Kidney failure
and treatments

Kidneys are the organs of the human body as necessary for our life as the heart or lungs. They have multiple functions:

  • ———Hormonal,
  • ———Regulation of the tension,
  • ———Elimination of toxins (with liver and lung).

The kidney is involved in several processes but its main role is to ensure the detoxification of the body by discharging the waste through urine.
It filters the blood plasma and ensures the balance between water and body salts (homoeostasis).The urinary output (dieresis) reaches 1.5 litre a day.
Human beings have two kidneys, located in the abdomen, according to a more or less balanced symmetry. However it is possible to lead a normal life with only one kidney.
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Kidney failure corresponds to the impairment of function of both kidneys which no longer filter the blood correctly.
The disease is said to be acute when the dysfunction is temporary and reversible, and chronic when the destruction is irreversible, without hope for a cure. In such case, the disease can be stabilized.
Kidney failure does not decline by definition. It is induced by pathologies (diabetes, high blood pressure …) which destroy progressively and irreversibly the various kidney structures.
There are five stages of the disease up to the end, to which the filtration capacity is lower at 15% of the standard for the whole kidneys. This stage needs the setting of replacement techniques of kidney function: dialysis and kidney transplant.
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Treatments: chronic kidney failure may evolve very differently according to the patient and associated pathology. It needs different treatments in accordance with its evolution, the progression of which can be reduced for putting back the final stage.
Dialysis and kidney transplant have revolutionized the chronic renal disease since 1960s.

  • ———Kidney transplant consists in replacing the deficient kidneys by a healthy one. This technique allows several years to live without dialysis.
    More info
  • ———Dialysis helps remove toxins and excess water from the blood thanks to various techniques:
    • ———Hemodialysis enables to replace the function of kidney filtering through an extracorporeal circuit. It is generally held by 4 hours-session, three times a week. It can be done in specialized health care unit (proposed by UNH) and at home (proposed at ATIR).
    • ———Peritoneal dialysis, allows to filter the blood at the peritoneum serving as a membrane. It can be done at home by daily sessions (proposed at ATIR).
    More info

Follow-up and treatment of kidney failure in New Caledonia and at Wallis & Futuna Islands are dealt by three dialysis operators: Centre Hospitalier Medipôle (Medipole Hospital Centre), UNH (Nephrology Hemo-dialysis Unit) and ATIR, all partners of public organizations in the optimization of this health coverage.

About
UNH

History: In 1988, UNH carried out hemodialysis in the new Baie des Citrons Clinic under the impulsion of Dr. J. Freund.
The Bourail Centre was afterwards opened in 1991, followed by Jules Ferry Centre and finally La Foa Centre in 2006.
In 2014, UNH takes another turn in modernizing its infrastructures and in increasing its dialysis capacity in Baie des Citrons Clinic. It improves its integration in the Caledonian health system and becomes integrated in the care trail along with the hospital centre and ATIR association.

Presentation: UNH is a company of more than 50 professionals devoted in the ongoing quest for quality improvement in taking charge of patients with impaired renal functions and their treatments.
Patients for nephrology consultation and for treatments of kidney failure are taken charge by:

  • ———A medical team of 4 nephrologists
  • ———One pharmacist
  • ———An administrative pole (executive and consultation secretary)
  • ———A logistics and technical pole (dialysis technicians – IT engineer)
  • ———A paramedical team: health managers, coordinators, nurses, orderlies, servicing agents
  • ———One psychologist, one dietitian

UNH activities

Clinical activity :
extra-renal purge


———Hemodialysis:
UNH is capable of ensuring the hemodialysis as well as clinical or technical withdrawals of patients coming from peripheral units or other modes of treatments (peritoneal dialysis, renal transplant).

———Peritoneal dialysis:
DP catheters setting, consultations of peritoneal dialysis follow-up, cooperation with ATIR for taking charge of peritoneal self-dialysis at home.


Activities of nephrologic
and diagnostic interventions


———Nephrologic interventions and function tests:
- placement of dialysis catheter (hemodialysis or peritoneal dialysis),
- creation of vascular access of dialysis,
- supervision of vascular sutures (ultrasound and Doppler monitoring,
- function tests making, angioplasty of dialysis vascular access),
- renal biopsies.

Hospitalization
activity


———Hospitalization for dealing with clinical nephrology, nephropathy assessment and for supervising complications of dialyzed or transplanted patients.

———Day hospital for ambulatory care and renal function tests.


Activity
of consultation


The activity of consultation is focused on clinical nephrology, prior treatment consultation of renal replacement (transplant, peritoneal dialysis, hemodialysis in the unit or at home). Patients with impaired renal function, patients with kidney transplanted or dialyzed, diverse renal diseases, by systemic diseases or linked to the kidney, metabolic, immune, lithiasis diseases are the central areas of consultation.
Remote consultation enables to strengthen the follow-up of patients in peripheral unit.

Modalities of proposed treatments

Kidney transplant: The team manages 3 possibilities from New Caledonia

  • ———Registration on the list of local transplantation (kidney removal from the donor in New Caledonia, transplant in Sydney RPAH)
  • ———Preparation of a transplant from a living donor
  • ———Transfer towards a French Metropolitan transplantation team

Treatments in dialysis unit: Nowadays is Hemodialysis mainly carried out in the categorized hemodialysis units. Centre, dialysis unit under medical supervision, and hemodialysis unit nearby meet the proper requirements to the health status of the patients.

  • ———The Centre is appropriate for an extensive care. Located within the Baie des Citrons Clinic, the Noumea Hemodialysis Centre offers a technology platform allowing an optimized care to the patients. (operating theatre, radiology centre and CT scan, acute care setting). Daily medical care is ensured in dialysis sessions as well as medical on-call duty and nurse 24 hours a day. The centre performs 3 series of dialysis 6 days out of 7.
  • ———Dialysis unit under medical supervision UDM cares for patients who do not require the constant presence of a physician or an extensive technology platform. According to the medical need of the patient, UDM can provide the visit of a physician once to three times a week, in the course of dialysis session UDM also ensures a consultation with a full medical checkup to each patient.

UNH sites and partners

UNH sites

UNH partners: CHT

UNH partners: ATIR

UNH projects

Ile Nou Magnin clinical

The Baie des Citrons Clinic in which is located the UNH intensive dialysis care unit, will be moved in 2018 towards the new Ile Nou Magnin Clinic. UNH Centre will then benefit from this new structure and all these amenities.

The medical centre MEDISUS

Jules Ferry dialysis unit will be moved towards the new medical centre MEDISUS which is planned to be opened in 2018.

Kone Hospital

Next to the future KONE Hospital Centre, a hemodialysis centre with 8 medicalised stations, 3 days a week and 10 hemodialysis stations 3 days a week, operated in association with ATIR.

UNHcontacts


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