As the global community marks World Kidney Day on 13 March, the incidence of chronic kidney disease is accelerating worldwide - and in South Africa. Treating this life-threatening condition must meet all the complex needs of kidney patients – beyond the necessity for regular, lifesaving renal replacement therapy (dialysis or transplant).

A holistic approach to managing the disease must consider everything from the patient’s medical needs and their emotional state to their quality of life and the financial cost of treatment.

Leading healthcare organisations are developing integrated-care solutions that balance these interrelated factors. This means solutions can be tailored to individual needs, and requirements are incorporated into a single, multidisciplinary strategy.

South Africa’s Life Healthcare Group is at the forefront of this approach, having developed a renal integrated care programme that places the patient at the centre of treatment. To date the renal integrated care programme has been successfully rolled out across 30 of its renal dialysis units, with a further 11 units in progress and an additional 27 units planned over the next year. The programme prioritises the patient, and delivers significant improvements in quality and other healthcare benefits s while lowering the overall cost of care. 

The Life Healthcare renal integrated care programme is a pioneering initiative that is improving the management of chronic kidney disease (CKD) in South Africa. By embracing a value-based care (VBC) approach, the renal programme delivers superior patient care.

The renal integrated care comes at a time when the prevalence of chronic kidney disease is surging, and the demand for renal-care services is soaring worldwide.

CKD impacts approximately 1 in 10 people in South Africa, and Life Healthcare reports growing demand for renal therapies in the country. A 13% compound annual growth rate is forecast in the market for end-stage renal dialysis from 2024 – 2030. The rise in CKD cases is driven by diabetes, hypertension, obesity, ageing populations, infections, including HIV, and exposure to herbal and environmental toxins.

In 2021, 80% of new kidney replacement therapy patients were treated in private medical care facilities. Globally, there was an 80% increase in cases of chronic kidney disease between 1990 and 2019.

Life Healthcare’s renal programme includes patient education – in English, isiZulu and isiXhosa – on managing kidney health, as well as quality-of-life assessments and care co-ordinators who provide practical and emotional support.

“I think it’s been a different journey, (since being treated at Life Healthcare) ,she (care co-ordinator) explained things a lot more carefully. I feel like I have a trusted partner”, says Chanel Fourie, who receives dialysis at a Life Renal Dialysis unit.

“The care co-ordinator relationship is based on an understanding that patients living with end-stage kidney disease require more than just dialysis treatment,” explains Life Healthcare Chief Medical Officer Dr Karisha Quarrie. “Our co-ordinators create a partnership between the patient and the teams involved in their care – including nephrologists, vascular surgeons, clinical pharmacists, dietitians and social workers.” 

“I know if I have an issue with a fistula, or whatever the issue is, she will send me a private message. Like, hey, how are you? Are you OK? Are you doing better? And she's really caring”, said Chanel.

Chronic Kidney disease means the kidneys begin failing in their vital role of filtering waste, maintaining fluid balance, and regulating blood pressure, if not managed this may progress to end-stage kidney failure, renal replacement therapy (dialysis or kidney transplant) becomes crucial. Dialysis treatment (haemodialysis or peritoneal dialysis ) eliminates toxins and excess fluids from the blood, and to alleviate symptoms like nausea, muscle cramps and swelling.

The treatment has a major physical and psychological impact on patients’ lives – hence the value of integrated care pathways, with a well-trained team of professionals to support the patient on their treatment journey and ensure continuity of care.

The Life Healthcare renal integrated care programme also leverages technology to ensure improved patient outcomes. “We’ve built a Clinical Management System that provides a 360-degree view of each patient,” says Dr Quarrie. “The system automates patient care-plan navigation, enables real-time alerts for missed appointments or abnormal clinical values, and generates dynamic outcomes reports for clinicians and medical aids.”

Life Healthcare’s programme has driven improved clinical quality and reduced patient admissions, while patient compliance to dialysis attendance is up to 97% from 85%. At the same time, there has been a 17% reduction in renal patient admissions to Life hospitals.

Patient experience surveys indicate enhanced patient experiences, with patients reporting a seamless transition through service providers and an experience score that rose to 85% from a base of 78%.

The Life Healthcare renal integrated care programme is set to be rolled out across more of the organisation’s 76 renal dialysis units. Expanding the programme into the remaining 46 Life Renal Dialysis units across southern Africa will ensure more renal patients can access this successful programme and help them achieve better clinical outcomes.

Learn more about Life Renal Dialysis services here.