Kidney Health For All: Addressing Australia’s Dialysis Capacity Challenge

Advocacy

Jane Walton, Marketing & Market Access Manager, PD

For World Kidney Day, I spoke with Professor Nigel Toussaint, Director of Nephrology at St Vincent’s Hospital Melbourne, in an interview led by Rozalina Sarkezians from Health Industry Hub. We used this year’s World Kidney Day theme, Kidney Health for All – Caring for People, Protecting the Planet, as a starting point for a practical discussion about what kidney care looks like on the ground in Australia, and where the pressure points are becoming impossible to ignore.

The sections below highlight the main themes from that conversation, including equity of access, dialysis capacity, patient quality of life, and the need for more sustainable models of care.

Equity, sustainability and access

Kidney health for all starts with equity. That means early detection and fair access to treatment, regardless of location or background. In Australia, this includes addressing persistent disparities for people in regional and rural communities, as well as the disproportionate burden of kidney disease experienced by Aboriginal and Torres Strait Islander peoples.

The theme also brings environmental and economic sustainability into sharper focus. Healthcare has a significant carbon footprint, and improving sustainability through innovation in technology and models of care is becoming increasingly important.

At its core, kidney health for all is about ensuring patients can access treatments that suit their lives, while clinicians are supported with models of care that allow them to practice to the best of their ability.

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Dialysis demand is outpacing capacity

Across Australia, demand for dialysis continues to rise, placing increasing pressure on workforce and infrastructure. Many services are struggling to meet the growing need while maintaining optimal levels of care.

Where possible, dialysis should be delivered close to home. Home-based therapies offer clear advantages, although they are not suitable for everyone. For patients who require in-centre dialysis, proximity matters, yet many hospital-based kidney units are unable to offer treatment locations close to where people live. In some settings, capacity constraints are already limiting flexibility and placing strain on clinical teams. 

These challenges are no longer theoretical; they are playing out daily across kidney services nationwide.

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What patients are asking for

For people living with kidney disease, dialysis can be life-sustaining but highly restrictive. Many patients are managing multiple conditions and want treatments that minimise burden, reduce travel, and support independence, work and family life.

Quality of life consistently emerges as a central concern. Reducing the disruption associated with frequent travel to dialysis units is a key priority, alongside effective symptom management and long-term sustainability of care.

Rethinking funding and models of care

Despite clear benefits, existing funding models can slow reform. In-centre haemodialysis is well supported, while home dialysis requires upfront investment in training, infrastructure and support that is not always well recognised.

Expanding assisted home dialysis models, including assisted peritoneal dialysis, offers one way to increase capacity without major capital investment. These models can support patients to dialyse at home, sometimes short term, sometimes longer term, while relieving pressure on in-centre services. Pilot programs will be essential to identify implementation challenges and inform broader adoption.

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Listen to the full conversation

Meeting current and future kidney care needs will require coordinated policy reform, workforce redesign, and smarter use of technology such as telehealth and remote patient monitoring.

You can listen to the full Health Industry Hub podcast featuring Professor Nigel Toussaint and myself, where a 14-day free access trial is available. The full discussion provides deeper insight into the challenges – and opportunities – facing kidney care in Australia.