WHY
WAS THE WFRC FORMED ?
About Renal Failure
Renal
failure is the body's inability to dispose of natural waste by-products
through the renal system (kidneys), in effect, poisoning the body
from within. Acute (sudden) kidney failure can result in severe illness
or even death. Chronic (long term) kidney failure eventually leads
to the need for a kidney transplant or dependence upon dialysis treatment.
Renal failure can occur as a result of an injury, as a secondary result
of another disease (such as diabetes or high blood pressure) or as
the result of a primary kidney disease. Worldwide it is estimated
that there are over a million people who suffer from partial or complete
renal failure and are dependent upon dialysis treatment or have received
a kidney transplant. Of these over 85% live in the so-called developed
countries. However, it is estimated that as a result of the inequitable
distribution of the world’s wealth, in excess of 75% of the people
suffering from chronic renal failure have no possibility of entering
a program of chronic kidney treatment. So hundreds of thousands of
lives are lost every year as a direct result of the lack of trained
staff and resources
Treatment
Treatment
options include peritoneal dialysis, haemodialysis or kidney transplantation.
Because renal failure and its treatment have such a dramatic impact
on people's lives, and secondary complications include a loss of libido,
dietary restrictions, etc., patients require an entire team of specially
trained care givers. This team includes doctors, trained renal nurses,
technicians to operate the specialised artificial kidneys, dieticians
to advise the patients on eating habits and social workers to support
patients and their families.
The Problem
Right
now, there is a need for trained renal team members world-wide. At
present there is a serious shortage of team members with the proper
specialized skills and experience. The need to train and educate staff
is greatest in those countries that now have a renal programme or
are starting one, but do not have a history of treating renal patients.
These countries are the newly developing nations of South America,
Africa, Central Europe and the Asian sub-continent.
Possible Solution
The
World Foundation for Renal Care coordinates and develops teaching
programmes, delivered by volunteers from the above area, who are experts
with many years' experience administering modern renal replacement
therapies. These teaching teams travel to meet, educate and share
experiences with their counterparts in the developing world. These
unique, volunteer teaching experiences provide an invaluable transfer
of knowledge so that local doctors and their renal care team partners
can treat their patients in the best possible way.
The challenge
facing WFRC
The growth of chronic dialysis 1970 - 1992
 In
1992 Professor Hans Gurland of the University of Munich published figures
that showed how the provision of dialysis services for patients with
chronic renal failure was predominantly limited to Europe, USA and Japan,
with over 400,000 of the world’s 480,000 chronic dialysis patients.
Very little of the dialysis services in the rest of the world occurred
in the so-called developing countries.
Professor Gurland showed that, contrary to predictions in the 1970s
that the growth in numbers of chronic dialysis patients would rapidly
slow, the actual growth of dialysis programs worldwide has been inexorable
at around 7.5% per year.
Projected growth of dialysis 1995 - 2020
 In
considering the alternatives to this inexorable growth, Professor Gurland
projected that the impact of Xenotransplantation would not be evident
until beyond 2005, when a slowing in the growth of the dialysis population
would result from an over twofold increase in the number of patients
with functioning grafts.
In 1993 Dr. Feidhlim Woods, then at the National Kidney Foundation of
Singapore, calculated that whilst over 85% of the world’s chronic dialysis
patients live in the developed countries which enjoy over 80% of the
world’s wealth, over 80% of the world’s population lives in the developing
countries. This inequitable distribution of wealth results in 75% of
the people reaching end stage renal disease each year having no possibility
of entering a program of chronic renal replacement therapy.
Possible need for dialysis in developing countries
 Dr.
Woods projected that many of the economies of the developing countries
would support the commencement of dialysis programs. Assuming a significantly
lower rate of incidence of new chronic dialysis patients in the developing
countries, Dr. Woods nevertheless calculated that by 2010 the number
of chronic dialysis patients in the developed countries would be matched
by those in the developing countries, with a 3:2 or higher ratio of
patients in developing countries to developed countries by 2020, and
the world’s total dialysis population approaching 5 million.
The future demand for trained renal staff
 Using
the most economic model for staffing of dialysis services, Dr. Woods
calculated the numbers of physicians, registered nurses, technologists/engineers
and patient care technicians that would need to be trained in order
to support the enormous numbers of patients projected to be receiving
dialysis by 2020 - close to 1 million staff in total. In order to meet
this need, teams from countries with established renal care programs
will need to share their knowledge, information and experience with
colleagues from countries embarking on the creation of renal care programs.
Training and development relationships between established and newly
created centers will be needed in order to facilitate staff exchange
programs in order for colleagues in developing countries to access the
resources of the established centers and for those from the established
centers to understand the context within which the new centers are being
developed.
|
