Dialysis Services Beyond Capacity As New Data Reveals Pressure On Access To Treatment

Kidney Health New Zealand is warning that dialysis services across Aotearoa are at or beyond capacity, with growing pressure on access to life-sustaining treatment and a system that has not kept pace with rising demand.

This follows the release of a new report from the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) and the Australian and New Zealand Society of Nephrology (ANZSN), which provides the most comprehensive picture to date of dialysis capacity across both countries.

The report highlights workforce shortages, funding constraints and limited ability to expand capacity, even where infrastructure exists. Dialysis care requires highly specialised clinical staff, meaning services cannot simply redeploy nurses from other parts of the health system to meet demand.

Kidney Health NZ General Manager Madi Keay says the data reflects what clinicians and patients have been experiencing for some time.

“What this shows is that dialysis services are under real pressure across the country. In some areas, it’s not just about being busy, it’s about whether there is capacity to take on new patients at all.”

Dialysis is a life-sustaining treatment for people with kidney failure, and it must be carried out multiple times each week to replace the essential functions of the kidneys.

“Dialysis isn’t optional. People need to be able to rely on access to treatment when they need it.”

The report shows New Zealand has an average of 4.53 people receiving haemodialysis for every available machine, above the level services are designed to safely operate at.

Once services reach around four patients per machine, they are effectively full. In many parts of the country, demand is now exceeding that, leaving little room to safely meet current demand, let alone respond to new patients or unexpected needs. In some areas, services are operating well beyond that level.

In some regions, services are already operating at their maximum staffing levels, meaning any increase in demand immediately places pressure on access to care. In others, patients are travelling long distances to receive treatment, reflecting growing inequities in access across the country.

“This isn’t about one hospital or one region, it’s a system-wide issue. Demand for dialysis is growing, but the way services are planned and resourced hasn’t kept up.”

While the pressure is most visible in dialysis units, Kidney Health NZ says the story starts much earlier.

“Chronic kidney disease is often silent, but it can be detected earlier and managed in a way that delays – and in some cases avoids – the need for dialysis.”

Without stronger national planning and earlier intervention, the organisation warns pressure on dialysis services will continue to grow.

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