annual report 2008/2009 · 2013. 11. 7. · khnz, and your patience while i work through a...

Kidney Health New Zealand, 24 St Asaph Street, Christchurch.Freephone 0800 543 639 • Fax (03) 374 2176 • www.kidneys.co.nz • email [email protected]

A n n u a l R e p o r t 2 0 0 8 / 2 0 0 9


AcknowledgementsKidney Health New Zealand wishes to take thisopportunity to thank the following for their generoussupport during the year:

Just Water (Red Eagle Corporation)

Community Publishing Company Limited

Roche Products (New Zealand) Limited

Ocean Spray

Nick Polaschek - Senior Project Manager,Sector Capability & Innovation Directorate,Ministry of HealthNew Zealand Renal Units

Board

Chairman David Henderson (Wellington)

Secretary/Director Guy Johnson (Christchurch)

Treasurer Assoc. Prof. Richard Robson (Christchurch)

Medical Director Prof. Kelvin Lynn (Christchurch)

Dr David Voss (Auckland)

Nora Van der Schrieck (Auckland)

Sue Patience (Auckland)

Bobbie Kitchen (Palmerston North)

Paula Daye (Auckland)

Paula Martin (Wellington)

Remembrance donationsKevin Murray BrownMary TreacyMelville Laurence RuddleDeborah A. RedfernAllan Albert BlakeleyLawrence HazlewoodsShirley LondonPeter OwersJohn Maynard FrancoisGraham Thomas ThompsonAlison Brigitt ChisholmAlbert MacGibbon BeckJan FurrellJoy McKinley-RuawaiJack EggersGraeme William BeaumontRaymond ShuePatricia Mary WyattNoel John FirthNeal FergusonColin McPhail

BequestsEstate D.L. BoultonEstate Claire Palmer-JonesEstate S.E. Gimblett

Donations - $500 and over

Noel & Melva Charitable Trust $2,000Tui Gaspard $2,000Sarah Chapman (Fundraise OnLine) $1,671.10W.G. Johnston Charitable Trust $5,139.81NZ Kidney Research Trust $4,873.34

Annual Report for the year ending March 2009


In 2008 Paul Hawken published the book “Blessed Unrest: How the greatestmovement in the world came into being and why no one saw it coming”.This book has been described as the real news of our time – a manifesto ofhope, and Hawken concludes that this is the largest social movement in history.

In the book Hawken describes this as a movement of individuals who maynever meet or know each other, but who are part of a coalescence made upof hundreds of thousands of organisations.

Kidney Health New Zealand is one of these. We have grown as a result of ourshared recognition that we can improve services and support for people withrenal disease and their families in Aotearoa/New Zealand.

Kidney Health New Zealand is the leading nationalorganisation in this particular area. Our focus, as ourletterhead indicates, is Prevention, Support andResearch, and our Board involves patients, physicians,kidney donors, family members, and support workers.

We work together based on a shared vision of what canbe achieved, and in this we are part of Hawken’s socialmovement that spreads through every city in everycountry, involving nearly every tribe, culture, languageand religion, providing support and meaning to billionsof people.

Hawken describes the three basic roots of thismovement: environmental activism, social justice andindigenous cultures’ resistance to globalism – all ofwhich have become entwined as an expression of thedesire of the majority of people on this earth to sustainthe environment, wage peace, democratise decisionmaking and policy, and reinvent public governance.

The Strategic Plan developed by the KHNZ Board canbe seen as an expression of the particular needs of renalpatients and families in relation to these themes. Theplan is broad, so it has provided the basis for a widerange of actions, but they all address our core focus.

Details of our work are in the following reports fromour Medical Director Kelvin Lynn and Education OfficerCarmel Gregan-Ford. I want to express my thanks andthat of the Board for their commitment, dedication andefforts on behalf of KHNZ. Particularly pleasing are thepositive and productive relationships we have been

FINANCIAL POSITION

The year to 31 March 2009 saw an increase inincome over the previous year by $115,000. Theincrease is due to bequests totalling $200,000.

Whilst expenses were down on the previous yearby $44,000 the downturn in the financial sectormeant that we have an impairment in ourinvestments of $333,000. Unfortunately, one ofthese investments might not be recoverable. Thishas reduced the Trust’s equity as at 31/3/2009 to$1,317,790 down from year end 2008 $1,626,867.

Full audited financial statements are availablefrom Kidney Health New Zealand, 24 St AsaphStreet, Christchurch.

Kidney Health New Zealand2009 Chairman’s report

Dave Henderson, chairman

able to build with the Ministry of Health and withregional and local patient support societies.

I would also express my thanks to all the other BoardMembers, and to our Executive Director Guy Johnson.I have appreciated your commitment to the vision ofKHNZ, and your patience while I work through a difficulttime with my own kidney failure, dialysis andtransplantation. I look forward to continuing to worktogether as a Board, building on our achievements todate and supporting continued improvement in theservices and support available to renal patients andtheir families.


Kidney Health New Zealand2009 Medical Director’s report

Kelvin Lynn, Medical Director

region is under great pressure because of difficulties inattracting and retaining sufficient kidney specialists.Living donor transplants continue to increase in numberand new transplant technologies – paired kidneyexchange and ABO incompatible transplants (only inAuckland) – are now available. The Health SelectCommittee recently addressed the issue of organdonation and the need for an organ donor registry.KHNZ’s position is that establishing and maintainingsuch a register would be complicated, expensive, andunlikely to increase organ donor rates. It is pleasing tonote that a report to the Committee from Margie Apa,Deputy Director-General, Sector Capability andInnovation, at the Ministry of Health supported thisview.

A major achievement this year has been thedevelopment of a simple guide for family practices onthe management of CKD. Royal New Zealand Collegeof General Practice, the Ministry of Health and renalunits, supports this CKD Treatment Guide. Copies weredelivered to 3,800 GPs in April with the assistance ofthe College. The University of Otago has ordered 350copies for medical students and a number ofprofessional groups have asked for additional copies.

World Kidney Day 12 March 2009A major focus each year is the annual Kidney HealthWeek and World Kidney Day. The InternationalFederation of Kidney Foundations (IFKF) and theInternational Society of Nephrology share the globalmanagement of World Kidney Day. These events during

The Executive have been working hard over the pastyear to achieve the goals set out by the Board in theStrategic Plan 2008-2011.

Chronic kidney disease in New ZealandThe invaluable annual report from the Australian andNew Zealand Dialysis and Transplant Registry showsthat 461 people started dialysis in 2007 and that 41percent had diabetes as the cause of their kidneydisease. At the end of 2007, there were 2,064 NewZealanders on dialysis: 30 percent hospital dialysis,19 percent satellite dialysis, 51 percent home dialysis.The largest adult kidney unit had 444 dialysis patientsand the smallest 59 dialysis patients. There were 1,289people with a functioning kidney transplant. There areno accurate figures for the number of people withadvanced CKD not on dialysis. KHNZ estimate that thereare likely to be 12-13,000 people with kidney functionless than a third of normal.

New Zealand leads the world in the provision of homedialysis but there has been decline in the proportionon home haemodialysis or peritoneal dialysis and anincrease in hospital and satellite dialysis. It is pleasingto hear of the success of the recently opened hometraining unit at Auckland Hospital and the plans todevelop kidney services for the half a million peopleliving in Waitemata District Health Board region. Thearrival of Dr Drew Henderson in the Hawkes Bay hasenabled that region to develop its own services afteryears of support from Wellington. The kidney unit atWaikato Hospital responsible for the large Midland

IntroductionIt has been three years since I became the Medical Director of Kidney HealthNew Zealand (KHNZ). During this time, the organisation has changed significantly.There has been a change of name and a consolidation of links with kidney units,patient support groups and the National Renal Advisory Board (NRAB). KidneyHealth New Zealand now has a national presence as evidenced by our beingawarded a contract by the Ministry of Health to produce web-based informationresources and the Medical Director being an ex officio member of the keynational advisory group on renal services, the NRAB. Working for KHNZ hasbeen enjoyable and I have had great support from my colleagues in the Executive– Guy Johnson and Carmel Gregan-Ford. Our Chairman, Dave Henderson,provides wise guidance for the organisation and much appreciated support forthe Executive.


International Congress on Nutrition andMetabolism in Renal Disease in Marseilles, France.Lyn’s comprehensive report from this meeting isavailable from the KHNZ office on request.

KHNZ work with the Ministry of HealthKHNZ is fortunate in having excellent support for ouractivities from Stephen McKernan, Director-General ofHealth and his staff at the Ministry of Health. KHNZ isparticularly grateful to Nick Polaschek, Senior ProjectManager in the Sector Capability & InnovationDirectorate. Nick has been working with the NRAB onthe Renal Service Improvement Project.

This work has five defined projects with timelines fordelivery of outcomes agreed by NRAB. They are:

1. Improving CKD management in primary care

2. Increasing rates of renal transplantation

3. Regional coordination in planning to addressdemand and access

4. National coordination in renal workforcedevelopment

5. Improving information about and for renal patients(this work has been contracted to KHNZ)

KHNZ has a contract with the Ministry to conduct astock take of all renal information resources and todevelop five or six renal client information documentsfor web publication.

Issues of importance to people with CKD raised withthe Ministry of Health and the Minister of Health are:an increase in the financial compensation for livingkidney donors; streamlining access to assessment andsurgery for kidney donors and recipients; recognitionand financial support for people on home dialysis;improved regional co-ordination and access to renalservices; continued support for the work of the NRAB.

KHNZ and global connectionsKHNZ is a member of The International Federation ofKidney Foundations (www.ifkf.net). The IFKF’s missionis “to foster international collaboration and exchangeof ideas between local kidney foundations and not forprofit organisations to enable and help empower localmembership organisations to improve health, well beingand the quality of life of all individuals at threat fromkidney disease.” The IFKF aims to bring a global focusto the prevention and treatment of kidney disease andhas 66 member organisations representing 42 countries.

the week of 9 – 15 March 2009 provided an idealopportunity for KHNZ to deliver its message to thepublic and politicians and to raise its profile. This yearthe theme for World Kidney Day was the link betweenhigh blood pressure and chronic kidney disease (CKD).Carmel Gregan-Ford describes Kidney Week’s activitiesin more detail elsewhere in this report. I would like toacknowledge the great support received from patientsupport groups and renal units for the week’s activities.The theme for World Kidney Day 2010 will be “CKD andDiabetes”.

The increasing public profile of KHNZ has led to largeorganisations and service groups requesting CKDscreening. Currently such screening – blood pressuremeasurements and urine protein tests - has beenprovided by KHNZ staff and local nurse volunteers. Allthose screened receive written advice on the results ofscreening and any need for follow-up in primary care.The results of screening done to date suggest that theestimate of one in ten adults having a sign of CKD islikely to be accurate.

ResearchFunding of research has been a key activity of KHNZsince its inception. The Strategic Plan identifies specificresearch areas that KHNZ would like to fund. In 2008,no research applications met these criteria. Six researchgrant applications received this year are under reviewby the Scientific Assessment Committee of theCanterbury Medical Research Foundation. The Boardwill make the final decision on funding after receipt ofthe committee’s report in mid August. KHNZ funded aSummer Studentship at the University of Otago,Christchurch for 10 weeks over the university vacationfor a medical student, Isaac Campbell. Dr John Pickeringfrom the Christchurch Kidney Research Groupsupervised Isaac’s project Timing of injury and biomarker-based diagnosis of Acute Kidney Injury (AKI). Isaac wonthe prize for the best scientific report.

Research projects currently supported by KHNZ are:

1. Kidney Disease and Quality of Life Follow-up Study,Dr Sarah Derrett ($32,280)

2. Characterisation of genes involved in polycystickidney disease in a sheep model, Professor MichaelEccles ($35,817)

3. Renal Endothelial Function in Models of ChronicRenal Failure. Professor Zoltan Endre ($76,668)

4. Lyn Lloyd , Senior Renal Dietitian at Auckland CityHospital, received $3,000 to attend the


From left to right: Kelvin Lynn, KHNZ Medical Director,Carmel Gregan-Ford, KHNZ Education Manager, Jo Goodhew, MP,Kay McLaughlin, Pre dialysis Nurse, Capital Coast District HealthBoard, standing at the kidney screening stand inside the Beehivein Wellington.

Kidney Health New Zealand2009 Education Manager’s report

Liaison with other support groupsI write a regular newsletter for the Christchurch KidneySociety that is then distributed to all patient supportgroups. The Executive continue to work with ElizabethCunningham, Ngai Tahu, member of Canterbury DHBResearch Manager, Maori at the University of Otago,Christchurch to learn how best to get the messageregarding CKD heard in Maori communities. KHNZ hasstrong links with Diabetes New Zealand, and theDiabetes Societies in Christchurch and Auckland. WorldKidney Day 2009 enabled KHNZ to stress the linksbetween hypertension and CKD.

Kidney Health Australia is an active member of the IFKFand provides invaluable support to its smaller cross-Tasman cousin. The IFKF co-sponsors the World KidneyDay and is working with governments and theiragencies worldwide to raise awareness of theimportance of CKD as a major public health problem.I have attended the last three conferences organisedby the IFKF. This has given me an insight into theproblem of CKD in countries as disparate as Bulgariaand Pakistan and the responses of local kidneyfoundations.

A representative from each support group gave a briefoverview of their group’s activities and achievementsthroughout the year. I am always impressed by thededication of these groups, nearly all run by volunteersand this year was no exception. It was also interestingto hear about the different projects individual groupsfocused on, including fundraising events andinformation sessions to support people and theirfamilies with kidney disease.

As usual at our annual conference, we opened theprogramme up to the general public. Advertisementswere placed in the renal clinics and the local newspaper.We were pleased to see some new faces attending fromthe Waikato region.

Senior Renal Nurses’ ConferenceOur annual Senior Renal Nurses’ Conference was heldin Auckland in September. This conference is heldspecifically for nurses working within hospital renalunits and satellite dialysis units throughout the countryto provide an opportunity for networking and sharingideas and initiatives around care of the renal patient.The senior renal nurse advisory group meet prior to theconference and provide a report at conference aboutthe progress they have made in the area of educationfor nurses and attracting and retaining nursing staff inrenal medicine.

Organ Donation Forum - TimaruIn October I spoke to Year 11 and 12 students (15 –16 yrolds) from secondary schools in South Canterbury aboutOrgan Donation. This was a prelude to the OrganDonation Forum held in Timaru on October 30th. It

2009 Education Manager’s ReportThe past year, 2008/2009, has been a busy andexciting one for our organisation, with a widevariety of activities undertaken and requestsincluding several speaking engagements andprovision of resources for a number of groups.

Kidney Patient Support GroupConference – Hamilton, June 2009

Our annual conference was held in the Waikatoregion, which has one of the highest incidences ofkidney disease in New Zealand, and we hoped to attractsome interest from the community to attend theinformation morning held on the Saturday.


advised to see their GP for further investigations. Manyof the staff had come back to see us following our visitlast year and were keen to know if their results hadimproved.

Once again, the success of this week could not havehappened without the help and support of the stafffrom the Auckland, Middlemore, Wellington,Christchurch and Dunedin renal units. We are verygrateful for all of their efforts.

National Just Water Week again focused on educationabout kidney health and the benefits of drinking waterwhen thirsty, rather than sugar-containing drinks, inorder to prevent obesity and diabetes (the leadingcause of CKD). This year there was a large increase inthe number of schools wanting our resource packs toassist their schools in promoting water as the drink ofchoice.

Website and 0800 information lineThe free phone information line continues to be wellutilised with on average of 50 -60 calls per month. Themost common calls continue to be from people wantinginformation about being a live kidney donor, but I havenoticed a significant increase in calls from GPs andpractice nurses wanting to use our resources, which isvery encouraging. Also of interest are the calls frompeople wanting to know how to look after their kidneys.

Our website is continually being updated; we frequentlyreceive positive feedback about the site and the layout.With information being made available for medicalprofessionals and patients this has been a useful toolto help provide information and resources for a wideaudience, with plans to expand on the informationcurrently available.

As a member of the Executive team for Kidney HealthNew Zealand, we meet weekly to ensure we are up todate with news and events happening around thecountry and overseas.

Throughout the year I am asked to speak to a varietyof groups about various aspects of kidney health andkidney disease; groups include Rotary, Kiwanis, Women’sInstitutes, Catholic Women’s League, Primary andSecondary Schools, Diabetes Support groups andnursing education programmes. Any opportunity toraise awareness about kidney disease and its impact,and promote detection and early intervention, isanother chance to get our message out there:

“Kidney Disease is common, harmful, treatable”

was interesting to hear the students’ thoughts aroundorgan donation and the knowledge they had regardingthis subject.

Kelvin Lynn, Richard Robson and I were invited speakersat the forum which saw approximately 150 peopleattending to learn more about organ donation. Twodonor families spoke of their decision to donate kidneysor corneas to their loved ones: a very moving experience.A man who had a corneal transplant and a man, whohad a lung transplant, spoke of their life changingexperiences and their gratitude to the donors and theirfamilies. The feedback from this event was very positive.

Kidney Health Week and World KidneyDay.

World Kidney Day, marked this year on Thursday, March12, is a major part of Kidney Health Week. The aim ofWorld Kidney Day is to raise awareness about the roleof the kidney in health and the need for early screeningfor people at increased risk of kidney disease. The themefor 2009 was "Keep the pressure down" to highlight therole of blood pressure as one of the key symptoms andcauses of chronic kidney disease.

Lion Nathan, a national organisation with sites in all themain cities, including three in Auckland, allowed us tocome into their facilities during Kidney Health Weekand educate their staff and offer screening for signs ofkidney disease.

Staff had their blood pressure taken and urine testedfor signs of protein. Each staff member was given writteninformation about kidney disease and the opportunityto speak to a nephrologist and/or renal dietitian (at theGrafton and Khyber Pass sites).

This screening was only possible because of the supportfrom the nursing and medical staff from the renal unitsin the cities we visited. We referred 12 .5% of the staffwith indicators of CKD (i.e. staff with high blood pressureand /or protein in their urine) to their GPs for furtherinvestigation. Although this appears to be a largeproportion it is in keeping with international experience.It is encouraging to know early detection of CKD offersthe chance for early, effective treatment in many people.

Our, now annual, visit to Parliament was anothersuccessful event, with a very busy day spent screeningMPs and Parliamentary staff for signs of CKD.Once againthe enthusiastic team from the Wellington HospitalRenal Department made it a very worthwhile day withtheir assistance. Those working in the Beehive are noless at risk of CKD: 12% of the staff screened were


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annual report 2008/2009 · 2013. 11. 7. · khnz, and your patience while i work through a...

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