British Journal of Renal Medicine - 2011

Comment: Learning from experience – pregnancy in renal transplantation
John Bradley
pp 3-3
It is over 50 years since the first child was born to a female renal transplant recipient. The woman received a kidney from her identical twin in 1956, and completed a normal full-term pregnancy, by delivering a healthy baby by Caesarian section, 21 months later.
QOF in chronic kidney disease: what has it taught us?
Lowri Phillips, Aled Phillips and Kieron Donovan
pp 4-8
In April 2004, the UK introduced a new General Medical Services (GMS) contract, incorporating a pay-for-performance (PFP) scheme, the Quality and Outcomes Framework (QOF) of the GP contract. Additional funding of £1.8 billion was committed to this scheme over the first three years. It attracted remuneration for GPs in return for meeting targets relating to 146 clinical, organisational, and patient experience indicators.
Iatrogenic atheroembolic renal disease in a patient with one functioning kidney
Jonathan Lyske and Robert Mullan
pp 9-11
A 69-year-old male was referred to a nephrology unit with acute kidney injury (AKI) and dusky discolouration to both feet.
Using quality improvement to reduce catheter infections
Helen Alderson, Christopher Skeoch, Adele Corbett, Julie Gordon and Janet Hegarty
pp 12-14
Central catheter-associated infections cost money and lives. In our acute kidney care unit, part of the Salford Royal NHS Foundation Trust, we significantly reduced the number of acute haemodialysis catheter-associated infections through a quality improvement collaborative.
What I tell my patients about contraception and pregnancy in renal disease
Neil Turner, Rhona Hughes and Cheryl Dunlop
pp 15-18
Kidney diseases affect both fertility (how easy it is to become pregnant) and pregnancy itself. The chance of becoming pregnant decreases with worsening kidney function. Nevertheless, even women on dialysis can become pregnant. Renal transplantation restores fertility, with the first successful pregnancy in a kidney transplant recipient occurring in 1958 in a woman from Oklahoma after receiving a kidney from her twin sister. As our management of kidney disease improves, so the numbers of women who become pregnant with kidney disease, a kidney transplant or even when on dialysis are increasing.
Managing renal disease in HIV-positive patients
John W Booth and John O Connolly
pp 19-23
The first clinical cases of AIDS were described in 1981 by the Centers for Disease Control and Prevention, and HIV infection was identified as the cause of AIDS in 1984. A specific form of HIV-associated nephropathy (HIVAN), characterised by nephrotic syndrome and rapidly progressive kidney failure, was reported early in the epidemic. It became apparent that HIV infection could also result in the development of other immune-mediated glomerular diseases.
Live kidney donation: from renal doctor to kidney donor
John Scoble
pp 24-26
I am a doctor who is involved with living donor transplantation. Over the last ten years, I have assessed two living donors per week. I have admired their desire to help their relatives or friends. I have been intrigued as to their motivation. I felt that I had accumulated a significant understanding of the issues that living donors raised and could reply to their queries. I had learnt an enormous amount from the patients whose donation I had facilitated.
'Lifting the cloud': patient-centred approaches to depression in renal patients
Dominic Bray, Alex Crowe and Joanne Iddon
pp 27-30
It is something of a commonplace that people who are faced with a lifetime of ill health will, from time to time (if not in some cases habitually), become weighed down by the burden of their disease. Depression and anxiety are two to three times more common in those with a long-term physical illness, and approximately 25% of those with long-term conditions experience psychological distress and ill mental health. This co-morbidity increases healthcare use and, therefore, costs, as a quarter of patients admitted to hospital with a long-term physical illness also have a mental health condition.

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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