British Journal of Renal Medicine - 2006

Comment: Handle with care – the skeleton after transplantation
John Bradley
pp 3-3
Renal bone disease is complicated. Following transplantation, its complexity and associated morbidity increase considerably. The risk of fracture in renal transplant recipients is increased, compared with dialysis patients, and is at least four times higher than that seen in the general population.
The implementation of eGFR reporting
Mark S MacGregor
pp 5-8
Measuring kidney function is a fundamental part of clinical nephrology, and of medicine in general. The kidneys are complex organs with many functions, but the glomerular filtration rate (GFR) is generally accepted as the best overall measure of kidney function. Formal measurements of GFR with exogenous markers are time-consuming, expensive and expose patients to radio-isotopes or iodine-based contrast.
Introduction and evaluation of the vascular access nurse practitioner
Alison J Cornall
pp 9-11
To resolve the difficulties surrounding the provision of dialysis vascular access, several renal units in the UK have employed nurse practitioners with expertise in vascular access, who have responsibility for co-ordinating the vascular access service. Four features of this new role are critical to success: ownership and control of the vascular access pathway, effective surveillance, education and clinical audit.
Clinical implications and diagnostic value of renal biopsy – a retrospective study
Clive L Hall, Judith SL Partridge and Gemma L Mullen
pp 12-14
Renal biopsy is an essential investigation for many patients with renal disease, providing a precise renal diagnosis and often identifying associated systemic disease.
What I tell my patients about living kidney donation
Ann Marsden
pp 15-18
Since the first living donor transplant 50 years ago, living donation has increasingly become, by necessity, a more commonplace event in the field of renal transplantation. The number of patients waiting for kidney transplantation continues to increase, while the number of organs available from cadaveric (deceased) donors is decreasing and, therefore, not meeting the demand (UK Transplant data).
Patient adherence with phosphate binders
Rob Higgins
pp 19-21
Adherence with phosphate binders, or indeed any form of healthcare intervention, is a behaviour that is influenced by an individual’s knowledge, motivation and ongoing experience of its effects. Some of the factors affecting adherence are shown in Box 1. These form a ‘chain of adherence’ and any break in this chain may result in non-adherence.
My experience with phosphate binders – a patient’s account
Michael Steninger
pp 22-22
It has been three years now since I was diagnosed with kidney failure and of all the drugs, injections and therapies I have to endure, phosphate binders are still the drugs I find hardest to take. I do not mean physically – after all, they are just two or three orange-flavoured tablets that I must chew 15 to 20 minutes before meals. It is remembering to take them that is difficult.
Assisted automated peritoneal dialysis (aAPD) – results of a feasibility study
Edwina A Brown, Kim Pryde and Claudia Schmalzhaf
pp 23-23
Many patients with established renal disease are unable to undertake peritoneal dialysis (PD) on their own, yet they would prefer to undergo treatment in their homes. Most elderly patients are on haemodialysis (HD), despite the problems and costs associated with transport, achieving vascular access and poor tolerance of HD.
Audit of osteoporosis in a renal transplant clinic
Julie Spencer, Jane Sutton and Aleck Brownjohn
pp 24-26
A kidney transplant is now the treatment of choice for patients with established renal failure (ERF) and over the past decade survival rates have increased significantly. Glucocorticoid therapy has been the mainstay of antirejection therapy since transplantation began in the 1960s and, in spite of the advent of more modern maintenance antirejection therapy, including ciclosporin, tacrolimus and mycophenolate, many centres still use large doses of glucocorticoids for inducing and maintaining immunosuppression.
Skin cancers and their precursors in renal patients
Neil H Cox
pp 27-30
The incidence of skin cancer has risen over several decades in many countries. The most important aetiological factor is sunlight, usually exposure over some decades with a long lag period before damage becomes evident. Increasing age of the population and greater use of therapeutic immunosuppression are also important, particularly in nephrology. Increased awareness and earlier treatment of precursors may help to reduce skin cancer risk.

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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