British Journal of Renal Medicine - 2006

Comment: Dispensing with risk
John Bradley
pp 3-3
The internet provides unprecedented opportunities for feelings of inadequacy. As Neil Turner describes on page 19, patients can be better prepared for consultations than their doctors, while unsolicited emails offering problem-solving lifestyle drugs can serve to fuel feelings of inferiority.
Delivering a systematic diabetic renal service
Hugh C Rayner, Steve C Bain and Pam D’Arcy
pp 4-5
Diabetic nephropathy is the most common single cause of severe chronic kidney disease (CKD). Effective management of diabetes is a key part of primary care under the new GP contract. However, although diabetic patients are usually known to the health service well before they develop established renal failure (ERF), presentation for renal replacement therapy (RRT) is frequently ‘late’.
Achieving the standards for protein and calorie intake in haemodialysis patients
Louise Wells and Colin Jones
pp 6-8
Dietary reference values (DRVs) provide a benchmark against which the adequacy of nutritional intake for a population may be measured. The UK standards for protein and energy in healthy adult individuals are devised using data from studies in which energy and protein balance have been measured and requirements evaluated.
Commissioning specialised services for local populations
Nicky Coffey
pp 9-11
Since April 2002, primary care trusts (PCTs) have been responsible for securing all health services for their local populations – and this includes the commissioning of specialised services. The commissioning process involves the strategic planning, funding, monitoring and quality assurance of services provided by hospitals and other healthcare organisations.
Is increased treatment frequency a feasible option for haemodialysis patients?
Nicholas A Hoenich
pp 12-14
The treatment of chronic kidney disease by haemodialysis is generally undertaken on a three-times weekly basis although, when initiated, an incremental dialysis regimen to support declining renal function may be used.
What I tell my patients about home haemodialysis
Grahame Wood, Nader Ahmadzadeh, Jacinta Ormerod, Anne Carney, Janet Walker, Beryl Jepp and Maurice Harrington
pp 15-16
This article discusses undergoing haemodialysis at home, which can lengthen your life and provide you with the best quality of life.
What I tell my patients about interstitial nephritis
Nicky Boddy and Paddy Gibson
pp 17-18
What is interstitial nephritis? Nephritis means inflammation of the kidney. Interstitial refers to a specific part of the kidney that is inflamed.
Nephrology and the internet – a revolution only just starting
Neil Turner
pp 19-21
It is amazing to think that the world wide web is less than 15 years old. Hypertext transfer protocol (http – the way to write a web page) was invented in 1990, but the growth of the web was made possible by the development of the first browser, Mosaic, in 1993, which made it possible to point and click.
Low GFR in the elderly – physiological or pathological?
Christopher G Winearls
pp 22-23
I suspect this question was posed because of the possible relation between the lower average glomerular filtration rate (GFR) found in older than younger people, the higher incidence of established renal failure in older people and the assertion that the prevalence of ‘chronic kidney disease (CKD)’ is extremely high in the elderly.
Low GFR in the elderly – physiology or pathology?
Charlie Tomson
pp 24-25
We measure – or estimate – glomerular filtration rate (GFR) for a variety of reasons in clinical practice, but in all instances we are attempting to measure the efficiency with which the kidneys remove waste products from the bloodstream by filtration.
PD catheter exit sites: a multicentre paediatric study
Patricia Smith, Roy Connell, Cathy Mosby and Mary Judge
pp 26-29
Recognition and treatment of catheter exit site infections remains controversial, with treatments varying from salt and vinegar compresses to extended courses of antibiotics. Children undergoing chronic peritoneal dialysis (PD) for established renal failure (ERF) require meticulous management of their Tenckhoff catheters to minimise the risk of bacterial infection and prolong their time on PD.
Intravenous immunoglobulin-induced acute renal failure
Peter Halestrap, Aaron Chakera, Emma Vaux, Lindsey Barker and Ramesh B Naik
pp 30-31
Two weeks after returning from a holiday in Mauritius, a 68-year-old man presented to hospital complaining of leg weakness. His symptoms had begun 24 hours earlier and had progressed to the extent that on admission he was unable to stand unaided. He also complained of slight arm weakness, but denied any headache, bladder or bowel symptoms or visual disturbance.

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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ISSN 1365-5604 (Print)  ISSN 2045-7839 (Online)