British Journal of Renal Medicine - 2010

Comment: The salt have lost its savour
John Bradley
pp 3-3
Once regarded as a precious commodity because of its ability to preserve food, salt is now recognised as an important dietary contributor to cardiovascular morbidity and mortality. High salt intake is associated with increased risk of stroke and cardiovascular disease, and reducing sodium intake lowers blood pressure and reduces cardiovascular risk.
A safety comparison of the available phosphate binders
Claire MacEwan
pp 4-6
There is a strong association between hyperphosphataemia and morbidity, hospitalisation and mortality in dialysis patients. Altered vitamin D homeostatis is associated with hypocalcaemia and hyperphosphataemia, contributing to the development of hyperparathyroidism and mineral bone disease. There are no prospective studies demonstrating a reduction in mortality by lowering phosphate with specific agents (retrospective studies are to come), but the use of binders is associated with reduced mortality, compared with untreated patients.
Green waste management for renal medicine units
Andrew Connor, Mary Thomson and Frances Mortimer
pp 7-11
The disposal of waste contributes to the environmental impact of healthcare. Kidney care, and dialysis in particular, produces large amounts of plastic and packaging waste. If explored further, the fundamental principles of waste reduction, ‘reduce, reuse, recycle’, can be applied to kidney care and lead to financial savings.
Salt and fluid in dialysis patients: a review of practice
Elizabeth Southcott and Elizabeth Lindley
pp 12-13
Fluid balance to prevent fluid overload or dehydration, both of which can result in negative outcomes, is an integral part of haemodialysis treatment. High interdialytic weight gain (IDWG) and fluid overload can result in hypertension, oedema, shortness of breath, pulmonary oedema and heart failure. Low IDWG, however, has been associated with poor nutritional status and, therefore, can also be a negative factor and should be investigated.
What I tell my patients about the importance of calcium and phosphate
Caroline Ashley
pp 15-18
Calcium and phosphate are two minerals found in abundance in the body, and they are both vital for the maintenance of good health. If blood levels of calcium and phosphate become either too high or too low, this can affect normal bodily functions.
The BOLDE project: widening patient choices for dialysis
Edwina A Brown, Lina Johannsson, Maria da Silva-Gane, Ken Farrington and Hugh Gallagher
pp 19-22
BOLDE (Broadening Options for Long-term Dialysis in the Elderly) is a multicentre study funded by Kidney Research UK through a grant from Baxter Healthcare Ltd and supported by the Renal Association (RA) and the British Renal Society (BRS). There are three parts to the study: a comparison of the quality of life (QoL) of older patients on peritoneal dialysis (PD) and haemodialysis (HD); a questionnaire-based study to determine how older patients perceive their involvement in decision-making around choice of dialysis modality; and a qualitative study of patients six months after starting PD or HD to determine how dialysis has affected their life and what factors they regard as important in terms of choice of dialysis modality.
GFR estimation: is cystatin C preferable to creatinine?
Ahmir Ahmad
pp 23-24
The glomerular filtration rate (GFR) is the volume of fluid filtered from the glomerular capillaries into the Bowman’s capsule over time. The accurate measurement of renal function is clinically important, as it has an impact on diagnosis, treatment and prognosis. This measurement will become increasingly significant in the future, as our aging population is contributing to the rising incidence of kidney disease.
Mycophenolic acid therapies for autoimmune disease: a consensus statement
David Jayne, Lorraine Harper, Steve Harper, Alan Salama and Marius Scholtz
pp 25-31
Mycophenolic acid (MPA) was first isolated from Penicillium brevicompactum in 1896 by Gosio, and was named by Alsberg and Black in 1913. Activity against bacteria, fungi and leucocytes was first demonstrated by Sir Howard Florey in 1946. Antitumour activity was investigated in the 1960s and, in 1969, the compound was found to inhibit nucleic acid synthesis.

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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