A Focus Group Study of Self-Management in Patients With Glomerular Disease.

Introduction: Patients with glomerular disease experience symptoms that impair their physical and mental health while managing their treatments, diet, appointments and monitoring general and specific indicators of health and their illness. We sought to describe the perspectives of patients and their care partners on self-management in glomerular disease.

Methods: We conducted 16 focus groups involving adult patients with glomerular disease ( = 101) and their care partners ( = 34) in Australia, Hong Kong, the United Kingdom, and United States.

Patient Preferences for Longer or More Frequent In-Center Hemodialysis Regimens: A Multicenter Discrete Choice Study.

Rationale & Objective: Longer and more frequent hemodialysis sessions are associated with both benefits and harms. However, their relative importance to patients and how they influence acceptability for patients have not been quantified.

Study Design: Discrete-choice experiment in which a scenario followed by 12 treatment choice sets were presented to patients in conjunction with varying information about the clinical impact of the treatments offered.

A breakthrough series collaborative to increase patient participation with hemodialysis tasks: A stepped wedge cluster randomised controlled trial.

Background: Compared to in-centre, home hemodialysis is associated with superior outcomes. The impact on patient experience and clinical outcomes of consistently providing the choice and training to undertake hemodialysis-related treatment tasks in the in-centre setting is unknown.

Methods: A stepped-wedge cluster randomised trial in 12 UK renal centres recruited prevalent in-centre hemodialysis patients with sites randomised into early and late participation in a 12-month breakthrough series collaborative that included data collection, learning events, Plan-Study-Do-Act cycles, and teleconferences repeated every 6 weeks, underpinned by a faculty, co-production, materials and a nursing course.

Identifying Outcomes Important to Patients with Glomerular Disease and Their Caregivers.

Background And Objectives: Shared decision making in patients with glomerular disease remains challenging because outcomes important to patients remain largely unknown. We aimed to identify and prioritize outcomes important to patients and caregivers and to describe reasons for their choices.

Design: We purposively sampled adult patients with glomerular disease and their caregivers from Australia, Hong Kong, the United Kingdom, and the United States.

Posterior reversible encephalopathy syndrome in HIV-positive patients: a case report and literature review.

We are reporting the case of a woman who was admitted acutely to our intensive care unit without any collateral history. She was diagnosed with posterior reversible encephalopathy syndrome (PRES) as a consequence of poor adherence to anti-hypertensive, anti-diabetic and anti-retroviral medications. PRES is a rare condition, which may cause cortical blindness; contrary to its name it is not always reversible.

Rationale and design for SHAREHD: a quality improvement collaborative to scale up Shared Haemodialysis Care for patients on centre based haemodialysis.

Background: The study objective is to assess the effectiveness and economic impact of a structured programme to support patient involvement in centre-based haemodialysis and to understand what works for whom in what circumstances and why. It implements a program of Shared Haemodialysis Care (SHC) that aims to improve experience and outcomes for those who are treated with centre-based haemodialysis, and give more patients the confidence to dialyse independently both at centres and at home.

Methods/design: The 24 month mixed methods cohort evaluation of 600 prevalent centre based HD patients is nested within a 30 month quality improvement program that aims to scale up SHC at 12 dialysis centres across England.

Cathasept Line Lock and Microbial Colonization of Tunneled Hemodialysis Catheters: A Multicenter Randomized Controlled Trial.

Background: Catheter-related bloodstream infections (CRBSIs) cause morbidity and mortality in hemodialysis (HD) patients. Cathasept (tetra-sodium EDTA) solution has antimicrobial and anticoagulant activities.

Study Design: Multicenter prospective randomized controlled study.

Rare complication of a dialysis catheter insertion.

Insertion of a dialysis catheter is a very common procedure in renal medicine, which is associated with one or more complications in ∼15% of patients. Central venous catheter vascular erosion is a rare but serious complication, the incidence appears to be between 0.4 and 1% which can be difficult to diagnose, leading to increased morbidity and mortality.

Delayed appearance of markers of intravascular haemolysis in a case of paroxysmal cold haemoglobinuria.

The aetiology of haemolytic disease is diverse and the diagnosis often relies on laboratory testing. We describe a case of intravascular haemolysis, which illustrates that significant intravascular haemolysis can occur in the absence of any abnormal haematological findings. Despite gross haemoglobinuria at presentation, the haemoglobin and reticulocyte counts were both within reference limits and a normal blood film was observed.

De novo SLE after cadaveric renal transplantation.

De novo lupus nephritis in a renal transplant recipient has not been previously reported. We present a transplant recipient with long-standing insulin-dependent diabetes mellitus who presented 9 years posttransplant with hematoproteinuria and acute renal failure. New findings of positive antinuclear antibody and double-stranded deoxyribonucleic antibody and renal histology findings consistent with lupus nephritis suggest a diagnosis of de novo systemic lupus erythematosis.