The Kidney Patient Charter
Principles for optimal care of Australians with Chronic Kidney Disease
This Australian Patient Charter - sets out the 24 principles which Kidney Health Australia will strive to achieve through consumer participation, education, support services and changes in clinical practice.
Health resources are limited and the needs of all individuals cannot be met at all times, but these requirements do not reduce the need to seek the best possible care for Australians with chronic kidney disease.
Your National Consumer Council coordinated a nationwide consultative process, inviting comments from our consumers and renal medical practitioners, via their state Consumer Participation Councils and noted international examples of Patient Charters. Points addressed in this Charter represent a truly national framework that will guide the representative work of Kidney Health Australia on behalf of those affected by CKD.
Kidney Health Australia extends the challenge to all Australians, whether in health administration, clinical medicine or everyday life, to act on these recommendations in order to optimize care for their fellow citizens. These principles express concerns of individuals who live with the daily reality of renal replacement therapy and sets out their expectations for services and procedures to benefit those with this increasingly widespread condition.
1. Early diagnosis of chronic kidney disease
There are three simple tests for kidney disease. These include a blood pressure, urine protein, and a blood test for kidney function (eGFR). These tests should be performed every year for people in high risk groups.
2. Slowing the progression of kidney disease
Kidney disease progression can be slowed with medicines that protect your kidneys. Your GP can prescribe these medicines and they are available through your community pharmacy. Aim to keep your blood pressure around 120/80. Lead a healthy lifestyle, be active for more than 30 minutes most days, have a healthy diet, become a non smoker. If you have diabetes make sure you actively manage your blood glucose. Normal glucose levels are 4-6mmol/L before meals and 4-8mmol/L two-hours after meals.
3. Informed choice and discussion of treatment options
Information about all treatment options should be fully explained and available.
4. Maintaining independence
People with kidney disease are encouraged to lead a life as normal as possible and should have the opportunity for a two week holiday every year.
5. Confidentiality and respect
Personal information will remain confidential and treatment will be provided with dignity and respect.
6. Early referral for treatment
Patients should be referred to a specialist with adequate time to prepare them for dialysis or a kidney transplant.
7. Waiting period for treatment
There should be no waiting time for surgical procedures to enable people with kidney failure to access renal replacement therapy.
8. Location and time of dialysis service
Patients should be treated at the nearest suitable location on a regular and predetermined schedule.
9. Treatment facilities and staff
Dialysis centres should provide adequate facilities and well trained staff for patients with chronic kidney disease.
10. Best practice and total patient care
Patients should be able to access the best available treatment and care.
11. Peritoneal dialysis
Peritoneal dialysis should be explained and be available as a treatment choice.
Haemodialysis should be explained and the restrictions on lifestyle understood by patients before a decision is made on which treatment to use.
13. Renal transplantation
Patients should be fully informed about kidney transplantation and whether or not it is suitable treatment for them.
14. Self management
Patients should be encouraged to play an active role in their management and treatment.
15. Adequate nutrition
Patients should be provided with appropriate information on nutrition.
16. Medication use
All medication should be thoroughly explained by the prescribing doctor and the pharmacist at the commencement of treatment.
17. Minimisation of adverse outcomes
Health care professionals should be vigilant for possible complications and risks and should monitor to avoid adverse outcomes.
18. Presentation of renal patients to the emergency department
When a patient with chronic kidney disease presents to a hospital emergency department, the renal team should be notified and a nephrological consultation conducted as soon as possible.
19. Refusal of treatment and end-of-life decisions
Patients should be able to choose whether to accept or refuse treatments that are offered and should have palliative care offered as a treatment option.
20. Health service planning
Both short and long term planning to provide the necessary infrastructure for care of patients should include consumer input.
21. Access regardless of health insurance status
Patients with chronic kidney disease should receive appropriate treatment regardless of health insurance status.
22. Costs of care
Patients should not suffer financially for the cost of undergoing treatment.
Transport to and from dialysis would normally be the responsibility of the individual but no one should be denied dialysis because they cannot afford the cost of transport or are unable to access transport that will provide treatment. The cost of transport should be built into the dialysis funding in both the public and private sector so that adequate transport arrangements are available for people living with end stage kidney disease.
24. Employment and workplace flexibility
Patients with chronic kidney disease should have the opportunity to find work and if needed, assistance should be provided to help them achieve this goal.