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Renal replacement therapy

NHS renal services deal with patients with kidney failure and provide patients with renal replacement therapy (RTT). This includes dialysis and kidney transplants.

In England around 58,000 people receive RRT. According to NHS England around 4 in 10 RTT patients are treated by circulating their blood through a machine which cleans it of toxins (haemodialysis). This can be done either in hospital or at home. About 1 in 10 people are treated using the thin membrane that lines the abdominal cavity (the peritoneum) as a filter. This is called peritoneal dialysis. Approximately half of RTT patients are treated by having a kidney transplant.

Improving access to dialysis

In March 2021, NHS England and NHS Improvement published a report on renal medicine, as part of the Getting it Right First Time (GIRFT) programme. It is based on data as well as visits to all 52 adult renal centres in England, including transplant centres, and is supported by professional societies and kidney patient charities.

A summary of the report noted that key recommendations included ensuring more kidney patients have the opportunity for dialysis at home. It recommends the promotion of home dialysis therapy to ensure it is offered to all suitable patients, reaching a minimum target rate of 20% of dialysis patients in every renal centre.

The GIRFT report outlines seven actions to increase home therapy rates, including enhanced patient training facilities and staffing, and improved peritoneal catheter insertion services, to help achieve the minimum 20% target.

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