British Journal of Renal Medicine - 2001

Comment: Renal Association Standards Document: 3rd edition
Professor Alison McLeod and Professor Anthony Nicholls
pp 4-4
The 2nd edition of the Renal Association Standards Document was recently appraised by guideline methodologists at the Healthcare Evaluation Unit at St George’s Hospital, London (who independently act as referees for National Institute for Clinical Excellence guidelines). We received many helpful comments, including the observation that the review/consultation process should be wider and more transparent. The 3rd edition of the Renal Association Standards Document is currently being written. The internet and email afford an opportunity to improve the review process for the next edition.
Developing new solutions for peritoneal dialysis
Dr Ram Gokal
pp 6-9
The bioincompatibility of current peritoneal dialysis (PD) solutions is now well recognised. Other than the unphysiological nature of the solutions, glucose and glucose degradation products (GDP) are regarded as important factors leading to peritoneal membrane damage with long-term PD. New solutions (icodextrin; glucose solution with a higher pH and lower GDP; bicarbonate as a buffer; amino acid solutions) are now available and allow for better preservation of the peritoneal membrane and impart other advantages that improve outcomes in peritoneal dialysis.
The UK Renal Registry
David Ansell
pp 10-11
In December 1999 the UK Renal Registry published its second report. In this report the registry covered 43% of the UK population and included data on 15,000 patients. By November 2000 another 15 units had joined the registry, taking the UK coverage to over 60%. In March 2001, as this article goes to press, the third report has just been published. The Department of Health has asked all commissioners for a timescale of when their renal units will be joining the registry.
What I tell my patients about diabetes
Dr AC Felix Burden
pp 13-16
People become diabetic when the sugar in their blood is too high. Diabetes often shows itself by the appearance of sugar in the urine. This happens when the sugar level in the blood is so high it spills out through the kidney and passes into the urine. Sugar levels in the blood are controlled by insulin. Insulin is normally made in the pancreas and it allows the body to make use of the food we eat.
Identification of predialysis patients from a general nephrology population
Elizabeth G Attrill, Elizabeth Ann Morrison and Martin J Raftery
pp 17-20
The literature provides little information concerning who the predialysis population are, and what their care needs may be. An established method of identifying a population is by clinical audit. Clinical audit has become both accepted and expected in clinical practice. It is designed to evaluate whether or not clinical practice conforms to professional standards, but does not establish what those standards should be. Audit provides information on performance and quality of care from which performance can be assessed, future care can be planned and improvements can be made where necessary.
Medicine abroad – a vital part of clinical training
Sunil Bhandari
pp 21-23
The Calman system, with all its virtues, has imposed rigid restraints on clinical training, with experience tending to be limited to that gained within a single region. Clinical experience abroad is therefore an increasingly essential part of a comprehensive training curriculum. With the ever-changing environment of the NHS in the UK, experience of the workings of a different healthcare system is an invaluable asset.
Kidney allocation in the UK
Susan V Fuggle, Rachel J Johnson, Mark A Belger, J Douglas Briggs and Peter J Morris
pp 24-26
On 1 July 1998 a new scheme for the national allocation of cadaver kidneys was adopted in the UK, replacing the beneficial matching scheme that had been in place since 1989. The new scheme is the culmination of the work of task forces of the UK Transplant Kidney and Pancreas Advisory Group and is based on data from a rigorous analysis of the National Transplant Database to determine factors that influence renal transplant survival in the era of modern immunosuppression.

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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