British Journal of Renal Medicine - 2002

Comment: The right to die
Christopher G Winearls
pp 4-4
Was I alone in reflecting on the implications of the judgement in the recent case of ‘Miss B’ for patients on dialysis and those who care for them? She was paralysed from the neck down and maintained on a ventilator, with no prospect of recovery. The judge ruled that in keeping her alive against her wishes, the NHS Hospital Trust had acted unlawfully, and ordered the trust to pay £100 for unlawful trespass. Miss B would be permitted to refuse treatment at any point in the future. This case reinforced patient autonomy as the overriding principle in medical decision-making.
Pain and kidney disease: a practical approach
Geoffrey Bihl
pp 6-9
Pain is common in patients with kidney disease. Its treatment is usually inadequate and it is associated with significant morbidity. Many commonly prescribed analgesics are nephrotoxic and tend to accumulate in renal failure. They may even be removed from the body during dialysis. Treatment of pain is particularly important in patients with a kidney transplant, as interactions between analgesics and immunosuppressant drugs are common.
Urinalysis – a valuable tool
Simon Fletcher and Waqar Ayub
pp 10-12
Urinalysis is a simple and easy test, which can be carried out in the ward, clinic or GP surgery. In theory, it should always be part of our routine history taking and examination, but in practice it is often neglected. It is a valuable investigational tool, which may highlight underlying disease of the genitourinary tract. This article concentrates on the glomerular causes of haematuria and proteinuria and offers guidelines for their identification and referral patterns.
kidney and bladder problems detected before birth
Alan R Watson
pp 13-16
Ultrasound examinations are now a routine part of antenatal care. Most women receive a booking scan at approximately 12 weeks, and most are offered a detailed scan at 18–20 weeks. Further scans may be carried out later in the pregnancy to check on the baby’s growth or position, or for other reasons which are decided by the obstetrician.
The advantages of using integrated dialysis modalities
Simon J Davies
pp 18-20
Historically, the proportional use of peritoneal dialysis (PD) and haemodialysis (HD) modalities to treat renal failure has varied considerably worldwide. There have been several reasons for this, including socioeconomic factors, types of healthcare provision and methods of remuneration of nephrologists. The relatively high use of PD in the UK in the 1980s and 1990s might suggest that these treatments have been used in an integrated fashion to deliver renal replacement therapy.
Professor Ratcliffe elected Fellow of the Royal Society
Christopher G Winearls
pp 21-21
Peter Ratcliffe, Professor of Renal Medicine at Oxford University and an Honorary Consultant Nephrologist in the Oxford Kidney Unit, has been elected a Fellow of the Royal Society. This singular distinction is in recognition of his remarkable scientific achievement in explaining how cells recognise and respond to hypoxia, the process which, for example, gives rise to the production of erythropoietin.
The importance of workforce planning in renal healthcare
Donal J O'Donoghue
pp 22-26
The British Renal Society has established a multiprofessional National Renal Workforce Planning Group in response to the Kidney Alliance Report, End Stage Renal Failure – A Framework for Planning and Service Delivery. The Kidney Alliance document proposed seven national service standards aimed at improving the quality of renal care and reducing the burden of renal disease. It highlighted the multiprofessional nature of renal healthcare, the increasing prevalence of renal replacement therapy and the importance of workforce planning.

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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