NDT Advance Access originally published online on January 8, 2008
Nephrology Dialysis Transplantation 2008 23(4):1323-1329; doi:10.1093/ndt/gfm809
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Current structure and organization for renal patient assistance in Italy
1 Renal and Dialysis Unit, Regional Hospital, Aosta, Italy 2 NHMRC Centre for Clinical Research Excellence in Renal Medicine, University of Sydney School of Public Health, Australia 3 Cochrane Renal Group and Mario Negri Sud Consortium, S. Maria Imbaro (Ch), Italy 4 Renal and Dialysis Unit, S. Gerardo Hospital, Cinisello Balsamo, Italy 5 Renal and Dialysis Unit, Umberto I Hospital, Siracusa, Italy 6 Renal, Dialysis and Transplant Unit, University of Bari, Policlinico, Bari, Italy
S. Alloatti, 3 Viale Ginevra, 11100 Aosta, Italy. Tel: +39-165-543226; Fax: +39-165-543246; E-mail: alloatti.sandro{at}uslaosta.com
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Abstract |
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Background. Given the public health challenge and burden of chronic kidney disease, the Italian Society of Nephrology (SIN) has compiled a national census of Renal Units (RU) existing in the twenty Italian regions related to the year 2004.
Methods. An on-line questionnaire including 158 items explored structural and human resources, organization aspects, activities and epidemiological data in SIN, 2004.
Results. The census identified 363 public RU, 303 satellite Dialysis Centres (DC) and 295 private DC totalling 961 DC [16.4 per million population (pmp)]. The inpatient renal beds were 2742 (47 pmp). Renal and dialysis activity was performed by 3728 physicians (64 pmp), of whom 2964 (80%) were nephrologists. There was no permanent medical assistance in 41% of satellite DC. There were 1802 renal admissions pmp and 99 renal biopsies pmp. The management of acute renal failure (13 456 cases; 230 pmp) represented a relevant proportion of the activities conducted in public RU. In 2004 there were 9858 new cases of end-stage kidney disease requiring renal replacement therapy (RRT) (169 pmp). On 31 December 2004, 60 058 patients were on RRT (1027 pmp), 43 293 of which (740 pmp) were on dialysis and 16 765 (287 pmp) with renal graft.
Conclusions. This census of the Italian RU and DC in 2004 provides decision makers and healthcare stakeholders with detailed data for benchmarking and has financial implications for the public health system. Similar analyses may be conducted in other countries permitting standardization of medical and cost-related aspects of renal care.
Keywords: census; dialysis; nephrology; registry; transplantation
Received for publication: 19.12.06
Accepted in revised form: 16.10.07