British Journal of Renal Medicine - 2004

Comment: The renal NSF – a useful tool or just a blunt instrument?
Stuart Rodger
pp 4-4
Renal replacement therapy (RRT) has been such a successful treatment for patients with advanced kidney failure that demand has outstripped supply for over 30 years.

Renal services and the paediatric intensive care unit
Ben Harvey and Alan R Watson
pp 12-14
This paper describes the role of a paediatric renal critical care educator (RCCE) and the facilitation of joint working between renal services and paediatric intensive care. This role is unique in that it crosses departmental, trust and geographical boundaries to ensure the safe delivery of continuous renal replacement therapy to critically ill children.

What I tell my patients about donating a kidney
Michael L Nicholson
pp 15-18
The surgical term for donating a kidney is live-donor nephrectomy and the newest technique involves only a small surgical cut (laparoscopy). This was introduced into clinical practice in the USA in 1995. The first operation in the UK took place in Leicester in September 1998. A number of other UK centres are now offering potential kidney donors a laparoscopic approach and the techniques involved are likely to be introduced more widely in the next decade.

Recruitment and retention of nurses in renal healthcare
Cathy Mansell
pp 19-21
Are you struggling to recruit staff? If you are able to recruit, do they soon leave? Do staff constantly complain about shortages and firefighting? If this is you – this was us! Renal staff at Wrexham Maelor Hospital worked together to review working practices within the unit. A number of practices were identified for review including: the provision of a more relaxed working environment, more time for patients and the need for effective evaluation of care provision. Staff also wanted to enjoy their time off.

The importance of correcting acidosis in chronic renal failure
David Reaich
pp 22-25
Chronic renal failure (CRF) is often associated with the development of metabolic acidosis. It is well established that acidosis has a number of deleterious effects, particularly on protein metabolism and bone. It is now accepted that correction of acidosis forms part of the standard treatment of the patient with CRF or end-stage renal failure.

Developing a competence framework for renal services
Brian Payne
pp 26-28
The Department of Health (DoH) recently commissioned Skills for Health to identify a renal competence framework to support the development of the Renal National Service Framework (NSF). This article explains why this work was commissioned, how the framework is being developed, how it can be used and how to get further information on the project.

Undertaking renal biopsy as a day-case procedure
Kieron Donovan
pp 29-31
Renal biopsy remains a cornerstone of nephrological investigation. Although there may be some disagreement about the precise indications for biopsy, and consequently quite marked differences in practice across the UK, there is little doubt that histology can: ? Guide and modify treatment ? Unveil features that cannot be gleaned non-invasively ? Give useful prognostic information ? Favourably influence treatment and outcome.