Dialysis Capital of the World: Kidney Disease and Aeromedical Retrieval in Central Australia

Mr David Carpenter1

1Royal Flying Doctor Service Central Operations, Alice Springs, Australia

Central Australia has the highest rate of renal dialysis in the measured world due to the extremely high incidence of chronic renal failure in the region.  Patients have moved up to 800 km into Alice Springs to commence and continue dialysis indefinitely, as historically there were no dialysis facilities in remote communities.  This resulted in either fractured social networks and difficulties in meeting cultural obligations (for people who remained in town) or in people choosing to return to their home communities for these reasons.  Having missed multiple scheduled dialysis sessions and become fluid overloaded and electrolyte imbalanced, those in this latter group would be aeromedically retrieved back to Alice Springs, often multiple times per year.

This presentation gives an overview of the interface of the morbidity of chronic renal failure, the pathophysiological extremes of missed dialysis and the logistics of aeromedical transport in this remote context, as well as of the models of care which have recently been introduced in the region that better meet the needs of patients and which have resulted in a reduction in the numbers of associated aeromedical evacuations.


Biography:

Tasmanian born and bred, David swapped temperate island life for the vast deserts of Central Australia and has worked as an Alice Springs-based Flight Nurse with the RFDS since 2011.