British Journal of Renal Medicine - 2006

Comment: Learning to be lean?
John Scoble and John Drew
pp 3-3
Those interested in the financial pages of the Sunday newspapers have become comfortable with Toyota as the dominant car manufacturer. What is the relevance of this to simple nephrologists? Toyota offers a consumerbased ideology that is parallel with what we want for our patients. ‘Lean’ is the term that Dan Jones and his academic colleagues coined to describe Toyota’s manufacturing philosophy – although Toyota do not use this term themselves. Do we have to be ‘lean’ to survive?
Immunosuppression: the new biological treatments
Menna R Clatworthy
pp 4-8
Biological agents can be defined as those of biological origin, the majority of which are based on antibodies or receptor proteins. Unmodified biological agents, such as antithymocyte globulin (ATG), have been used in transplantation medicine for decades. However, recent technical advances and a clarification of the pathogenic processes involved in autoimmunity and organ rejection have allowed the development of newer biological agents designed to disrupt specific pathogenic processes.
The renal ‘Do Once and Share’ project
James Medcalf, Kevin Harris and Bernie Stribling
pp 9-11
Information technology (IT) is becoming ever more important in the care of patients across the NHS. Increasingly, patients expect healthcare professionals to be able to access appropriate information to correctly manage them in a timely manner.
IDWG, salt and water – a survey of dialysis staff
Claire Gardiner, Helen Scott, Mark Wright, Elizabeth Greaves and Elizabeth Lindley
pp 12-14
Our haemodialysis service comprises two teaching hospital-based centres and six satellite units, which merged some years ago. The teaching hospitals were traditionally managed by separate groups of dietitians and dialysis staff. Consequently, there were differences in practice within the service, including the methods used to determine an acceptable interdialytic weight gain (IDWG).
What I tell my patients about renal transplants in children
Heather Maxwell
pp 15-19
People with chronic renal failure will eventually need dialysis or a transplant. This article provides information for children and young people about to undergo renal transplantation.
The Human Tissue Act – what are the implications for the renal community?
Keith M Rigg
pp 19-21
The Human Tissue Act 2004 was fully implemented on 1 September 2006. The Act set a framework for regulating the storage and use of human organs and tissue from the living, and the removal, storage and use of tissue and organs from the deceased, for specified health-related purposes and public display.
Time for a change – using action learning to transform renal services
Rachel Lewis
pp 22-23
Changing practice in complex healthcare systems is difficult. People with kidney disease rely on interdependent systems and processes, yet change is often concentrated in individual areas of practice. Failure to integrate with other service providers can result in a ‘silo mentality’.
Erectile dysfunction in a haemodialysis population – prevalence and service use
Alex Pitcher and Jonathan MR Goulding
pp 24-26
Erectile dysfunction (ED) is common in patients with renal impairment, particularly those undergoing renal replacement therapy by haemodialysis. There are a number of contributory causes, including pelvic vascular disease, neuropathy, psychological problems and side-effects of drugs. It is associated with a decrease in quality of life.
Daily home haemodialysis – a patient’s perspective
Matthew Rouse
pp 27-27
When I first heard about daily home haemodialysis, I thought it would not be an option for me, because I did not like the thought of having to dialyse seven days a week. Although there seemed several advantages to more regular dialysis, such as better blood pressure control, improved energy levels and a less restrictive diet and fluid intake, I was apprehensive about needling my fistula so often.
Symptoms experienced by patients during haemodialysis – a cross-sectional study
Ramesh Thulavavenkateswaran, Habib Akbani, Ramla Mumtaz, Gary Carlisle and Andrew Scally
pp 28-31
Chronic kidney disease (CKD) is defined as the substantial and irreversible loss of kidney function over a period of at least several months to many years, depending on the underlying pathophysiology and aetiology. It is a long-term condition. One of the more accurate methods of measuring renal function is by measuring glomerular filtration rate (GFR).

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)