British Journal of Renal Medicine - 2014

Comment: Accessing technology
John Bradley
pp 3-3
In 1960, Quinton and colleagues described the development of a technique for the long-term cannulation of arteries and veins that allowed haemodialysis to be used for patients with chronic renal disease.
Exercise tolerance in children with chronic kidney disease – a review
Andrew T MacLaren and Ihab S Shaheen
pp 4-7
Chronic kidney disease (CKD) requiring renal replacement therapy has a prevalence in children aged 0–19 of 55 per million. Although the prevalence of CKD in children is on the increase, survival rates are improving and hospitalisation rates are decreasing. However, while more children are surviving to adulthood, they have a lower health-related quality of life than age-matched healthy children. Studies suggest children with CKD have a reduced level of physical functioning and conditioning, as well as poorer emotional and social well-being, compared with healthy children.
Establishing a care planning system
Deborah Grove
pp 8-10
Chronic kidney disease (CKD) is a long-term condition that is often irreversible. Understanding the psychological and physical impact that living with CKD brings should not be underestimated by those involved in the person’s care. Making some lifestyle changes may reduce the rate of deterioration of kidney function but, usually, due to its progressive nature, care plans will need to be made for the person’s future. These plans may include kidney dialysis, transplantation or conservative management.
A quality improvement programme for modifiable risk factors in hospital haemodialysis patients
Vishal Dey, Siobhan McManus, Val Jeffrey, Maria Smith, Morag Ryan, Kath McCreadie, Graeme Crawford, Morag Gorrie, Stuart Rodger and Robert Mactier
pp 12-14
Quality improvement programmes are used to ensure that the best possible care is delivered to every patient. Performance measures of key indicators for dialysis are collected regularly by most haemodialysis units, and these data are audited as separate variables for local and national projects, such as the Renal Registry.
What I tell my patients about clinical research
Allan Gaw, Derek C Stewart, Philip A Kalra and Fiona O’Neill
pp 15-17
Healthcare professionals all have an interest in research. Whether actively designing studies, recruiting and following up patients or analysing data for publication, they all recognise the need for new knowledge and understanding to guide their practice.
Prevalence of chronic kidney disease in adults in Kashmir, North India
Shabir Ahmad Parry, Imtiyaz Ahmad Wani, Hakim Irfan Showkat, Khursheed Ahmad Banday and Muzaffar Maqsood
pp 19-22
The incidence of chronic kidney disease has increased in recent years in both developed, and developing, countries. The incidence rate of renal replacement therapy for end-stage renal disease in the USA (adjusted for age, race and gender) in 1981, 1991 and 2001 increased from 91 per million population (pmp) to 223 pmp and 334 pmp, respectively.
What are the main risks for safety of renal patients?
Paul Rylance and Catherine Fielding
pp 23-26
Ensuring patient safety is a mandatory requirement of healthcare. The Francis and Berwick reports have given recommendations of priorities for safe clinical care. As patient safety is a multiprofessional responsibility, the strategy of what began as a Renal Association (RA) project is now being developed as a collaboration between the RA and the British Renal Society (BRS) as the RA/BRS Patient Safety Project.
Pregnancy with a failing kidney transplant
Dominic Taylor and Joanne Taylor
pp 27-28
We present the case of an advanced (Stage 5) chronic kidney disease patient who had two successive pregnancies at the age of 40 and 41, while undergoing renal replacement therapy; the first with a failing renal transplant and the second while on haemodialysis. At 14 weeks gestation of her first successful pregnancy, she declined a second transplant due to the risk of miscarriage. During her second successful pregnancy, she declined increased dialysis hours because of the commitments of looking after a young child.
Commissioning for quality not quantity
Donal O’Donoghue
pp 29-30
The UK may have finally emerged from its longest economic slump in more than a century, but further deep cuts in government spending are expected in an attempt to reduce the country’s deficit. With the focus of the NHS on integrated care, hospital avoidance and managing long-term conditions in the community, it may be tempting to squeeze hospital budgets using cuts in the Payment by Results tariff as a lever to impose productivity improvements. The considerable financial pressures are driven by an ageing population, with higher expectations, more expensive drugs and technology adoption driving up costs, rather than releasing productivity savings, along with the hidden, but equally large, cost for NHS organisations and individuals of much higher pension contributions.

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)