Dr Peter Choi, Director of Nephrology: My name is Peter Choi. I'm a nephrologist, a kidney specialist and the Director of Nephrology at John Hunter Hospital in Newcastle New South Wales. So, Leading Better Value Care Renal supportive care program is a new model of care that we have been able to offer to patients with end-stage kidney disease and severe chronic kidney disease.
Renal supportive care is designed to plug a gap in the traditional care that we provided to patients with kidney disease. In essence it's the application of the principles and the practices of palliative care medicine and symptom control to the specific context of patients with kidney disease and specifically, most commonly patients who are on long-term dialysis.
Many of the renal disorders that we deal with affect young people, affect children, young adults but in general renal disease is most common in patients who have other disorders - heart disorders, liver disorders, connective tissue disease. So, for that reason most of our patients are on the more senior end of the age spectrum, but compared to a lot of other chronic diseases we have a lot of young patients as well.
Their disease processes are often complex and affect many aspects of their lives and their disease process is often difficult for other non-specialists to engage with.
Patients with kidney disease often didn't live very long. The dialysis procedures are often very arduous, they often have a significant impact and are invasive upon the daily lives of patients and they're often not that successful in terms of removing the symptoms that the patients suffer. What Renal Supportive Care seeks to do is to deal with those symptoms that dialysis can't fix.
Historically for some patients they were faced with a very difficult choice of either going for a dialysis treatment that they didn't really want or accepting a non-dialysis treatment that might deny them appropriate care going forwards. Renal supportive care allows all patients now to have a clear choice about what they want for their care.
Renal supportive care since its introduction has made a massive impact upon the delivery of care in the way that I have not seen in many other situations over the last 20 years. It affects everybody that touches the service. So firstly, for patients it's transforming in the care that they're able to receive and it's liberating in the choices that they can make for themselves. For the services that provide Renal supportive care it's meant that we can provide a much more balanced and a much more patient focused care. It allows clinicians to work in a way that is so patient focused that it provides greater satisfaction at work and a real sense that we're making a difference and that is very specifically due to the availability of Renal supportive care.