Nephrology-Dialysis

The Iris Network is a key player in the history of medicine in Belgium, being the first to offer dialysis to patients with terminal renal insufficiency and performing the first renal transplants at Brugmann University Hospital. The first haemodialysis session was carried out in Belgium in 1956 under the aegis of Professor Pierre-Paul Lambert, and the first renal transplant in 1963 under the authority of Professor Charles Toussaint and Professor Jean Van Geertruyden. And these traditions of excellence and innovation are now continued by its Nephrology and Dialysis Clinic.

The Iris Sud Hospitals have developed dialysis centres, offering convenient local treatment at their Joseph Bracops and Etterbeek-Ixelles sites. With one of the country’s first peritoneal dialysis centres, CHU Brugmann is joined in this speciality as part of the Iris Network by the Iris Sud Hospital departments at the Joseph Bracops and Etterbeek-Ixelles sites.

Ranged across the whole of the Brussels Region, the nephrology and dialysis services offered by Iris Network public hospitals are particularly concentrated in the centre of Brussels itself. They aim to provide first-rate monitoring of conditions that may, partly, be associated with lower socio-economic levels, including arterial hypertension and obesity (and diabetes mellitus often related to this); these disorders are responsible for more than half the causes of chronic renal disease. Renal disease creates a demand by patients for consultations, on occasions for hospitalisation and, most importantly, a variety of renal replacement therapies. The care we offer these patients is comprehensive.

The range of consultations offered to patients, begins with the prevention and the control of arterial hypertension and diabetes in order to prevent the resulting kidney damage. Continuous care then follows the main stages of chronic and acute renal disease:

• management of the multiple consequences of chronic renal insufficiency in the broad sense (phosphocalcic metabolism and bone disorders with consequent vascular calcification and acid-base balance, with the prescription of erythropoietin to relieve anaemia);
• supported care path (in collaboration with the patient’s GP);
• multidisciplinary predialysis consultation (nursing staff, psychologists, dieticians, nephrologists);
• access route planning for the different types of dialysis (arteriovenous fistulas and/or central venous and peritoneal catheters) by surgeons and interventional radiologists;
• pre-transplant assessment where transplantation is judged to be possible (in collaboration with several academic centres and the ULB in particular);(joint) monitoring of transplant patients.

Hospitalisation makes it possible to diagnose various problems patients may have and, where necessary, to choose together with the patient the best renal replacement therapy. The Iris Network is able to offer the full range of medical care for all the classic nephrological syndromes (such as nephrotic syndrome, acute renal insufficiency, glomerulonephritis, etc.), including renal biopsies, where necessary. Hospitalisation also allows monitoring of patients on dialysis and transplant patients.
Adult transplants are performed in Iris Network partner hospitals. Paediatric transplants are performed at the QFCUH, which has one of the only two paediatric dialysis units in Belgium, along with the KUL at Gasthuisberg. Paediatric nephrology and screening for nephro-urological malformations are one of the QFCUH’s specialities.

When dialysis is essential

The hospital team starts by offering the patients all the information they need to allow them to make an accurate choice between haemodialysis (mainly at the centre) and peritoneal dialysis (at home). The Iris Network practises “traditional” dialysis techniques but also more modern and innovative techniques: day and evening haemodialysis at the centre and at home; auto-dialysis; peritoneal dialysis at home; manual and automated dialysis, etc. Considerable emphasis is placed on training patients and/or those close to them in cases of continuous ambulatory (or manual) peritoneal dialysis and automated peritoneal dialysis (with the possibility of support from home care nurses trained by the Iris Network).

In this context, the convenient local nature of the Iris Network public hospitals plays an important role. Our centres are also open to patients “on holiday” or passing through Brussels.