British Journal of Renal Medicine - 2014

Comment: The facts of life
John Bradley
pp 3-3
In 1971, Confortini and colleagues reported the case of a 35-year-old woman who became pregnant after receiving haemodialysis (HD) for 32 months for end-stage renal failure resulting from chronic glomerulonephritis. Twice-weekly HD for 24 hours per week using a Kiil dialyser was maintained throughout the pregnancy.
Pregnancy after kidney transplant
Priya Patel and Ravindra Rajakariar
pp 4-7
In 2012, 46% of kidney transplant recipients were women of childbearing age. With growing numbers of transplants in this patient population, and more women opting to conceive, there are many issues that must be considered.
Hyponatraemia: a difficult challenge in PD patients
Maria Guedes Marques, Patrícia Cotovio, Francisco Ferrer, Pedro Maia, Teresa Mendes, Armando Carreira and Mário Campos
pp 8-10
Chronic kidney disease constitutes a major public health problem; its progression and increasing prevalence worldwide frequently dictate the need for renal replacement therapy. Patients often present with numerous complex and specific complications, among which hyponatraemia is one of the most frequent.
Think like a patient, act like a taxpayer
Donal O'Donoghue
pp 10-11
In stormy waters, a good captain turns his boat to meet the waves obliquely. Simon Stevens, the new Chief Executive Officer of NHS England, would be adept at the helm. Just when you think he has clarified a particular position, he switches tack and brings a different perspective into play.
Electronic patient record sharing between primary and secondary care to support renal pathways
John Stoves, Annie Wong, Ayesha Orlando, Vicki Hipkiss, Jeanette Middleton, Essi Lampinen, Tony Coman, Gary Carlisle, Wendy Green and John Connolly
pp 12-14
The care of patients with chronic kidney disease (CKD) is often initiated in general practice. Specialist renal services need to work in partnership with primary care teams, not only to optimise the community-based management of patients with less advanced CKD but also to enhance the quality of care for patients who require specialist support.
What I tell my patients about fibrillary glomerulonephritis and immunotactoid glomerulopathy
Hannah Wilkinson, Catherine Horsfield and Nicky Kumar
pp 15-18
Fibrillary glomerulonephritis and immunotactoid glomerulopathy are very rare diseases affecting the kidneys. The conditions are often described together, but most experts would agree that they should be seen as two separate entities.
Neurological symptoms in a dialysis patient with a Chiari II malformation and ventriculoperitoneal shunt
Lynn Redahan, Derek Crinion, Peter Conlon and Mark Denton
pp 19-20
There is marked geographical variation in the incidence of spina bifida (SB), with one of the highest worldwide incidences occurring in Ireland. Myelomeningocele is the most common form of SB and the most common neural tube defect.
Cutting the carbon cost of dialysis: efficient delivery of acid concentrate
Frances Mortimer, James Dixon, Fraser Gilmour, John Stoves, Andrew Owen, Andy Connor and Fraser Campbell
pp 21-23
The supply of medical equipment accounts for a larger proportion of the carbon footprint of renal services (25%) than of the NHS in general (8%). This is not surprising given the equipment needed for each of the over 67,000 dialysis treatments carried out annually in the UK.
Paid live organ donation: credibility crunched
Patrick A Ward, Christopher HD Lawrence and Isobel YD Chen
pp 24-27
Increasing numbers of patients are currently awaiting organs for transplantation in the UK and, while this shortage continues to exist, patients will tragically continue to die on the transplant list. Over the years, various schemes have been suggested to attempt to improve the availability of organs, from paid live organ donation to the most recent donor opt-out legislation, which will come into force in Wales by 2015.
Acute renal failure due to paroxysmal nocturnal haemoglobinuria
Judi Graham and Paul McKeveney
pp 28-31
A 71-year-old female presented with anaemia, jaundice and acute kidney injury. She had a ten-month history of painless, intermittent dark urine, which had been investigated by CT urogram and cystoscopy with no cause found. On review of blood tests over the previous six months, the patient was noted to have developed progressive anaemia two months prior to the acute decline in renal function.

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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