British Journal of Renal Medicine - 2003

Integrating renal healthcare
Donal J O'Donoghue
pp 4-4
The British Renal Society (BRS) established a multiprofessional National Renal Workforce Planning Group in January 2001 to prepare recommendations for establishments and staffing levels across each professional group involved in renal healthcare. This report was published in April 2003 and covers the whole range of specialist renal services, including the provision of children’s renal services and renal transplantation. The staffing recommendations are intended to complement the Renal National Service Framework (NSF), the Children’s NSF and the renal standards plans and guidance in Scotland, Wales and Northern Ireland. A workforce plan based on the demand forecast for the Renal NSF has also been produced.
Haemodialysis in the UK – lessons learned from DOPPS
Hugh Rayner, Roger Greenwood, Ronald L Pisoni and Friedrich K Port
pp 6-8
The Dialysis Outcomes and Practice Patterns Study (DOPPS) is an international observational study with the primary goal of identifying treatment practices that are associated with better or worse health outcomes for patients on haemodialysis (HD). In an analysis of HD patient survival, the UK was found to have a significantly higher mortality rate compared with that in France, Germany, Italy and Spain. Further analysis of the DOPPS database suggests possible reasons for this.
Adequacy of haemodialysis – a perspective on Kt/V
Nicholas A Hoenich and Catherine Pearce
pp 9-12
Haemodialysis has been used in the treatment of end-stage renal disease (ESRD) since the 1960s. While the basic concept of dialysis remains unchanged, it is now delivered using sophisticated technology and membranes based on synthetic polymers, and remains the most commonly used modality of treatment of ESRD throughout the world. The treatment of renal failure by dialysis raises issues relating to the amount or dose of dialysis to be prescribed to ensure low mortality and morbidity as well as how the prescribed dose may be quantified and monitored. Urea kinetic modelling has evolved as the method for dose quantification.
What I tell my patients about renovascular disease
Ala'a Eldeen Shurrab and Philip A Kalra
pp 13-16
Renovascular disease (also known as renal artery stenosis) describes the narrowing of the main blood vessels (renal arteries) which supply the kidneys. This can lead to a decreased flow of blood to the kidneys. With recent advances in the screening and diagnostic tests available for this condition, renovascular disease is now recognised to be a common cause of impaired kidney function (renal failure) and high blood pressure (hypertension). There are two main types of renovascular disease: atheromatous renovascular disease and fibromuscular dysplasia.
What I tell my patients about having a renal angiogram
Christopher G Winearls, Nigel C Cowan and Bridie Cornes
pp 17-18
To investigate or treat the cause of your kidney problem you have been advised by your doctor to have an angiogram. This is a special X-ray examination to look at the kidney blood vessels to see if they are narrowed or blocked, a problem which can cause high blood pressure or a reduction in kidney function.
Raising renal awareness
Jeremy Duffield
pp 19-19
The third National Kidney Research Fund Fellows meeting, supported by the Amgen Foundation, was held at Keele University on 16–17 April 2003 and was opened by the incoming Chairman, Professor Charles Pusey.
Should haemodialysis patients be treated with IV epoetin?
Jerome Rossert
pp 20-22
Recombinant human erythropoietin (epoetin) is a very effective drug that has been widely used for more than 15 years to correct anaemia in patients with chronic kidney disease (CKD). Its usage has dramatically improved the quality of life and functional status of CKD patients, and it has also contributed to ameliorating their cardiac status and decreasing the incidence of transfusion-induced diseases. Furthermore, epoetin is an extremely safe drug; until 1998 the most serious side-effects were an excessive increase in haemoglobin levels and a worsening of hypertension.
Educating renal transplant patients about skin cancer
Cristina Bordea and Fenella Wojnarowska
pp 23-24
To prevent rejection, transplant patients are subjected to intense immunosuppression that can cause seemingly banal skin lesions to become aggressive and life-threatening. The patterns of cancer which develop in immunosuppressed renal transplant recipients are now clearly established, and the patients and physician involved should be educated about these dangers.
Developing a nurse-led catheter insertion service
Jonathan Casey and Jon Davies
pp 27-29
Haemodialysis patients in the UK rely increasingly on venous catheters for vascular access, and their correct insertion, use and care has an important influence on morbidity and mortality. A thorough knowledge of the venous anatomy, line selection, placement techniques and management of complications is vital. Further factors to consider include any prior intervention at the anticipated access site, previous access history, any relevant clinical history and coagulation status.

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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