IgG4-related tubulointerstitial nephritis.

A 67-year-old man was referred to the renal team following an episode of acute kidney injury on a background of chronic kidney disease. He had a 9-year history of steroid-sensitive arthritis, epigastric pain and isolated submandibular gland enlargement. He was noted to have a raised eosinophil count, total serum protein and total immunoglobulin G4 (IgG4) level as well as a serum hypocomplementaemia.

Treatment of Immunoglobulin A Nephropathy Recurrence Post-Renal Transplant.

Immunoglobulin A nephropathy (IgAN) is the most commonly occurring glomerulonephritis. Recurrence of disease in the transplanted kidney can significantly reduce allograft survival rates. Currently, there is no definitive management plan for IgAN recurrence in a transplant that reduces the rate of decline of allograft function and prolongs time to dialysis or re-transplantation.

Elderly patients with chronic kidney disease: do they really need referral to the nephrology clinic?

Introduction: Chronic kidney disease (CKD) is becoming increasingly common, especially in the elderly. In the UK, there has been a marked increase in the awareness and detection of CKD over the last decade. This is largely attributable to the introduction of automated estimated glomerular filtration rate (eGFR) reporting and renal indicators in the primary care Quality and Outcomes Framework (QOF) initiative, both of which were introduced in 2006.

Should We STOP Angiotensin Converting Enzyme Inhibitors/Angiotensin Receptor Blockers in Advanced Kidney Disease?

Chronic kidney disease (CKD) is a worldwide public health problem associated with a high prevalence of cardiovascular disease (CVD) and impaired quality of life. Previous research for preventing loss of glomerular filtration rate (GFR) has focused on reducing blood pressure (BP) and proteinuria. Angiotensin converting enzyme inhibitors (ACEi) and angiotensin II receptor antagonists (ARB) are commonly used in patients with early CKD, but their value in advanced CKD (estimated GFR (eGFR) ≤30 ml/min/1.

30-day mortality after haemodialysis vascular access surgery: a retrospective observational study.

Purpose: The prevalence of haemodialysis is increasing globally. There is a consensus of international opinion that permanent vascular access is preferred for haemodialysis. Patients with end-stage renal disease carry a high burden of cardiovascular comorbidity.

Experiences with anaerobic treatment of fat-containing food waste liquids: two full scale studies with a novel anaerobic flotation reactor.

Fat-containing food waste can be effectively treated in a new type of reactor, the so-called BIOPAQ-Anaerobic Flotation Reactor or BIOPAQ(®) anaerobic flotation reactor (AFR). In the reactor a flotation unit is integrated to retain the sludge. In this study results from two plants with a 430 and 511 m(3)-AFR, respectively, are presented.

Tandem clerking: maximising workplace learning.

Background: Medical assessment units (MAUs) are a valuable source of educational opportunities, but these are often not realised because of service pressures. We trialled a method of collaborative working, where junior and senior trainees work in 'tandem' to see new admissions. The roles are alternated throughout the shift with the aim of encouraging shared decisions, learning and feedback.

Disseminated Nocardia infection in a renal transplant patient: the pitfalls of diagnosis and management.

This case report describes the progress of an immunosuppressed renal transplant patient who presented with signs and symptoms of community acquired pneumonia. He did not respond to conventional therapy and underwent further investigation. Definitive diagnosis proved challenging.

Postnatal health and welfare of offspring conceived in vitro: a case for epidemiological studies.

In vitro fertilization (IVF) has established itself as an important technique in human assisted reproduction and in livestock improvement. In both humans and livestock the possible long-term effects on health and welfare of offspring born after IVF and in vitro culture to the blastocyst stage are still largely unknown. Epidemiological studies in humans, using data collected for individuals born after normal (i.