machines. Instead of putting them into a hospital unit, he wants them to be used in a training centre outside the hospital, where patients could be taught to treat themselves.

After about eight weeks training, the patient would take the artificial kidney home and install it in his bedroom. He would then couple himself to the machine for treatment three nights a week for the rest of his life. Used by patients whose kidneys have broken down, the machines take over the job of purifying the blood. The machine is attached to a bypass or shunt tube in the patient’s leg or forearm. Dr Little said that the facilities he was recommending were not designed to prolong life, but r to return patients with chronic kidney failure to good health and useful and active employment. The home-treatment facilities were urgently needed to supplement the kidney-trans-plant facilities at Auckland. If a training centre for patients was established in Christchurch it would be the centre for the whole country.

“In a significant number of patients, transplantation either fails or is not feasible,” he said. “Also, quite strict age

limits are imposed by this technique and a very prolonged period of ill-health ensues even if a transplant is successful.” Where artificial-kidney machines were used in hospitals only a limited number of patients could be treated, a large staff was required, and there were problems of possible infection. Dr Little has just visited Seattle, where, he said, these disadvantages had been overcome by two hospitals through the use of training centres to prepare patients for home treatment.

Kidney transplantation could still be used, because the patients all had tissue typing and would join the pool of recipients waiting for a suitable kidney donor. Because the size of the recipient pool would then be much bigger, the success rate with transplantation would be much higher, through more exact matching.

The biggest advantage would be the well-being of the patients, who would be maintained in optimum

health and returned to almost normal life. Dr Little said that chronic kidney failure affected 10 to 15 patients in the board’s area each year. They were mostly aged 20 to 40, and often were young mothers. If Christchurch had a training centre it would take the pressure off the Auckland unit, which would be able to send patients to Christchurch for training on their own machines. He said it was unlikely that kidney transplants would be necessary in Christchurch under such a system. Auckland would be able to cope with all cases. A doctor in Seattle had offered to send his charge nurse to Christchurch for a month to help to set up the training centre. The board would have to pay the fare, but this outlay would enable Christchurch to initiate a programme equal to the best in the world. “The nursing of these patients has now become far more important than their medical care,” Dr Little said.