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NICE sets out standards for treating patients with renal failure

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A new quality standard that sets out how best to care for adults who need treatment for chronic kidney disease has been published by the National Institute for Health and Care Excellence.

Pre-emptive transplantation should be considered as the treatment of choice, if a living donor is available, because it provides the best chance of long-term rehabilitation, according to NICE.

“Providing access to renal replacement therapy services prevents thousands of people from suffering avoidable harm or dying prematurely”

Gillian Leng

Adults who have been on dialysis for only a short time, or have not received it at all, fare better with their kidney transplant, the quality standard said.  

It recommended that adults whose kidney function is progressively getting worse are placed on the national transplant lists within six months of their anticipated dialysis start date.

Adults who have to start dialysis in an unplanned way – for instance if they do not receive a transplant in time or if they were diagnosed late – should continue to be supported to receive a kidney transplant, added NICE.

Professor Gillian Leng, deputy chief executive and director of health and social care at NICE, said: “For many people with kidney disease, progression can be prevented.

“However there are instances where the decline in kidney function becomes irreversible and a person will need life-saving dialysis or a transplant,” she said. “Providing access to renal replacement therapy services prevents thousands of people from suffering avoidable harm or dying prematurely.”

Gillian Leng

She added: “With survival rates better than ever, the number of people receiving treatment for chronic kidney disease continues to increase.”

The quality standard also highlights a number of other areas of best practice for treating those with kidney failure.

For example, it said renal healthcare professionals should perform necessary procedures in advance to prepare adults with chronic kidney disease for dialysis, such as modifying the blood vessels in the arm to make haemodialysis more straightforward.

In addition, adults with chronic kidney disease should be supported to carry out home-based dialysis if possible, and education courses should be offered to adults preparing for renal replacement therapy, as well as their family members and carers.

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