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Found 15 results
  1. News Article
    A senior medic has won a whistleblowing case after judges ruled she was dismissed after raising concerns about a new procedure her department was using. An employment tribunal found consultant nephrologist Jasna Macanovic was fired from Portsmouth Hospitals University Trust in March 2018 after telling bosses a dialysis technique called “buttonholing”, which had been “championed” there, was potentially dangerous. The trust’s case was that the way she had gone about raising concerns had made for an untenable working environment in the Wessex Kidney Centre. The process saw a Care Quality Commission complaint, an independent investigation and multiple referrals to the General Medical Council. Employment Judge Fowell said: “The plain fact is that after over twenty years of excellent service in the NHS, Dr Macanovic was dismissed from her post shortly after raising a series of protected disclosures about this one issue. It is no answer to a claim of whistleblowing to say that feelings ran so high that working relationships broke down completely, and so the whistleblower had to be dismissed.” Dr Macanovic resigned from the regional renal transplant team in July 2016 when she discovered two incidents had occurred that “had not been reported by either surgeon” and felt that one of the surgeons had misled the medical director over the issue, the tribunal heard. In an email sent after the resignation meeting, Dr Macanovic said the practice was considered inappropriate by the vast majority of experts in the field and that no other renal unit in England was using it. The case exposes some worrying governance, both within the trust and between it and the Care Quality Commission, with which the issues were raised in 2016. When the CQC asked the trust for more information the unit’s clinical director responded that in his view that the deaths and infections were not due to the buttonholing. The CQC made no further enquiries and wrote back saying “they were satisfied that there were no safety concerns and that appropriate governance had been followed”. Read full story Source: HSJ, 24 March 2022
  2. News Article
    Researchers have completed the first successful in-patient trial of liver dialysis. The DIALIVE device, invented by researchers at UCL’s Institute for Liver and Digestive Health, was found to be safe and effective, research suggests. According to a new study, the device is associated with substantial improvement in the severity of symptoms and organ function in a greater proportion of patients with acute-on-chronic liver failure (ACLF), when compared with patients receiving standard of care. The next step would be a larger clinical trial, which if successful could see DIALIVE approved for clinical use within the next three years. Read full story Source: The Independent, 1 June 2023
  3. News Article
    A young woman receiving end-of-life care says she is “just waiting to die” as an agonising three-year wait for a kidney transplant has left her “living like a prisoner”. Diana Isajeva is one of approximately 7,000 patients who are on the waiting list, according to the NHS Blood and Transplant service (NHSBT) – the highest figure in a decade. The 29-year-old was due to have a transplant last year but was denied it at the last minute, after the living donor she was matched with pulled out just 24 hours before her planned surgery. Data from NHSBT shows that the rate of families giving consent for their loved ones’ organs to be donated has dropped – despite a change in the law in 2020 aimed at boosting the number of organs available, which means that consent for donation is now presumed after death. Professor Peter Friend, transplant lead for the Royal College of Surgeons (RCS), said decreasing donor rates are a “big challenge” and that it is concerning that the number of donations has not yet recovered to its pre-pandemic level. Read full story Source: The Independent, 27 March 2023
  4. News Article
    More than a quarter of patients with COVID-19 on ventilators also need renal support in the form of dialysis, raising concerns that there could be significant supply problems as countries attempt to stock up on the required fluid and plastic consumables. Nephrology consultant Graham Lipkin told The BMJ, “This is an under-recognised challenge. While the original focus has been on whether we have enough ventilators and intensive care beds, it has become apparent that there is a high incidence of acute kidney injury (AKI) requiring some form of renal replacement therapy (RRT) through dialysis. With the volume of people coming into intensive care, there are increasing challenges to capacity across the system.” Lipkin, who is president of the Renal Association, has been working with NHS England to develop new clinical guidelines for the prevention and optimal management of AKI in hospital. The guidance aims to reduce the incidence of AKI and therefore the demand for dialysis. Read full story Source: BMJ, 21 April 2020
  5. News Article
    New guidelines have been published to help doctors and nurses decide how to prioritise patients during the coronavirus pandemic. The advice from the National Institute for Health and Care Excellence (NICE) was produced amid concerns that the NHS would be overwhelmed by the demand for intensive care beds and ventilators. The three new NICE guidelines, which have been drawn up within a week rather than the usual timescale of up to two years, cover patients needing critical care, kidney dialysis and cancer treatment. They say all patients admitted to hospital should still be assessed as usual for frailty “irrespective of Covid-19 status”. Decisions about admitting patients to critical care should consider how likely they are to recover, taking into account the likelihood of recovery “to an outcome that is acceptable to them”. Doctors are advised to discuss possible “do not resuscitate” decisions with adults who are assessed as having increased frailty, such as those who need help with outside activities or are dependent for personal care. Read full story Source: Independent, 22 March 2020
  6. Content Article
    Renal replacement therapy is treatment that are given to patients whose kidneys stop working properly, including chronic kidney disease and acute kidney injury. The therapy includes haemodialysis (HD), peritoneal dialysis (PD) and continuous renal replacement therapy (CRRT), sometimes referred to as haemofiltration. This guidance has been produced in collaboration with the UK Kidney Patient Safety Committee, to summarise known safety issues with dialysis and CRRT and describe what to do to minimise or prevent serious injury. This guidance is aimed mainly at healthcare professionals and patients who carry out their own dialysis. This guidance replaces the previous Dialysis Lessons Learn guidance published by the MHRA.
  7. Content Article
    This review in the World Journal of Nephrology assesses the value of clinical audit in nephrology settings. It looks at areas where the use of clinical audit has been effective, such as hypertension and mineral metabolism control in haemodialysis patients. The authors suggest ways to make the process effective and recommend that clinical audit is used more widely within the field of nephrology.
  8. Content Article
    Jamie Lee Poole was diagnosed required the lifesaving surgery of a kidney transplant in 2011. After the transplant she was placed on a dose of immunosuppressant to prevent rejection of the transplanted kidney. One of the known side effects of the use of the medication is that it can cause low levels of magnesium within the body. Jamie was admitted to the Royal Stoke University Hospital on 27 June 2017 with low levels of magnesium and low calcium and was treated for correction of electrolyte disturbance. On the 28 June 2017 she was found on the floor having collapsed. It was discovered that she had significant swelling on her brain. This was caused by a lack of oxygen to the brain, which was either caused by a heart problem or a seizure, which on balance would have been caused by the low levels of magnesium. She was transferred to the intensive care unit at the Royal Stoke University, Stoke-on-Trent where she died.
  9. News Article
    The programme of giving third Covid vaccinations to people with compromised immune systems has been a “chaotic failure”, charities have said, with fewer than half of those eligible contacted about a third jab before an NHS deadline this month. Surveys by Blood Cancer UK and Kidney Care UK found that for both groups of patients, between 55% and 60% had yet to be invited to get a third injection, seen as particularly vital for conditions which affect people’s immune systems, as they are generally less protected by two jabs. The charities said many of those who responded were desperately worried and were struggling to get information about a third vaccination. Some people with blood cancer had resorted to going to vaccination centres without an appointment, pleading for a third dose, Blood Cancer UK said. Official figures show there were 45,066 confirmed new Covid cases in the UK on Thursday, the highest daily total since mid-July. Kidney Care UK said the poor communication highlighted what seemed to be a “woeful lack of preparation” for the programme, the guidance for which was agreed on 2 September. The third dose programme for people with compromised immune systems is separate to the wider rollout of booster jabs being offered to everyone over 50, and others with clinical vulnerabilities, which started on 15 September. Read full story Source: The Guardian, 15 October 2021
  10. News Article
    The family of a man who bled to death during kidney dialysis treatment at Royal Shrewsbury Hospital have said they believe lessons have been learned. Mohammed Ismael Zaman, known as Bolly, died after hospital staff failed to check the connection on his dialysis machine, despite it sounding an alarm after the catheter had become disconnected. During Mr Zaman’s treatment at the Royal Shrewsbury Hospital on October 18, 2019, his dialysis machine set off a venous pressure alarm. An unidentified member of staff reset the alarm without checking that the connection was still secure. As a result of the reset, Mr Zaman bled out for seven minutes losing 49% of his blood circulating volume. He was found unconscious in a pool of blood and despite resuscitation attempts, died two hours later. The coroner, Mr John Ellery concluded that the death was due to systems failure and individual neglect on the part of the unidentified staff member. Read full story Source: Shropshire Star, 16 January 2021
  11. Content Article
    Our understanding of race and human genetics has advanced considerably, yet these insights have not led to clear guidelines on the use of race in medicine. The result is ongoing conflict between the latest insights from population genetics and the clinical implementation of race. For example, despite mounting evidence that race is not a reliable proxy for genetic difference, the belief that it is has become embedded, sometimes insidiously, within medical practice. One subtle insertion of race into medicine involves diagnostic algorithms and practice guidelines that adjust or “correct” their outputs on the basis of a patient’s race or ethnicity. Physicians use these algorithms to individualise risk assessment and guide clinical decisions. By embedding race into the basic data and decisions of health care, these algorithms propagate race-based medicine. Many of these race-adjusted algorithms guide decisions in ways that may direct more attention or resources to white patients than to members of racial and ethnic minorities. To illustrate the potential dangers of such practices, Vyas et al. have compiled a partial list of race-adjusted algorithms.
  12. Content Article
    The Canterbury Renal Unit is situated at Kent and Canterbury Hospital and provides renal services for the East Kent, Medway and Maidstone areas. There are currently 680 transplant patients currently being followed up. There have been a number of immunosuppression related prescribing errors in the surrounding hospitals. Indeed, one such error occurred in the renal unit itself, when a transplant patient had prednisolone inadvertently withheld resulting in rejection of the kidney. Thus, a group of 12 transplant patients attended a co-production group to discuss the problems and potential solutions.
  13. Content Article
    The Royal College of General Practitioners (RCGP) have developed this toolkit to disseminate learning highlighted from acute kidney injury (AKI) case notes reviews, part of the RCGP AKI Quality Improvement project. Working with GP practices, they have put together resources, alongside national Think Kidneys guidance, to support the implementation of quality improvement methods into routine clinical practice.
  14. Content Article
    A team at South Tees Hospitals NHS Foundation Trust in Middlesbrough developed a programme to raise awareness of acute kidney injury (AKI) and to recognise and treat the condition promptly. Since the programme started there has been a sustained reduction (36%) in AKI cases within the surgical wards at Middlesbrough. This successful programme and pathway has been shared with seven other trusts in the North East of England. As a result of the AKI project and its links to CRAB Clinical Informatics Limited (C-Ci), other NHS Trusts (Imperial, Frimley Park, Wexham Park, North Devon, St Helen’s, Lincoln, Yeovil, Bartholomew’s, The Royal London and Southend) have now also been consulted, meaning this project has the potential for much wider spread. Commonly AKI starts in the community so the team is now focusing on strategies to support primary care to reduce AKI in the community and to harmonise AKI aftercare between hospital and community services. The South Tees Hospitals NHS Foundation Trust team was also highly commended in July 2017 at the national Patient Safety Awards.
  15. Content Article
    UCLPartners delivered two breakthrough series collaboratives with 13 acute hospital trusts in the north Thames region to transform the care provided to patients with acute kidney injury (AKI) and sepsis. The aims for the AKI and sepsis collaboratives were to achieve improvements in the recognition and treatment of patients admitted to hospital with AKI or sepsis, as well as to increase NHS staff quality improvement capability across the region. The analysis of over 2,000 AKI and sepsis cases throughout the programme showed that both collaboratives exceeded their aims, and reduced AKI mortality by 47%, and sepsis mortality by 24%.
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