British Journal of Renal Medicine - 2019

Editor John Bradley discusses dialysis catheter insertion including selecting the right side, the right place and anatomical variation. 

The success of nephrology as a specialty is undeniable. Over the past 50 years, enormous strides have been made, specifically in the areas of transplantation and renal dialysis, and many patients have enjoyed an extended good quality of life. However, with increasing numbers of frail elderly patients joining renal replacement programmes, some unintended consequences of this success have emerged.

A regular update from the National Kidney Federation. 

Patients with renal disease have a high incidence of foot ulcers and amputations. In London, around 6,000 people receive dialysis at least once a week. They should also receive foot care to reduce the risk of ulceration and save life and limb, with some requiring intensive management. This article aims to provide an opportunity for healthcare professionals and commissioners to consider how patients with renal disease can access good-quality foot care in an appropriate setting that is holistically centred around the patient’s needs.

A regular update from Kidney Care UK.

A regular update from The Renal Association.

A regular update from Kidney Research UK.

The importance of cookery is becoming more recognised across all areas of renal care and support, from hospitals to charities such as Kidney Care UK. The North Wales Kidney Kitchen is an innovative project developed through the combination of dietetic and social work services for people in end-stage renal failure. The renal dietitians at Betsi Cadwalader University Health Board (BCUHB) in North Wales had identified that the delivery of dietary advice and information within a hospital setting was not wholly conducive to learning and, therefore, discussed with the social work team the joint benefits of learning in people’s communities. As a result, they decided to pilot a cooking skills course and evaluate its impact on empowering patients to enjoy a diet which meets their health needs and socialisation and self-efficacy. 

The authors discuss a case report of a 66-year-old gentleman presenting to the nephrology service with a three week history of rapidly worsening peripheral oedema. He had a history of genetically confirmed limb-girdle muscular dystrophy type 2A and hyperlipidaemia. He had also suffered a transient ischaemic attack three years prior to this presentation. He had no family history of note.

A regular update from the British Renal Association. 

Competence in haemodialysis (HD) catheter insertion is a training requirement for specialty trainees in renal medicine in the UK. HD catheter insertion is a lifesaving skill but can cause serious complications, which are more likely to occur when inexperienced trainees perform the procedure. Training programmes ensuring renal trainees achieve competence in HD catheter insertion are variable nationwide but are required to ensure patient safety. Appropriate training is, therefore, required for ultrasound-guided vascular cannulation.

Approaching the recent general election, I was perplexed – was it about Brexit, the NHS or fake news? The pledges and rhetoric from the main parties were unhelpful, disingenuous and undeliverable. Nurses, doctors and other healthcare professionals so vital to the delivery of high-quality 21st century care cannot be knitted. If, at some point in the glorious future, NHS staff are enjoying a 32-hour week and providing a world-class service, the NHS will need considerably more people in all of the professions of the multidisciplinary team that we have previously thought and planned for. Workforce is the key issue facing the NHS and, therefore, in many ways, the health of the nation.