British Journal of Renal Medicine - 2004

Comment: Money in the bank
John Bradley
pp 4-4
Recent advances in genetic research have meant that the ability to collect, store and analyse DNA has often accelerated ahead of the principles and regulations that govern its use. Issues relating to informed consent, confidentiality, quality, ownership and benefit of DNA collections have aroused fervent discussion and, at times, international outcry.
Measuring malnutrition in peritoneal dialysis patients
Caroline Bird
pp 6-8
The incidence of malnutrition in peritoneal dialysis (PD) patients has been well documented. Young et al showed that 8% of the dialysis population studied were severely malnourished and 33% were mildly to moderately malnourished.
Donation and transplantation in the South Asian population
Neerja Jain and Alison Crombie
pp 9-11
The National Kidney Research Fund position paper ‘Preventing Kidney Disease – the ethnic challenge’ provided the most recent crosssectional survey of ethnic patients taken on for renal replacement therapy. Even a decade ago the take-on rate for Caucasians was 90 per million population (pmp) for men and 50 pmp for women, compared with 281 pmp for South Asian men and 196 pmp for South Asian women. Thus, as Cairns has suggested, the incidence of established renal failure (ERF) is three to five times higher in patients of South Asian origin, compared with Caucasians. Two possible reasons for this are the known higher incidences of hypertension, as well as type 2 diabetes in this group – both of which are linked to chronic kidney disease (CKD) and ERF.
Haemodialysis catheter thrombus – restoration of flow
Jonathan Davies, Jonathan Casey, Chui Li, Alex V Crowe and Peter McClelland
pp 12-14
Urokinase and streptokinase are commonly used thrombolytic agents for obstructed central venous catheters (CVCs). Although proven to be efficacious, these agents have the potential to induce systemic fibrin breakdown. We conducted a study to report on the safety and efficacy of alternative catheter thrombolysis, namely recombinant tissue plasminogen activator (rt-PA).
What I tell my patients about intravenous iron therapy
Sathish Kallankara and Sunil Bhandari
pp 15-18
Anaemia is a condition in which you have a lower than normal amount of haemoglobin in your blood. Haemoglobin is the red pigment in the red blood cells (erythrocytes), which transports oxygen. An important cause of anaemia is the lack of sufficient iron in the body to produce a normal amount of haemoglobin. If red blood cells contain less haemoglobin, they become pale or ‘hypochromic’. As a renal patient, you may require intravenous (IV) iron therapy (where iron is injected into your veins) to boost your iron levels.
The impact of a living donor transplant co-ordinator
Chris Rudge and Sue Sutherland
pp 19-20
Recollections of the first successful living donor kidney transplant in 1954, describe issues that are still highly relevant today – particularly the conflict between the perceived risks to the donor and the benefits to the recipient. The investigations to ensure that the donor was suitable, the possibility of coercion or pressure on the donor, the possibility of future disease in the donor and the whole consent process were identified as areas of concern for the first time.
Enhancing fluid management in haemodialysis patients
Linda Fisher
pp 21-23
Fluid overload appears to be a common problem for many haemodialysis patients with low urinary output, and is associated with the development of other serious medical conditions in both the long and short term. It can also complicate medical and nursing management on the dialysis unit. Consideration of the behavioural, emotional, social and perceptual factors that influence fluid management can complement existing knowledge regarding the physiological determinants of thirst and drinking and may be helpful to patients.
Exploring the role played by the renal consultant nurse
Karen Jenkins and Natasha McIntyre
pp 24-27
As consultant nurses we are commonly asked the question, ‘What do you actually do?’ At the time of writing, there are only ten renal consultant nurses in the UK, so the question does not come as a surprise.
Establishing a DNA collection for vesicoureteric reflux
Ambrose Gullett and Aisling Stewart
pp 28-28
Primary vesicoureteric reflux (VUR) occurs in about 1% of young children and is often familial, with several genetic loci probably involved. A review of 11 publications on the screening of siblings of patients with reflux found that the mean incidence of reflux in siblings was 32%.
Developing a renal satellite unit to improve patient services
Jane Middleton
pp 29-21
The demand for renal replacement therapy is increasing. Statistics from the Kidney Alliance show that, between 1993 and 1998, patients with end-stage renal failure (ESRF) rose from 396 to 539 per million population. The increase of patients needing treatment is greater than the decreasing transplant and death rates; this has led to an imbalance and, therefore, a need for increased provision of care.

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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