British Journal of Renal Medicine - 2019

Chronic kidney disease impacts on many aspects of a child’s life. Even children with mild-to-moderate chronic kidney disease tend to experience a reduced health-related quality of life, with functioning at school being a particular concern. Physical illness, interference with school attendance because of medical care, and impairment of neurocognitive function may all contribute to poorer academic performance.

Over three million people in the UK are estimated to be at risk of malnutrition at any one time, contributing a significant 15% to national health and social care expenditure.

The opt-out system of organ donation in England has been passed into law and is expected to save up to 700 lives a year. The legislation will take effect in Spring 2020 and will mean adults will be assumed to be donors unless they chose to opt-out.

Pain is commonly experienced by long-term dialysis patients, with studies reporting a prevalence of between 50% and 82%. Although published guidelines for the management of such pain are available, inadequate treatment remains common. Concerns about treatment adequacy and the adverse effects of analgesics may partly explain the variability in opioid prescribing rates between centres in the USA, with the incidence of opioid prescription for dialysis patients ranging between 5% and 64%.

For most people in kidney care, multiprofessional working is a normal part of our daily experience. Nurses, psychologists, dieticians, managers, pharmacists, therapists, technicians and doctors all work together in integrated teams to provide the best possible patient-centred care, and we enjoy doing it. For many, multiprofessional working is one of the attractions of a career in kidney care.

Eye disease frequently complicates chronic kidney disease (CKD). Here we report a severe presentation of a common complication of diabetic retinopathy in a patient on haemodialysis and review the ophthalmic complications of CKD.

The Surveying People Experiencing young Adult Kidney failure (SPEAK) study highlights the challenges faced by young people on dialysis or with a kidney transplant. The study was led by Dr Alex Hamilton, at the University of Bristol and Southmead Hospital. Dr Hamilton recently delivered the Raine lecture at UK Kidney Week in Brighton, based on this work.

When healthcare professionals think of the ‘renal diet’, their thoughts might first go to the importance of a dietary potassium restriction. Dietary salt restriction is likely a close second. However, emerging evidence is highlighting the vital importance of dietary phosphate restriction, ideally as early as stage 3b chronic kidney disease.

When the NHS was first established in 1948, it was supported by a workforce of around 144,000 people. Now, 70 years later, the NHS is the largest employer in the UK, with around 1.1 million full-time equivalent (FTE) staff in hospital and community services in England alone. Our people are the health system’s greatest asset. Without its many different members of staff – think of all the types of staff that make a renal unit work – there would be no health service.

A new era for the Renal Association SpR Club

The law on organ donation in England is changing - pass it on. 

Kidney cancer is the seventh most common cancer in the UK, with approximately 12,500 new cases diagnosed in 2014, accounting for 3% of all new cancer cases, and its incidence has increased by 78% since the 1990s. Renal cell carcinoma (RCC) accounts for 90% of all kidney cancers and usually originates within the lining of the tubules of the kidney. Over the last two decades, the treatment of advanced and metastatic RCC has been revolutionised by an increased understanding of the biology of the disease and the use of tyrosine kinase inhibitors as well as anti-angiogenic drugs. This has translated into significant improvement in overall survival of patients with kidney cancer. In the last two years, treatment options have been further improved with the introduction of immune checkpoint inhibitors.