Prevalence of cognitive impairment in patients attending pre-dialysis clinic.

Approximately 20-30% of patients on renal replacement therapy (RRT) have cognitive impairment. Less is known about the prevalence of cognitive impairment in patients with advanced kidney disease awaiting the initiation of dialysis. Routine cognitive assessment was implemented in the pre-dialysis clinic, which enabled the Nephrologist and Pre-dialysis Nurse to identify those patients with impaired cognitive function and utilise this information to assess the suitability for self-care treatments, such as peritoneal dialysis, as well as to adapt information to meet their needs.

Managing CKD.

The reality is that the majority of the CKD population have one or more co-morbid conditions with a known higher prevalence in ethnic minorities and lower socio-economic groups; combine this with the increase in childhood obesity and prevalence of diabetes and it is clear why we have an epidemic of CKD. Without effective prevention and early detection programmes, this will continue to escalate. Early detection and referral of CKD patients to nephrology teams is pivotal in slowing the progression to ESRD and reducing the demand for dialysis.

The efficacy of sildenafil for the treatment of erectile dysfunction in male peritoneal dialysis patients.

Background: The aim of this study was to evaluate the safety and effectiveness of sildenafil in male peritoneal dialysis patients with erectile dysfunction.

Methods: Sixteen peritoneal dialysis patients were recruited to this prospective, randomized, double-blind, placebo-controlled, crossover study of sildenafil during a period of 8 weeks. Efficacy was assessed by using the International Index of Erectile Function and a Global Assessment Question.

Investigations in renal failure.

The investigations which have been discussed above are by no means exhaustive. Since those with renal disease usually have multifactorial disease processes, many other specific investigations may be indicated. Although techniques and tests will continue to be updated and improved, it is hoped that by nurses understanding something of the current techniques used in renal investigations, they will be able to inform and reassure their patients reliably.