A low rate of end-stage kidney disease in membranous nephropathy: A single centre study over 2 decades.

Introduction: Membranous nephropathy is the commonest cause of nephrotic syndrome in non-diabetic Caucasian adults over the age of 40 years. Primary membranous nephropathy is limited to the kidneys. Clinical management aims to induce remission, either spontaneously with supportive care, or with immunosuppression.

Increasing Uptake of COVID-19 Vaccination and Reducing Health Inequalities in Patients on Renal Replacement Therapy-Experience from a Single Tertiary Centre.

Background: COVID-19 vaccination has changed the landscape of the COVID-19 pandemic; however, decreased uptake due to vaccine hesitancy has been observed, particularly in patients from minority ethnic backgrounds and socially deprived areas. These patient characteristics are common in patients on Renal Replacement Therapy (RRT), a population at extremely high risk of developing serious illness from COVID-19 and who would thus benefit the most from the vaccination programme. We designed a bespoke COVID-19 vaccination programme for our RRT population with the aim of decreasing health inequalities and increasing vaccination uptake.

Humoral Response in Hemodialysis Patients Following COVID-19 Vaccination and Breakthrough Infections during Delta and Omicron Variant Predominance.

Background: The advancement of COVID-19 vaccination programs globally has been viewed as an integral strategy to reduce both the number of COVID-19 cases and consequential complications of COVID-19, particularly for high-risk patient groups. There are limited data on the antibody response and protection from disease infection and severity in patients requiring hemodialysis (HD) following COVID-19 vaccination during the Delta and Omicron variant predominance. We conducted a study aiming to evaluate humoral immunity derived from two different COVID-19 vaccines administered to our in-centre HD population and investigated the characteristics of breakthrough COVID-19 infections occurring post-vaccination within this population.

Safely reducing haemodialysis frequency during the COVID-19 pandemic.

Background: Patients undergoing haemodialysis (HD) are at higher risk of developing worse outcomes if they contract COVID-19. In our renal service we reduced HD frequency from thrice to twice-weekly in selected patients with the primary aim of reducing COVID 19 exposure and transmission between HD patients.

Methods: Dialysis unit nephrologists identified 166 suitable patients (38.

Evaluating the implementation and impact of a pharmacy technician-supported medicines administration service designed to reduce omitted doses in hospitals: a qualitative study.

Background: Of the various types of medication administration error that occur in hospitals, dose omissions are consistently reported as among the most common. It has been suggested that greater involvement from pharmacy teams could help address this problem. A pilot service, called pharmacy TECHnician supported MEDicines administration (TECHMED), was introduced in an English NHS hospital for a four-week period in order to reduce preventable medication dose omissions.

Reducing acute kidney injury incidence and progression in a large teaching hospital.

Acute kidney injury (AKI) is a common syndrome that is associated with significant mortality and cost. The Quality Improvement AKI Collaborative at Salford Royal Foundation Trust was established to review and improve both the recognition and management of AKI. This was a whole-system intervention to tackle AKI implemented as an alternative to employing separate AKI nurses.

Complications and outcomes of trimethoprim-sulphamethoxazole as chemoprophylaxis for pneumocystis pneumonia in renal transplant recipients.

Background: Following a pneumocystis pneumonia (PCP) outbreak in our nephrology unit, all transplant patients were offered chemoprophylaxis with trimethoprim-sulphamethoxazole (TMP-SMX) as the first line agent. A high rate of complications was noted. We aimed to quantify TMP-SMX associated adverse events and evaluate its prophylactic benefit in their light.

Dapsone-induced methemoglobinemia in renal transplant recipients: more prevalent than previously thought.

Background: After an outbreak of Pneumocystis pneumonia (PCP) in our nephrology unit, dapsone was used as the second-line chemoprophylactic agent. Dapsone is the most common cause of drug-induced methemoglobinemia (MHb). Its prevalence is poorly described in the renal transplant population.

Accelerated total dose infusion of low molecular weight iron dextran is safe and efficacious in chronic kidney disease patients.

Background: Low molecular weight iron dextran (LMWID) is licensed for use as a total dose infusion (TDI) over 4-6 h. In order to improve patient convenience and cost-effectiveness of therapy, we investigated the safety and efficacy of adopting accelerated dosing regimens and compared this with a standard rate LMWID infusion.

Methods: A retrospective study of patients undergoing accelerated and standard rate TDI of LMWID was conducted across three centres.

Comparison of intravenous iron sucrose versus low-molecular-weight iron dextran in chronic kidney disease.

Background: Low-molecular-weight iron dextran (CosmoFer) is the only form of parenteral iron that can be administered as a total dose infusion (TDI) in the United Kingdom (UK). This study aimed to evaluate the safety and efficacy of TDI CosmoFer in comparison to intravenous iron sucrose infusion (Venofer) in patients with chronic kidney disease (CKD).

Methods And Results: A retrospective study of outpatients with CKD undergoing intravenous TDI CosmoFer or Venofer infusion was conducted at Salford Royal Hospital and Sunderland Royal Hospital.

Small bowel angiodysplasia in a patient on haemodialysis: difficulties in diagnosis and management.

Angiodysplasia is a common cause of gastrointestinal blood loss in patients with end stage renal disease. Diagnosis is especially difficult when the angiodysplastic lesions are concentrated in the small bowel. This report describes a case of a patient on haemodialysis who had transfusion-dependent anaemia from small bowel angiodysplasia.

Milk alkali syndrome associated with excessive ingestion of Rennie: case reports.

Milk alkali syndrome is a cause of hypercalcaemia, renal failure and alkalosis, and is potentially reversible if detected early and the calcium and alkali source withdrawn. It was originally described in patients ingesting large amounts of calcium containing milk for the treatment of peptic ulcer disease. We present a modern day version of the syndrome in three cases which were associated with excessive intake of Rennie, a calcium carbonate containing antacid.

Serious adverse incidents with the usage of low molecular weight heparins in patients with chronic kidney disease.

Background: The aim of the study is to describe serious adverse events in patients with renal insufficiency administered low molecular weight heparins (LMWHs).

Methods: Systematic case note review from July 2002 to March 2003, Hope Hospital, Salford, UK, was used.

Results: Ten patients experienced an adverse incident on LMWH therapy.