British Journal of Renal Medicine - 2019

Comment: Life and death decisions; advanced care planning in chronic kidney disease
John Bradley
pp 59-59

Renal units now offer comprehensive education and support to prepare patients with progressive chronic kidney disease for renal replacement therapy. Despite this, patients can feel that they are uninformed and have limited scope for independent decision-making, with family members or healthcare professionals often strongly influencing their decision.

The impact of a renal supportive care service on symptom control, advance care planning and place of death for patients with advanced chronic kidney disease managed without dialysis
Claire Douglas, Joanne Sloan, Sarah Cathcart, Louisa Adam, Samira Bell, Lorna Frame, Miles D Witham and Maureen E Lafferty
pp 60-65

The authors describe how they redesigned their renal supportive care (RSC) service for patients with advanced chronic kidney disease (CKD) managed without dialysis, to enable consultations over a wide geographical area and within the community. The redesigned service includes an RSC nurse, a renal consultant and a palliative medicine consultant. The main components of the service are continuing care of CKD without dialysis, symptom assessment and management, and advance care planning.

Moving with the times – the UK Renal Registry
James Medcalf, The Renal Association
pp 65-65

The UK Renal Registry will celebrate its 25th anniversary next year – here we highlight some of its achievements and future developments.

Spend, spend, spend
Donal J O’Donoghue
pp 66-67

Rudolf Virchow, the 19th  century German physician who is often referred to as ‘the father of modern pathology’, identified the three factors contributing to thrombosis – Virchow’s triad; he also coined the phrase that ‘politics is nothing else but medicine on a large scale’. In a system like ours, where health service funding is provided from general taxation, that is definitely the case.

BRS in focus: an update from the new president
Sharlene Greenwood, British Renal Society
pp 67-67

UK Kidney Week 2019, jointly hosted by the British Renal Society and the Renal Association, was located in Brighton this year. The conference was heralded as a ‘great success’, with in excess of 1,000 delegates attending from all areas of the multiprofessional team. The programme team worked tirelessly to deliver a truly varied programme, which was thoroughly enjoyed by all those who attended the conference.

A patient with parvovirus B19 infection and acute anaemia after simultaneous pancreas-kidney transplantation: a case report
Qiaoling Zhou, Mohammad Saddam Jeelani, Frances Edwards and Madhu Potluri
pp 68-70

A greater index of suspicion is needed for PVB19 infection in renal transplant recipients (RTRs) with erythropoietin-resistant anaemia and low reticulocyte counts. The major challenge in managing symptomatic PVB19 infection in RTRs involves balancing the reduction of immunosuppressant dose and the risk of rejection. The authors discuss the case of a 53-year old woman who presented over a year after a simultaneous pancreas-kidney transplant with fatigue and breathlessness on minimum exertion.

Return-to-work fellowship tackling muscle weakness in chronic kidney disease
Kidney Research UK
pp 70-70

Muscle weakness and wasting is a known consequence of chronic kidney disease (CKD). Now, new research led by the University of Plymouth hopes to improve patients’ quality of life by establishing how mitochondria are involved in this deterioration.

The role of rituximab in kidney and other solid organ transplantation
Shiv Bhutani, Melissa Oliveira-Cunha, Arvind Ponnusamy, Alexander Woywodt and Titus Augustine
pp 73-78

Rituximab is increasingly being used as a therapy for B cell-mediated events in transplant recipients. The authors review the role of rituximab in different transplant settings, including its use in acute antibody-mediated rejection, post-transplant lymphoproliferative disorders and as an adjunct therapy in desensitisation protocols, as well as discussing the future use of B-cell-depleting agents in solid organ transplantation.

Paracetamol toxicity and acute kidney injury; the liver is not the only bystander
Hana Ahmed and Naushad Junglee
pp 79-81

Despite paracetamol-induced nephrotoxicity being less commonly diagnosed in comparison with hepatotoxicity, acute renal injury may be more common than previously recognised. This case report presents a young patient with delayed onset of acute kidney injury (AKI) following a paracetamol overdose, which demonstrates that AKI may be missed if patients are discharged early.

Organ donation update across the UK
National Kidney Federation
pp 82-82

Legislation to introduce an opt-out system of organ and tissue donation for Scotland was granted Royal Assent on 19th July 2019, giving formal confirmation that it will become law.

Dialysis Transport – Finding a way
Fiona Loud, Kidney Care UK
pp 82-82

If you have kidney failure, dialysis is a vital option. Some are not able to have a transplant and others may have to wait years until they are able to receive a donated kidney.

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)