Comment: Water’s edge John Bradley pp 3-3 For many haemodialysis patients with minimal urine output, fluid restriction has an unacceptable impact on emotional well-being and quality of life. For some patients with polycystic kidney disease, the converse is true; they must learn to cope with the consequences of a high fluid intake and urine output in order to prevent the need for renal replacement therapy, and the associated distress of fluid restriction. Tolvaptan, a vasopressin receptor antagonist, slows decline in kidney function in patients with autosomal dominant polycystic kidney disease; however, some patients are unable to tolerate treatment because of polyuria, nocturia, thirst and polydipsia.
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Management of cardiovascular risk factors in chronic kidney disease patients Timothy Lewis-Morris, Daniel Stewart, Thomas Jorna and Jo Taylor pp 4-7 Chronic kidney disease (CKD) is a global public health issue. In England, the incidence is estimated to be between 4% and 6.3%, with an associated estimated cost of £1.44 to £1.45 billion for the year 2009–2010, equivalent to more than 1% of the NHS budget. Since 2006, the Quality and Outcomes Framework has incentivised GPs in England to keep a register of patients with CKD stages 3 to 5.
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Resources: British Renal Society Simon Ball pp 7-7 The past three months have been busy for the renal community. The British Kidney Patient Association and British Renal Society awarded seven grants, in areas including illness perception, the relationship between quality of life and mood, the role of information delivery and peer support, management of cutaneous malignancy in transplant recipients and patients’ perspectives on achieving a dry weight. Congratulations to the successful applicants and thank you to the reviewers.
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Predict, prevent and manage acute kidney injury: a collaboration to detect a devastating condition Lui Forni, Richard Venn and Luke Hodgson pp 9-11 Acute kidney injury (AKI) is a potentially devastating condition, thought to contribute to the deaths of tens of thousands of patients every year in the UK. However, it is often preventable. A new automated electronic alerting project at Western Sussex Hospitals NHS Foundation Trust aims to detect the risk of AKI early, promote intervention and save lives.
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The 7th European Multidisciplinary Meeting on Urological Cancers Bethan Du-Mont pp 12-13 Between 12 and 15 November 2015, experts in the field of uro-oncology from across Europe and beyond gathered in Barcelona for the 7th European Multidisciplinary Meeting on Urological Cancers, organised by the European Society for Medical Oncology, European Society for Radiotherapy and Oncology and European Association of Urology. Over four days of presentations, workshops and discussions, delegates were presented with a wealth of findings from the forefront of clinical research into prostate, bladder, renal and testicular cancer.
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Renal research report is a hit at the House of Lords Kidney Research UK pp 14-14 Parliamentarians from across the political spectrum were united in their support for the launch of Kidney Research UK’s report into renal research in the UK, which took place at the House of Lords on Tuesday 19th January.
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What I tell my patients about cystinuria John A Sayer and Charles Tomson pp 17-20 Cystine is an amino acid found in high- protein foods such as meat, eggs and dairy. High concentrations of cystine, particularly in acidic urine, result in crystallisation of cystine, leading to the formation of kidney stones. These cystine stones are a rare form of kidney stone, accounting for around 6% of kidney stones in children and around 1% of those in adults.
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Resources: National Kidney Federation Timothy F Statham pp 21-21 In 2015, the British Renal Society offered the National Kidney Federation (NKF) a breakout session at their annual conference. This offer has been repeated for UK Kidney Week 2016, and the NKF has decided to concentrate the 90-minute session on a topic that is of vital importance to kidney patients: dialysis away from base.
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Right good renal care Donal J O’Donoghue pp 22-23 Austerity is biting hard across the UK and many of those reading this article will be employees of acute providers under enormous financial strain. Few informed commentators would seriously argue that a high-quality healthcare system can be provided for 8.5% of a country’s gross domestic product. The NHS needs more money and our professional societies and patient charities must continue to lobby to secure more resources.
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Resources: British Kidney Patient Association Fiona Loud pp 23-23 Kidney transplantation seems like a modern miracle to people with kidney failure, as it takes away the burden of dialysis and offers a real chance to improve quality of life. However, the cocktail of drugs used to prevent rejection needs to be personalised and does not come without side effects, including risk of malignancy and serious gastrointestinal reactions.
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Hantavirus nephropathy: a diagnosis to consider Jiehan Chong, Mike Ankcorn, Jane Osborne, Barry Atkinson, Sarah Lumley, Kim Suvarna and Martin Wilkie pp 24-26 Hantaviruses are a large group of RNA viruses that are carried by rodents worldwide. They cause haemorrhagic fever with renal syndrome in Europe and Asia, and hantavirus cardiopulmonary syndrome in the Americas. Of more than twenty species known to cause human disease worldwide, five circulate in Europe: Seoul virus (SEOV), Puumala virus (PUUV), Dobrava-Belgrade virus (DOBV), Saaremaa virus and Tula virus. Hantavirus is endemic in mainland Europe (including Russia) – over 10,000 cases are reported annually; mostly PUUV and DOBV, although the numbers vary significantly both geographically and temporally. There are sporadic autochthonous cases of hantavirus in England, Scotland and Wales and a mounting evidence of SEOV in both wild and domestic rat populations in the UK.
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Resources: Kidney Research UK Kidney Research UK pp 27-27 Kidney Research UK’s work addressing health inequalities has been recognised in Scotland. Members of the Scottish peer educator team (pictured below) – who work on the charity’s organ donation awareness project joined a shortlist of just two others in the ‘Unsung Hero’ category in the Scottish Health Awards, run by the Daily Record and NHS Scotland. The team then went on to win the Community Award at the Scottish Asian Business Awards.
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