Comment: A matter of choice
John Bradley
pp 35-35
The International Alliance of Patients' Organizations (IAPO) describes patient centred healthcare as a healthcare system designed and delivered to address the healthcare needs and preferences of patients so that healthcare is appropriate and cost-effective. The IAPO has defined five principles that should form the basis of patient-centred healthcare: respect, choice and empowerment, patient involvement in health policy, access and support, and information. Providing accurate, relevant, and complete information in a format that is accessible and takes account of language and cultural differences among patients and carers is fundamental to shared care.
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Renal young adult transition services: a national survey
Alexander Hamilton, Rachel Gair, Robert Elias and Constantina Chrysochou
pp 36-38
New National Institute for Health and Care Excellence (NICE) guidance regarding transition of young people using health services was published this year. Transition describes the process of preparing paediatric patients with a long-term condition with the knowledge, skills and confidence to manage their condition. Transfer describes the physical move from the children’s hospital to the adult hospital. During the transition process, the focus of care management shifts from the parent or carer to the young person. Renal transition has been shown to be effective in terms of attendance, adherence, renal function, transplant failure rates, patient survival, and economic viability.
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Acute pancreatitis following thrombectomy of a haemodialysis graft
Charlotte K Boughton, Claire C Sharpe, Thoraya Ammar and Sui Phin Kon
pp 40-42
Percutaneous mechanical thrombectomy is an increasingly used treatment for the management of acute thrombosis. Case series and retrospective analyses have reported its safe and effective use in the treatment of haemodialysis access site thrombosis. Several devices exist that perform flow-based (rheolytic) thrombectomy; for example, the AngioJet™ (Boston Scientific) thrombectomy device removes intravascular thromboses, by using highly pressurised retrograde saline jets in the catheter tip, which simultaneously fragment the thrombus and create a pressure vacuum, and aspirates clot fragments through the catheter.
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Living donor transplantation
National Kidney Federation
pp 43-43
The National Kidney Federation is extremely concerned by the latest NHS Blood and Transplant (NHSBT) activity report, which shows a drop in the number of living donor transplants for the third year running, despite NHSBT’s living donor kidney transplant strategy, which aims to increase the number of living donor transplants by 2020. Clearly, this target will not be met unless immediate remedial action is taken.
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ACE: a peer educatorbased community project
Neerja Jain, Mazim Ali, Annette Dodds and Jyoti Baharani
pp 44-47
A disproportionate number of people in the UK choose to have dialysis in the home environment, despite it being well established that home therapy is associated with improved quality of life, better clinical outcome and substantial cost savings. In-centre and satellite-based haemodialysis are the most common forms of renal replacement therapy in the UK and, despite self-care for dialysis being available in some centres, it is not the norm in the majority of UK dialysis units.
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Launch of unique kidney biobank
Kidney Research UK
pp 47-47
Kidney Research UK has launched the first kidney biobank, covering England, Scotland and Wales. The biobank has been named NURTuRE (the National Unified Renal Translational Research Enterprise). Developed in the first instance to collect and store biological samples from 3,000 patients with chronic kidney disease and at least 800 patients with nephrotic syndrome, the biobank will provide a strategic resource for fundamental and translational research. In addition to the samples of plasma, serum, urine, DNA and tissue that will be stored, the repository will also have the considerable advantage of containing associated linked clinical data, through the UK Renal Registry.
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British Renal Society Conference Highlights 2017
British Renal Society
pp 48-48
For our 2017 conference, the British Renal Society programme committee set out to innovate and introduce new features. In this, they undoubtedly succeeded and those who attended were treated to a meeting with a fresh and vibrant atmosphere. The new and slightly unconventional venue at the University of Nottingham’s sports centre provided plenty of space for the exhibition and poster sessions. Four plenary sessions were included to give everyone the opportunity to hear our excellent invited speakers and award lectures.
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Long-term sustainability of the NHS and social care: we are in trouble
Donal J O’Donoghue
pp 51-52
Until the harrowing events in Manchester, the NHS was one of the key battle grounds of the 2017 general election. The British Red Cross has described the NHS as ‘a humanitarian crisis’ and the major political parties have all been criticised for the creative accounting behind their manifesto pledges. NHS funding was a central part of the Leave campaign’s message in the European Union referendum, with a pledge to ‘give our NHS the £350 million the EU takes every week’. Over five years that equates to £91 billion; yet the manifesto pledges are closer to £7–8 billion, much of it recycled money. Nigel Edwards, Chief Executive of the Nuffield Trust, has said, ‘even under a generous interpretation of what will actually happen, the share of Britain’s national income going to the NHS will continue to shrink from 7.3% to 7%; we are on course for more than a decade of unprecedented austerity’. That is before a commitment to double the charge that organisations pay to employ non-European Economic Area workers, which could exacerbate the NHS staffing shortages and ‘take around £7 billion a year from the NHS frontline’.
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What I tell my patients about shared haemodialysis care
Tania Barnes, Andy Henwood, Martin Wilkie and Sonia Lee
pp 53-55
In recent years, it has become more common for dialysis patients to take an active role in their care. Tania Barnes and colleagues explain what shared haemodialysis care involves, the aspects of care that you can participate in, and how it can benefit you.
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Home dialysis roadshow pilots
Kidney Care UK
pp 56-56
In 2002, the National Institute for Health and Care Excellence stated that up to 15% of patients might benefit from home haemodialysis. However, the numbers have remained stubbornly low, at around 4%. NICE guidance also supports the use of peritoneal dialysis as the first modality, with a suggested uptake of 39%. Yet the latest figures show that just 19% and 6% of incident and prevalent dialysis patients are on PD, respectively. Of the 28,000 people on dialysis, only around 5,000 are fit enough to go on the transplant waiting list, so having the best possible dialysis is vitally important. However, there is wide variation in uptake of home therapies across the UK. In light of this, the British Kidney Patient Association engaged with hospitals and industry partners to bring home dialysis technologies and patient education to units and test whether this could boost uptake.
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Immunosuppression in IgA nephropathy
Dharmenaan Palamuthusingam, Clare Castledine and Sarah Lawman
pp 57-61
IgA nephropathy is the most prevalent form of glomerulonephritis worldwide and an important cause of end-stage renal disease (ESRD). There is a significant risk of progressing to ESRD of 15–20% by 10 years from onset and 40% by 20 years. While previous studies have explored factors that predict outcomes in IgA nephropathy, risk stratification remains a challenge as the natural history of IgA nephropathy ranges from persistent asymptomatic microscopic haematuria to progressive kidney failure.
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The Renal Association
pp 62-62
I am privileged to become Clinical Vice-President of the Renal Association (RA) from June 2017. For six months I have shadowed the current executive team and have been truly impressed by their work on behalf of the association, dealing with the unanticipated and the urgent, while also shaping long-term developments. I am particularly grateful to my predecessor, Graham Lipkin, who has served a tremendous term dealing with the vagaries of our current environment and introducing innovative developments, such as the Kidney Quality Improvement Partnership (KQuIP), alongside Louise Wells of the British Renal Society.
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