British Journal of Renal Medicine - 2004

Comment: Telling the time
John Bradley
pp 4-4
‘In the process of trying to simplify the technique of continuous haemodialysis, the problem of long-term cannulation of arteries and veins presented itself. The technique which has been developed and is herein described solves this problem …’ Scribner’s description of his arteriovenous shunt made long-term haemodialysis possible.
BMP-7 – a new potential therapeutic agent
Aled Phillips and Matthew Davies
pp 6-8
Bone morphogenic proteins (BMPs) are growth and differentiation factors in the TGF-ß superfamily. Originally identified to induce bone and cartilage formation, they play many important roles in embryonic morphogenesis and in postnatal life.
A multimedia training system for renal transplant patients
Chris Farmer, Lisa Burnapp, Helen O’Sullivan, Hayley Wells, C Geoff Koffman and Rachel Hilton
pp 9-12
Nephrology and transplantation are complex and rapidly evolving fields, involving disparate groups of people, and there is continual scope for improved information and training. The renal unit at Guy’s Hospital has developed a patient information system for patients on the renal transplant waiting list and for potential kidney donors, in an attempt to clarify the challenging issues surrounding transplantation. The aims of the system were to improve the outcomes of transplantation by setting realistic expectations among patients; to promote living donor transplantation as an effective form of renal replacement therapy; and to assist in informing all potential renal transplant recipients as part of the consent process.
Renal vascular access services: meeting NSF standards
Smeeta Sinha and Donal O’Donoghue
pp 13-14
A renal access conference, held at the Royal College of Surgeons in March 2004, brought together a range of healthcare professionals involved in the care of renal patients, including nurse clinicians, radiologists and surgeons, as well as nephrologists. Presentations were aimed at improving renal access services in the UK and there was a focus on haemodialysis access issues. Some of the key areas discussed are highlighted in this report.
What I tell my patients about creating a fistula
Babatunde Campbell
pp 15-18
Your kidney doctor may have told you that your kidney is not working properly and that it may fail soon. One of the many functions of your kidney is to help get rid of waste products from your body. When your kidney does not work properly, these harmful waste products can be removed by the dialysis machine. After discussion with your kidney doctor and dialysis sister, you may have chosen to have haemodialysis. It is important that you are well prepared before you start dialysis and the process of preparation may take some time. Your kidney doctor may refer you to a surgeon to discuss forming an arteriovenous (AV) fistula for you. A fistula will provide the necessary access to your bloodstream to allow your blood to be ‘cleaned up’ by the dialysis machine.
There is more to sex than erythropoietin and Viagra
Hemali Kanji, Robert Higgins, Anne Bakewell and Linda Cerasoli
pp 19-22
Renal patients may develop sexual problems despite the use of effective treatments such as erythropoietin (EPO) and sildenafil, popularly known as Viagra® (Pfizer, UK). In particular, sexual problems may occur in women as well as in men, and attention should be given to middle-aged subjects, not just younger patients. Depression, if present, should also be treated, and sexual counselling may be appropriate in some cases. While it is not necessary for all health professionals to be expert in the treatment of sexual problems, it is suggested that patients should have access to specialist treatment in every renal unit.
Immunosuppression – past, present and what lies ahead
Mena Clatworthy
pp 23-26
Renal transplantation is now the preferred form of renal replacement therapy in most patients with end-stage renal failure. The major limit to the success of transplantation is organ rejection. This article reviews efforts undertaken to prevent allograft rejection, from the early exploits of the 1950s to present standard immunosuppressive regimens.
Launch of the Myeloma in Renal Impairment Trial (MERIT)
Neil Iggo
pp 27-27
The largest trial of plasma exchange in myeloma acute renal failure has begun. For the past 30 years, treatment of acute renal failure in patients with multiple myeloma (MM) has sparked lively discussion among nephrologists. Until recently the prognosis in MM had hardly altered despite many trials of chemotherapy combinations. This changed with the advent of stem cell autografting. Promising results are appearing for less toxic treatments such as thalidomide and simpler oral chemotherapy combinations are under study, such as cyclophosphamide, thalidomide and dexamethasone.
Achieving best practice – a review of 301 renal biopsies
Clive L Hall, Rachel J Bradley, Rao Attoti and Alistair J Kerr
pp 28-30
Percutaneous renal biopsy is an essential diagnostic procedure for many patients with renal disease but may cause severe and occasionally life-threatening perinephric and/or urinary tract haemorrhage. In experienced hands, using guidance techniques and automated biopsy needles – and with careful selection of patients and close adherence to established safety protocols – diagnostic renal tissue can be obtained in 93–99% of patients, with an acceptably low incidence of macroscopic haematuria or haemorrhage that necessitates blood transfusion.

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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