Causes of end stage renal failure

Glomerulonephritis - chronic inflammation of the part of the kidney that filters the blood Polycystic kidneys - kidney tissue replaced by large cysts Chronic interstitial nephritis - scarring of the kidney Hypertension - can accelerate decline in renal function Myeloma - cancer of the plasma cells of the bone marrow

The alliance - an umbrella organisation representing all UK organisations involved in renal services - wants the government to draw up a national framework for end stage renal failure similar to those already published for cancer and heart disease.

It says current services are dangerously stretched and suffering from severe under-staffing.

It has calculated that 316 nephrologists are required to service the renal community in England - currently there are 164 nephrologists.

In addition one in four posts for nurses qualified to treat kidney patients are unfilled.

The report is based on a comprehensive evaluation of the current provision of renal services.

It proposes a new framework for planning and service delivery for the next ten years.

Solutions

Austin Donohoe, chair of the Kidney Alliance and himself a renal patient, said: "We fully appreciate that the government has initially focused on the bigger problems of cancer and cardiovascular disease and we therefore proactively decided to explore the issues facing renal medicine and find solutions ourselves.

"We would wish to see moves by the government to commission a National Service Framework for End Stage Renal Failure at the earliest possible opportunity so that seriously ill patients can benefit from better treatment."

The Kidney Alliance says much of the current infrastructure developed to treat end stage renal failure in the UK is generally sound.

However, its analysis shows that:

• too few patients are receiving treatment
• some treatment received is inadequate
• there are inequalities in access to services and in the quality of service across the country