British Journal of Renal Medicine - 2002

Comment: Commissioning and providing renal services
John Bradley and Jean Peters
pp 4-4
Despite increasing numbers of people receiving dialysis, patients with kidney failure and their clinicians continue to express concern about inequalities of access to appropriate treatment. The recent reorganisation of the NHS, with increasing involvement of primary care trusts as commissioners, and the development of the national service framework (NSF) for renal services, offers a real opportunity for improvement.
Six steps to improved long-term transplant outcomes
Adnan Alam and Stephen H Powis
pp 6-9
Long-term graft survival rates following renal transplantation have been slow to improve. Nevertheless, there are a number of areas of clinical practice in which relatively straightforward interventions could make a significant impact on long-term graft outcome.
Sir Robert Christison (1797–1882): a neglected founder of nephrology
J Stewart Cameron
pp 10-11
Robert Christison was one of the three main pioneers of modern nephrology, but is much less well known than his contemporaries, Richard Bright and Pierre Rayer, even in his native Scotland. Among his many contributions to an amazingly wide variety of medical topics in a long and distinguished career, Christison confirmed rBright’s work on albuminuria and dropsy, established the basis for understanding uraemia, and described renal anaemia for the first time.
What I tell my patients about reflux nephropathy
Walaa WM Saweirs and Neil Turner
pp 13-16
The flow of urine from the kidney down to the bladder is an important part of maintaining correct kidney function. Although this is normally a straightforward process, when an abnormality does occur it can lead to problems with kidney function, such as reflux nephropathy.
Erythropoietin: subcutaneous or intravenous dosing?
Lynn Fullerton, Dipankar Bhattacharjee, Simon D Roe and Mike JD Cassidy
pp 17-19
The use of recombinant erythropoietins has become standard care in treating anaemia and preventing repeated transfusions in dialysis patients. Interestingly, however, there is still marked variation among countries, and even hospitals, in how they are administered. In the original clinical trials for recombinant erythropoietins, the intravenous (IV) route of administration was used, and this remains the preferred route of administration for many patients worldwide.
The hypertensive dialysis patient – a practical approach
James Tattersall
pp 20-23
Heart disease is the cause of over 65% of deaths in dialysis patients. Most dialysis patients have a particular type of heart disease – left ventricular hypertrophy – in which the coronary arteries can be relatively normal. This form of heart disease is caused mainly by hypertension and is preventable. To prevent left ventricular hypertrophy, a blood pressure of less than 130/80 mmHg is recommended, although lower targets are recommended for diabetic patients. This degree of blood pressure control is achievable but requires both understanding and time.
Drug interactions with complementary medications
Aileen D Currie
pp 24-27
Complementary therapies are gaining in popularity in renal medicine as patients become increasingly disillusioned with conventional medicines and their related side-effects. We, as healthcare professionals, have the role of advising patients which of these drugs are safe with respect to their renal disease or transplant and their concomitant medication. This article will provide a brief background to herbal medicine and will discuss their side-effects and interactions with some commonly used medications.

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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