British Journal of Renal Medicine - 2000


Comment: Ethnic susceptibility to renal disease
John Bradley
pp 4-4
On 26 June 2000 the Human Genome Project public consortium announced that it had assembled a working draft of the DNA sequence of the human genome, representing the vast majority of our genetic blueprint. On the same day, the private company Celera Genomics announced its own first assembly of the human genome sequence. The completion of these 'working drafts' has provided a major step towards understanding what makes us human. At the same time we need to understand what makes each human an individual.
The challenges of care for the long-term dialysis patient
Chris Pritchard
pp 6-8
Working in the renal services should provide healthcare professionals with the opportunity to sustain and enhance the quality of life of their patients. Although this is true for many patients, this premise may need re-examination for those on lifelong dialysis. Exciting developments in technology and professional skill have led to an expansion in services and a widening policy of dialysis as a right, rather than by selection. The result is an ever increasing population of older and more dependent dialysis patients.
Post-transplantation lymphoproliferative disorder
Phil Mason
pp 9-12
Post-transplantation lymphoproliferative disorder (PTLD) is an important cause of morbidity and mortality, affecting up to 3% of renal transplant recipients. The condition is a consequence of immunosuppression and infection with Epstein–Barr virus (EBV). The virus, like other members of the herpes-virus family, is a common, persistent virus present in over 90% of adults. It is lymphotropic and associated with several malignancies, including lymphoma and nasopharyngeal carcinoma. Among the normal immunocompetent population, primary infection is usually silent or non-specific in children, or presents as infectious mononucleosis in adolescents and adults.
What I tell my patients about haemolytic uraemic syndrome
Corinne HF Nevard
pp 13-16
Haemolytic uraemic syndrome (HUS) is a rare condition, which can affect people of all ages, but usually affects babies and young children. There are different kinds of HUS, but the most common kind happens following diarrhoea caused by a bacterium called Escherichia coli (E coli). This bacterium releases a harmful substance, called verotoxin, into the bloodstream. It is verotoxin that causes the collection of problems which we call haemolytic uraemic syndrome.
Erythropoietin therapy in predialysis patients
Jean Jenkins
pp 17-19
Erythropoietin (EPO) therapy has been shown to reduce morbidity and mortality for many dialysis patients, but in the predialysis population there have been constraints on treatments because of costs and management problems. Before June 1997, GPs in the Cardiff area were not routinely approached to participate in shared care for predialysis patients with renal anaemia. The small budget available for EPO was restricted to dialysis patients only. Patients starting EPO therapy were given little or no information on their treatment and were only followed up at routine clinic visits as there was no system to ensure follow-up in the community.
Anticoagulation in renal replacement therapy
Stephen Ashmore
pp 20-22
The efficacy and safety of haemodialysis has improved dramatically since dialysis began in the early 1920s. However, the safe maintenance of a patent extracorporeal dialysis circuit remains a challenge that has yet to be met. With the discovery of heparin and its application to haemodialysis, routine and sustained treatment for end-stage renal disease is now possible. This article discusses the various methods available for maintaining extracorporeal circuits in haemodialysis units.
Interdialytic weight gain in Indo-Asians on haemodialysis
Anne Davidson
pp 23-25
Cardiovascular complications are the main cause of death in dialysis patients. Hypertension is a major risk factor for cardiovascular morbidity and mortality in patients on dialysis. Achieving adequate blood pressure control, by controlling hypervolaemia, can improve left ventricular hypertrophy, another independent predictor of cardiac death on dialysis and patient survival. The cause of hypertension in dialysis patients is multifactorial; however, the role of excessive interdialytic weight gain (IDWG) coupled with the inability to achieve an accurate dry weight has been shown to significantly influence blood pressure control.

The British Journal of Renal Medicine was previously supported by Baxter Healthcare from 2011 to 2013, by Sandoz in 2011, by Shire Pharmaceuticals from 2006 to 2011, by Ortho Biotech and Shire Pharmaceuticals in 2005, by Ortho Biotech from 2000 to 2005 and by Janssen Cilag from 1996 to 2000.

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