British Journal of Renal Medicine - 2004

Comment: When preservation is preferable to replacement
John Bradley
pp 4-4
The majority of patients on dialysis are hyperphosphataemic. On page 27, Shaun Summers and Stanley Fan highlight the importance of controlling serum phosphate in preventing bone disease, but the consequences of hyperphosphataemia extend beyond bone metabolism. Haemodialysis patients with serum phosphate levels greater than 2.1 mmol/l have been reported to have a 27% higher risk of death than patients with serum phosphate between 0.65 and 2.1 mmol/l. High phosphate levels are associated with a higher risk of death from coronary artery disease, infection and sudden death.
Vascular access – the Achilles’ heel of haemodialysis
Gareth Lewis, Steven A White and Michael L Nicholson
pp 6-10
Each year, improved patient survival and more elderly patients being referred for renal replacement therapy (RRT) mean that increasing numbers of patients are requiring dialysis treatment. This is boosted further by a lack of suitable organ donors, which has resulted in a decline in the number of cadaveric renal transplants.
Using monoclonal antibodies in paediatric renal transplantation
Stephen D Marks and Richard S Trompeter
pp 11-14
Renal transplantation is the optimal therapy for children with end-stage renal failure (ESRF) as itavoids the need for dialysis and is known to reduce cardiovascular morbidity. It offers the potential for a normal lifestyle with the best rehabilitation, due to the restoration of normal or near-normal renal function.
What I tell my patients about Disability Living Allowance
Simon Jenkins
pp 15-18
I was a general practitioner for 35 years until I developed end-stage renal failure almost eight years ago. But the period since my enforced retirement has made me aware of the importance of disability benefits and the need to ensure that the application forms are properly completed in the first instance and then submitted to the Benefits Agency at the earliest opportunity.
Providing psychological support to paediatric renal patients
Sue Dolby
pp 19-21
‘My child’s not mad and neither am I, so why do we need to see a psychologist?’ This was a recent response from a parent as I introduced myself prior to offering a routine pretransplant session. These sessions contribute to the individual transplant preparation programme by looking at the child’s current understanding of their renal illness, their perceptions of what a transplant means for them and their adaptive coping and management strategies. They also identify any specific areas of concern for the child or carers, which the multiprofessional paediatric renal team might be able to help with.
A guide to preparing detailed qualitative research proposals
Mark Bevan
pp 22-25
The submission of research proposals is an arduous task and much effort is needed to meet the requirements of fund-awarding bodies. Awarding bodies often have a set of criteria that enables them to evaluate these proposals in relation to their scientific rigour. However, those researchers who want to use qualitative research methods may find themselves at a disadvantage. The reason for this is that often funding panels do not have the expertise to sufficiently review the proposal in a critical manner. Furthermore, qualitative research proposals may be evaluated against quantitative research criteria.
Implementing the renal NSF
Andrew Fry
pp 26-26
The National Service Framework (NSF) for Renal Services aims to provide a set of standards for the delivery of care to patients with kidney disease in England. Part one (on dialysis and transplantation) was published in January 2004, with the remaining two modules (covering prevention, primary care and end-of-life issues) to follow soon. It was the focus of a recent meeting of the Nephrology Section of the Royal Society of Medicine, titled ‘Implementing the renal NSF’.
Bone disease in patients with end-stage renal failure
Shaun Summers and Stanley Fan
pp 27-30
Patients with renal failure are at risk of developing abnormalities of their bone quality and quantity. Renal osteodystrophy encompasses high, low and mixed bone turnover states. These bone pathologies might explain the fourfold increased risk of hip fractures in renal patients, relative to the normal population.

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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