British Journal of Renal Medicine - 2010


Comment: Lightening the blues
John Bradley
pp 2-2
In 2007, the cost of services for depression in England was estimated to be £1.7 billion, but the costs of the associated misery and disability are greater. The consequences of lost employment bring the total to around £7.5 billion.
Standards for water used in haemodialyis: an update
Nicholas A Hoenich and Rob Levin
pp 3-5
Dialysis uses large volumes of water in the preparation of the dialysis fluid, which is separated from the patient’s blood by a semipermeable membrane contained in the dialyser. The transport of solutes from the patient’s blood into the dialysis fluid across the membrane is predominantly concentration- driven, although latterly there has been a shift towards convective therapies such as haemodiafiltration.
The NICE guidance on depression in chronic illness
Rachel Attfield, Janette Moran and Andrew Mooney
pp 6-8
Psychological distress has long been recognised as having a high prevalence among patients with chronic illness, including chronic kidney disease (CKD). Recently, the National Institute for Health and Clinical Excellence (NICE) published Clinical Guideline 91: Depression with a chronic physical health problem (CG91), addressing the management of depression in adults with chronic physical health problems. These guidelines are to be welcomed for raising awareness of depression and outlining a structure for intervention.
Practice development unit accreditation in renal care
Marie Bosworth, Lauren Gould, Jonathan Casey and Alex Crowe
pp 9-12
The practice development unit (PDU) accreditation process focuses on patient care at a multidisciplinary team level, where most significant and direct influence on quality of care can be achieved. This process drives healthcare professionals towards lasting, sustainable and realistic achievements, which are systematically planned and not reactive.
A new approach to contrast-induced nephropathy
Athat Badar, Azfar Zaman and Saeed Ahmed
pp 13-14
Contrast-induced nephropathy (CIN) is a common cause of acute kidney injury (AKI) in hospitals. A variety of different definitions have been used to describe CIN. One, from Mehran and Nikolsky, described CIN as an ‘absolute (x 0.5 mg/dl) or relative increase (x 25%) in serum creatinine 48–72 hours after exposure to a contrast agent compared to baseline serum creatinine values, when alternative explanations for renal impairment have been excluded’.
What I tell my patients about MRSA infection
Philip Masson and Wendy Metcalfe
pp 15-18
Methicillin-resistant Staphylococcus aureus (MRSA) – also known as multidrug-resistant Staphylococcus aureus or a ‘superbug’ – is a bacteria that is responsible for several difficult-to-treat infections. It includes any strain of Staphylococcus aureus bacteria that is resistant to conventional antibiotics.
A prospective study of acute kidney injury in Cornwall
Katie Wallace, Kassie Adain, Paul Johnston, Jonathon Stratton and Robin Parry
pp 19-21
Acute kidney injury (AKI) is an abrupt (within 48 hours) reduction in kidney function currently defined as an absolute increase in serum creatinine of more than or equal to 0.3 mg/dl (=26.4 µmol/l), a percentage increase in serum creatinine of more than or equal to 50% (1.5- fold from baseline), or a reduction in urine output (documented oliguria of less than 0.5 ml/kg per hour for more than six hours).
Alcoholic ketoacidosis: common but not so familiar
Hasnain Raza, Naushad A Junglee and Mahdi M Jibani
pp 22-24
Alcoholic ketoacidosis (AKA) is a common but frequently missed cause of high anion gap metabolic acidosis. It is usually identified in chronic alcohol abusers during an abrupt cessation of alcohol. We report a case of alcoholic ketoacidosis presenting with severe metabolic acidosis and a remarkable degree of respiratory compensation. Prompt recognition and treatment resulted in an excellent recovery.
Physical function assessment in chronic kidney disease
Pelagia Koufaki, Patrick F Naish and Tom H Mercer
pp 25-27
Measures of physical function have been shown to be related to clinically important outcomes (survival, morbidity and quality of life [QoL]) in patients receiving dialysis-based renal replacement therapy. Given the prognostic potential of these factors, it is recommended that their measurement should form part of the routine assessment (and management) of patients receiving maintenance dialysis therapy. The available literature suggests that, if good practice is followed, exercise tolerance and functional capacity assessment of the patient with chronic kidney disease (CKD) (stages 3–5) is safe, feasible and may be clinically useful.
Gadolinium and the risk of nephrogenic systemic fibrosis
Tara A Collidge, Scott T Morris and Giles Roditi
pp 28-31
In the renal failure population at high risk of contrast-induced nephropathy from traditional iodinated agents, the last decade initially saw a dramatic rise in the use of gadolinium-based contrast agents (GBCAs) used for contrast-enhanced MRI. This trend reversed late in 2006 following the first report of association between GBCA use and the rare condition nephrogenic systemic fibrosis (NSF); this observation was substantiated and the US Food And Drug Administration (FDA) issued an alert.

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)