British Journal of Renal Medicine - 2006

Comment: Community service – CKD management in primary care
John Bradley
pp 4-4
‘Last year thousands of people took part in two of the largest listening exercises on public services ever held in this country’. The result is a White Paper introducing yet more reforms to the NHS – this time, a new direction for community services that will lead to healthier, more independent lives. You asked for it.
ABO blood group-incompatible kidney transplantation
Phil Dyer and Phil Mason
pp 5-8
Kidney transplantation in suitable patients provides a far better quality and quantity of life than dialysis, and the evidence strongly indicates that the benefits are eroded the longer patients remain on dialysis. Unfortunately, there is a widening gap between the number of patients on the transplant waiting list and the number of available donors.
Measuring and preventing arterial calcification in CKD
Ben Caplin and David C Wheeler
pp 9-11
Despite major advances in the treatment of patients with chronic kidney disease (CKD), those receiving long-term dialysis therapy still have a dramatically shortened life expectancy, with cardiovascular events being responsible for most premature deaths on dialysis.
Clinical challenges in treating renal osteodystrophy
Osvaldo Espinosa
pp 12-14
Renal bone disease is one of the most challenging areas facing renal clinicians and researchers. Chronic kidney disease (CKD) is associated with a cascade of events that adversely affect mineral metabolism and lead to renal bone disease. As renal function decreases, phosphate retention and decreased synthesis of 1-alpha hydroxylated vitamin D take place.
What I tell my patients about the Renal PatientView system
Neil Turner
pp 15-18
Have you ever wanted to find out your test results after you’ve been to a clinic? Or find information about your disease or treament? Or show some of that information to someone somewhere else? Renal PatientView makes it possible to do all of these things. It may be at a renal unit near you already – or if not, it could be soon.
Exercise rehabilitation for haemodialysis patients
Pelagia Koufaki, Hameed KI Anijeet, Alexander V Crowe, Graham J Kemp and Tom Mercer
pp 19-20
The number of patients with chronic kidney disease (CKD) is increasing at an alarming rate, with new patients starting renal replacement therapy (CKD stage 5, or CKD5) constituting a fifth of the patients receiving treatment each year in the UK. At the same time, the age demographic of the CKD population has shifted, with over half of patients starting haemodialysis now over 60 years old.
Providing haemodialysis in a primary care setting
Smita Gunda and Steve Smith
pp 21-22
Lack of haemodialysis capacity has been the Achilles heel of renal medicine in the UK for decades and is set to remain a problem. The relentless rise in the number of patients needing haemodialysis and lack of adequate capital for new dialysis units will not change in the foreseeable future.
What is the future of funding in renal commissioning?
Jennifer A Scott
pp 23-25
The National Service Framework (NSF) for Renal Services recognised the importance of commissioning in achieving the standards and markers of good practice and in meeting the challenges of the projected increase in patient numbers. Recent national policy initiatives are changing the way services are commissioned and the relationship between commissioners and providers.
Managing chronic kidney disease in the community
Nicola Thomas, Frances Coldstream, Sue Cox, Janet Jarvis, Karen Jenkins, Natasha McIntyre, Karen Marchant, Madeleine Pipes and Hilary Robinson
pp 26-28
The National Service Framework (NSF) for Renal Services, Part Two was published in February 2005. It identifies four quality requirements covering chronic kidney disease (CKD), acute renal failure, and end-of-life care. Nephrology teams are familiar with caring for and managing patients with acute renal failure and are developing strategies to care for patients who have withdrawn from or do not wish to have dialysis.
The role of support nurses in outpatient haemodialysis units
Clare Taggart and Ann McGoran
pp 29-31
The role of dialysis support nurses (non-registered nurses) has steadily grown over recent years, seeing them embrace roles traditionally undertaken by registered nurses. Elements of custom and practice have seen this role increase over time. From a clinical governance point of view, concerns have been raised regarding the suitability of some expansions to practice, the legalities and the associated risks.

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)