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Kidney treatments
Supportive care
Is available to everyone living with advanced kidney disease, whether you are managing your disease conservatively, with dialysis or with a transplant.
Our goal is to help you to keep doing the things you enjoy by helping you manage your symptoms and plan for your future.
Kidney transplant
Tasmanian hospitals do not currently perform transplant surgery. We work closely with the Royal Melbourne Hospital and Monash Health in Victoria for Tasmanians to access this treatment.
To ensure you are suitable for a kidney transplant or to be a kidney donor we have a team of health professionals who will guide you through the assessment process.
You will have the opportunity to meet with the Royal Melbourne Hospital and Monash Hospital Transplant teams during regular visits by their team to our state. They also often hold telehealth appointments to oversee progress.
Extensive testing is undertaken for both kidney transplant recipients and kidney donors across the state. There is a dedicated Kidney Transplant Nurse Co-ordinator who is your first point of contact and who will assist you in arranging testing, providing education and who will be with you for ongoing care following your transplant and return to Tasmania.
Tasmanian Health Service provides financial assistance with travel to Melbourne through the Patient Travel Assistance Scheme.
If you or someone you know is interested in finding out more about Kidney Transplant, please visit the Kidney Health Australia website.
The Royal Melbourne Hospital also has a useful website with information and videos explaining more about the processes and services they provide.
If you are interested in this treatment, please talk through with your GP to request a referral to see a Kidney doctor. If you are an existing kidney patient, then please speak with your kidney doctor for further information.
Dialysis
Dialysis is a treatment that filters and removes excess water and waste products from your blood when your kidneys can no longer do this role. It can be done in several ways;
Home dialysis
Research shows that people dialysing at home have better quality of life and in general better dialysis. Our staff can educate and support you choose which dialysis treatment that suits you best.
There are two main types of home dialysis available – home haemodialysis and peritoneal dialysis. For more information on these treatments please refer to Kidney Health Australia website (link) or the Royal Melbourne Hospital website which has some good videos to watch.
Once you are ready for dialysis and training, the nurses will explain everything that you will need to know about caring for yourself at home.
Peritoneal dialysis patients undertake most of their training in their own home.
Home Haemodialysis training takes place within the renal unit initially. Once you have successfully completed your training you will be provided the equipment and supplies necessary to dialyse at home.
Some people trained for haemodialysis prefer to dialyse outside of their home at a satellite centre. Your nurse can advise you whether this option is available to you.
Our staff regularly check how your dialysis is progressing and visit you in your home to make sure you are managing well with your dialysis.
In centre dialysis
If you are unable to dialyse from home, incentre dialysis is available in Tasmania’s 3 main regional centres of Hobart, Launceston, and Burnie. You will be invited to view these centres prior to commencing dialysis so you are familiar with the service.
Peritoneal dialysis
Peritoneal dialysis is a very good dialysis method and is often recommended when first starting out. It can be offered in 2 ways
- Continuous ambulatory peritoneal dialysis (CAPD), is a home treatment you perform between 1 and 5 times a day by exchanging bags of fluid. It is a simple treatment and easy to understand.
- Automated peritoneal dialysis (APD), is where your dialysis is performed at night with a machine that sits by your bed.
Your CKD Nurse Educator will discuss options with you. Should you decide on peritoneal dialysis a catheter is needed to be inserted into your abdomen, to enable fluid to be drained in and out, and this is performed under surgical procedures. For more information, please refer to Kidney Health Australia or the Royal Melbourne Hospital website.
Fistula
A fistula is an enlarged vein (usually in the arm), created by joining an artery and vein together.
This section includes information on caring for your fistula after you start haemodialysis. There is information on having a fistula created for dialysis; how to check your fistula is working, what to do if your fistula bleeds at home and where to go if you think you have an infection. Some people with a fistula need to have a balloon inserted into your fistula to open up a narrowing called a stenosis. If your doctor tells you that you need to have this procedure, you can find the information in the section titled, Having a Vascular Fistulogram or Fistuloplasty .
Be aware of bleeding warning signs and what to do
Caring for your fistula now you have started Dialysis
Having a Fistula created for Dialysis
Having a Vascular Fistulogram and / or Fistuloplasty
This section contains information on a haemodialysis catheter commonly called a Permacath. This catheter is used for exchanging blood between your body and the machine. In this section you can find information about the catheter, how and where it inserted or removed; how you can care for your catheter and what problems to watch out for.
Caring for your dialysis catheter fact sheet
Having your Catheter Removed in Medical Imaging
Understanding Your Haemodialysis Catheter (permacath)
Understanding your Nasal Swab Pathology Result
Biopsy
A biopsy is a medical procedure frequently performed to assist in diagnosing and monitoring your kidney condition and transplant.
What is a renal biopsy?
A renal (kidney) biopsy is a medical procedure that involves using an ultrasound guided needle to take a sample of kidney tissue to examine under a microscope to assist in diagnosing or monitoring your kidney condition or your transplant kidney.
How is the biopsy done?
The biopsy is performed in the radiology or ultrasound department. If you are having a native (your own) kidney biopsy then you will be required to lie flat on your stomach for approximately 30 minutes. An ultrasound machine will be used to locate your kidney and a needle with local anaesthetic will be used to numb the area. A biopsy needle will put through your back below the rib cage into the kidney and a sample taken. Usually this requires one sample but on occasion further samples are taken. You may be given a sedative for the procedure to help you relax but you will remain awake.
If you are having a biopsy of a transplant kidney then you will remain on your back for the procedure and the biopsy needle will be passed through the abdomen into the transplant kidney.
Will the biopsy hurt?
There is some discomfort with the procedure however most patients tolerate this well. There are options for both tablet and intravenous pain relief and sedatives if needed.
Why do I need a kidney biopsy?
Some kidney problems can be detected with blood tests and ultrasound of the kidneys but often a kidney biopsy is the best test to get a clear answer.
Specific reasons to do a kidney biopsy include:
- Blood in the urine or protein in the urine.
- Abnormal kidney function tests.
- Acute kidney failure.
- Monitoring of a transplant kidney (done at 3 months and 12 months) or at any time if the transplant isn’t working well.
- A kidney tumour or mass.
Risks of a renal biopsy
As with any procedure there are risks associated with a kidney biopsy. Your doctor will carefully consider this when deciding if the biopsy should be done.
The main risks include:
- Bleeding or bruising of the kidney.
- Blood in the urine.
- Bleeding into the bladder requiring a urinary catheter.
- Pain during or after procedure.
- Injury to structures around the kidney (nerve, muscle, organs).
- Infection
Rare complications:
- Major bleeding requiring surgical intervention
- Loss of a kidney or long term damage to the kidney.
Risks are minimised by the clotting tests that you have done prior to the procedure, and with the use of ultrasound to locate the position of the kidney.
Before your renal biopsy
You will need to have bloods and urine test.
You will be asked to stop anti-platelet agents one week prior to your biopsy. If you are on blood thinners you will be advised when to stop these prior to the biopsy.
Important things to tell your Doctor before the procedure:
- If you have an infection or are unwell
- If you have not stopped your blood thinners
- If your blood pressure has been high
- If you are or might be pregnant
- If you have allergies to medication or anaesthetics
Please tell the doctor if you are taking any of the medications below.
- Warfarin
- Apixaban
- Rivaroxaban
- Dabigatran
- Fish Oil
- Tumeric
- Aspirin
- Clapidogrel
- Clapidogrel + aspirin
- Ticagrelor
- Prasugrel
- Ticlopidine
- Dipyridimole
- Dipyridimole + aspirin
- Cilostazol
- Ibuprofen
- Naproxen
- Celecoxib
- Diclofenac
- Indomethacin
On the day of your renal biopsy
- Have an early breakfast then fast from 6.30am.
- Take all regular medications including blood pressure tablets unless otherwise advised.
- Present to Ambulatory Care Centre at 8:00 am (see back of leaflet for directions).
After your renal biopsy
You will be required to lie flat on your back for four hours to reduce the risk of bleeding. A urine sample will be taken to check for blood.
