British Journal of Renal Medicine - 2011

Comment: Cancer screening in living donors
Inderjit Singh, Geoff Koffman and Jonathon Olsburgh
pp 3-3
Cancer screening is vital in kidney donors, as active cancer is an absolute contraindication to donation. Transmission of malignancy to kidney recipients from living donors has been reported; this may require surveillance of the recipient, cancer treatment and reduction in immune suppression, and, rarely, graft removal.
Microalbuminuria in diabetes: an update
Jason Seewoodhary, John Stephen Davies and Stephen Charles Bain
pp 4-7
The World Health Organization estimates that diabetes affects more than 170 million people worldwide. One-third of those affected will develop renal dysfunction, the first sign of which is microalbuminuria. Generally accepted diagnostic definitions of normo-, micro-, and macroalbuminuria are shown in Table 1.
AKI and renal replacement therapy – incidence, aetiology and outcome
Clare MacEwen, Ramesh Naik and Lindsey Barker
pp 8-11
Acute kidney injury (AKI) is common in hospitalised patients and associated with considerable morbidity and mortality. The recent National Confidential Enquiry into Patient Outcome and Death (NCEPOD), looking at patients who died in hospital with a primary diagnosis of AKI, has highlighted the problem.
Early venous filling on CT as a sign of arteriovenous fistula
Ganapathy Ananthakrishnan, Andre Stefan Gatt and Sam Chakraverty
pp 12-13
Post-biopsy renal arteriovenous (AV) fistulae have an incidence of up to 16%, according to studies. They may remain asymptomatic and resolve, but can present with renal bleeding, hypertension and deterioration of renal function. We report a case of a symptomatic post-biopsy renal AV fistula and its diagnosis by CT angiography.
Paying for value, not volume
Donal J O’Donoghue
pp 14-14
Outcomes for people with advanced chronic kidney disease are dependent on meaningful engagement with patients, carers and families and high-quality preparation for the chosen modality of renal replacement therapy or conservative kidney care. That needs a committed, skilled and adequately resourced multiprofessional team working with ‘activated’ patients.
What I tell my patients about transition to the adult renal unit
Alan R Watson
pp 15-18
Treatment for children and young people with chronic kidney disease (CKD) is centralised in 13 children’s units in the UK serving population bases of 2–8 million. The reason that there are so few paediatric units is that CKD is relatively rare in children compared with adults, so while in any one area there may be only one children’s renal unit, there may be up to ten adult units.
Can care bundles reduce variability in standards in primary care?
Nicola Thomas
pp 19-22
Care bundles are groups of high-impact, evidence-based healthcare interventions that are well known in secondary, but not primary care. A care bundle is a specific tool with clear parameters. It has a small number of scientifically robust elements that, when grouped (or bundled) together, create much improved outcomes.
Using the ‘Deadly Trio’ database to evaluate the use of NSAIDs in kidney disease
AC Felix Burden
pp 23-24
The British National Formulary (BNF) states that non-steroidal anti-inflammatory drugs (NSAIDs) ‘should be avoided if possible or used with caution in patients with renal impairment; the lowest effective dose should be used for the shortest possible duration, and renal function should be monitored. Sodium and water retention may occur and renal function may deteriorate, possibly leading to renal failure’.
Continuous and intermittent haemodialysis for acute kidney injury
Andrew Davenport
pp 25-28
Thirty years ago, haemodialysis (HD) for the critically ill patient with acute kidney injury (AKI) was typically delivered three times weekly using dialysis machines without accurate volumetric control, acetate-based dialysate warmed to body temperature, and unmodified cellulosic membrane dialysers. Peritoneal dialysis (PD) was performed with hard catheters and using low dwell volumes and short dwell times, with poor solute clearances and increased risk of peritonitis and leaks.
Altruistic kidney donation – a donor’s perspective
David Hemmings
pp 29-31
At the age of 66, David Hemmings donated a kidney in an altruistic donation. Here, he discusses his experience and his reasons.

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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