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New dialysis clinic to ease hospital burden

After four years of waiting, Irena Ashton has opened a new dialysis service allowing patients to get home treatment — a first for the Island, where kidney disease is rampant (Photograph by Blaire Simmons)

The Island’s first home dialysis service is up and running — and could save Bermuda’s healthcare system up to $2 million a year.

Bermuda Home Dialysis Service (BHDS) has been a dream four years in the making for local nurse Irena Ashton.

“Dialysis has never been done outside of the hospital in Bermuda,” Mrs Ashton said, showing off her new premises on Woodbourne Avenue in Hamilton where up to 40 patients could ultimately be treated. BHDS stands to alleviate the pressure at King Edward VII Memorial Hospital’s unit in the acute care wing, where about 170 patients receive dialysis.

Dialysis is the only recourse for people who have lost kidney function, and chronic kidney disease is on the rise in Bermuda. In traditional haemodialysis, a patient’s blood is filtered through a machine.

BHDS offers peritoneal dialysis, a procedure that patients can perform on themselves and at home — often scheduling the daily procedure to run while they are asleep.

“It’s a good option for new dialysis patients — it’s gentler and more natural,” Mrs Ashton explained. “Haemodialysis is now traditionally looked at as the last resort.”

Controlling their own treatment empowers patients, she said, while they continue to receive one-on-one time with healthcare staff.

“They will come here for training at the beginning, which is usually anywhere from a month to a month and a half,” Mrs Ashton said. “Then they start dialysis at home and come here for check-ups once a month.”

The 27lb device that administers the treatment, known as a Cycler, “fits into a suitcase”, meaning local patients can take theirs with them when they travel.

“The same applies to people coming to Bermuda — we will finally have a service that we didn’t have before,” Mrs Ashton said.

As healthcare costs climb year over year internationally as well as in Bermuda, she said peritoneal dialysis has become “mainstream”.

Mrs Ashton estimates that the service could cost $50,000 less each year per patient, and that as many as 40 per cent of patients could be eligible for it.

Moves to introduce peritoneal dialysis to Bermuda caught some political flak earlier in the year.

Mrs Ashton’s service had been approved by the Bermuda Health Council. She subsequently liaised with the hospital, which sought ultimately to offer its own peritoneal dialysis service.

Ms Ashton was taken on as a consultant by the hospital, but the contract was dropped after it came under fire in the House of Assembly.

Several Opposition Members of Parliament objected to the consultancy, suggesting a conflict of interest because Mrs Ashton’s husband Michael Ashton is head of infectious disease and hospital epidemiology at Bermuda Hospitals Board.

Mrs Ashton said her husband’s responsibilities and line of work had no bearing on her consultancy with BHB.

Confident that the new service will prove beneficial for Bermuda, Mrs Ashton called for existing dialysis patients or persons about to start on dialysis to contact her at 295-8999.

BHDS cannot self-refer, and the service is offered in conjunction with patients’ nephrologists and primary care physicians.