Implementing a multisite shared haemodialysis care programme.

Adults receiving centre-based haemodialysis (HD) have low levels of patient activation which are associated with poorer outcomes. Shared haemodialysis care (SHC) describes an intervention whereby individuals are supported to undertake elements of their treatment to improve their activation levels and promote better self-care. This project aimed to increase the proportion of those performing SHC in seven HD centres within the Oxford Kidney Unit's catchment area.

ERS statement on benign pleural effusions in adults.

The incidence of non-malignant pleural effusions far outweighs that of malignant pleural effusions and is estimated to be at least 3-fold higher. These so-called benign effusions do not follow a "benign course" in many cases, with mortality rates matching and sometimes exceeding those of malignant pleural effusions. In addition to the impact on patients, healthcare systems are also significantly affected, with recent US epidemiological data demonstrating that 75% of resource allocation for pleural effusion management is spent on non-malignant pleural effusions (excluding empyema).

Endorsing: closing the loop on diagnostic tests in electronic health care records.

The Oxford University Hospital NHS Trust (OUH) had introduced a policy to improve the timely endorsement of diagnostic tests. However, performance in the Oxford Kidney Unit (OKU) has been consistently below the OUH target of 85%. This project was undertaken to improve endorsement within the OKU.

Establishing a tele-clinic service for kidney transplant recipients through a patient-codesigned quality improvement project.

Kidney transplant patients in our regional centre travel long distances to attend routine hospital follow-up appointments. Patients incur travel costs and productivity losses as well as adverse environmental impacts. A significant proportion of these patients, who may not require physical examination, could potentially be managed through telephone consultations (tele-clinic).

Late presentation of patients with end-stage renal disease for renal replacement therapy--is it always avoidable?

Background: Twenty-five to 30% of new renal replacement therapy (RRT) patients present late to renal services. The proportion in whom this is avoidable, and whether awareness of chronic kidney disease (CKD) has reduced its incidence is not known.

Methods: Adult patients starting RRT (2003-2008) in a single unit were grouped according to the time interval between first presentation to the unit and start of RRT: <90 days (late presenters); 90-364 days; ≥ 365 days.

Chronic kidney disease in kidney transplant recipients-is it different from chronic native kidney disease?

Background: The rate of change in estimated glomerular filtration rate (ΔeGFR), factors influencing ΔeGFR, and its association with mortality has not been well studied in renal transplant recipients. METHODS.: Adult kidney-only recipients between January 2001 and December 2004, with surviving grafts 1 year after transplantation, from England and Wales were followed up till 31 December 2006, graft failure or death.

Socio-economic status, ethnicity and geographical variations in acceptance rates for renal replacement therapy in England and Wales: an ecological study.

Background: It is not known to what extent the reported regional variations in renal replacement therapy (RRT) acceptance rates in England and Wales are due to differences in the socio-demographic characteristics of the population.

Methods: The authors calculated age-gender indirectly standardised RRT rates in 2007 for Primary Care Trusts (PCT)/Local Health Boards (LHB) in England and Wales and Government Office Regions (GOR) in England. Multivariable Poisson regression was used to examine the regional variations in the age-gender standardised RRT rates before and after adjustment for area deprivation (Townsend index) and the proportion of non-white people living in an area.

HIV-related admissions to a district general hospital in the U.K.: a single centre study.

This study evaluates the patient and disease characteristics, potential cost implications and short-term outcomes of 64 adult patients admitted with HIV-related illnesses. The majority (65.6%) were black Africans and 75% were immigrants to the U.

Ethnicity, socioeconomic status, and attainment of clinical practice guideline standards in dialysis patients in the United kingdom.

Background And Objectives: The role of socioeconomic status (SES) and its contribution to ethnic differences in standards attainment among dialysis patients is not known.

Design, Setting, Participants, & Measurements: We examined associations between area- level SES (Townsend index) and ethnicity (white, black, South Asian) and standards attainment in 14,117 incident dialysis patients (1997-2004) in the UK.

Results: Deprived patients were less likely to achieve hemoglobin (Hb) > or = 10 g/dl (trend P < 0.

Blood pressure and mortality risk on peritoneal dialysis.

Background: The association of baseline blood pressure (BP) and mortality in incident peritoneal dialysis patients has not been adequately studied.

Study Design: Cohort study.

Setting & Participants: 2,770 patients on PD therapy at 180 days from start of renal replacement therapy in England and Wales between 1997 and 2004.