A5103180363- Dialysis and Renal Disease Management
- Health Systems, Economic Evaluations, Quality of Life
- Frailty in Older Adults
- Central Venous Catheters and Hemodialysis
- Geriatric Care and Nursing Homes
- Palliative Care and End-of-Life Issues
- Nutrition and Health in Aging
- Muscle and Compartmental Disorders
- Intestinal and Peritoneal Adhesions
- Abdominal Surgery and Complications
- Parathyroid Disorders and Treatments
- Transplantation: Methods and Outcomes
- Cardiac Structural Anomalies and Repair
- Family and Patient Care in Intensive Care Units
- COVID-19 and Mental Health
- Hospital Admissions and Outcomes
- Magnesium in Health and Disease
- Healthcare cost, quality, practices
- COVID-19 and healthcare impacts
- Clinical Nutrition and Gastroenterology
- Renal and Vascular Pathologies
- Healthcare Policy and Management
- Nosocomial Infections in ICU
- Chronic Kidney Disease and Diabetes
- Family Caregiving in Mental Illness
University of Salford
2023-2025
Salford Royal Hospital
2023-2025
Northern Health and Social Care Trust
2023-2024
Manchester Academic Health Science Centre
2015-2022
Manchester University NHS Foundation Trust
2016-2022
University of Manchester
2014-2021
National Taiwan University
2020
British Renal Society
2019
National Institute for Health Research
2018
Devices for Dignity
2018
Lay summary The International Society for Peritoneal Dialysis last published a guideline on prescribing peritoneal dialysis (PD) in 2006. This focused clearance of toxins and used measure waste product removal by using urea as an example. suggested that specific quantity small solute was needed to achieve `adequacy'. It is now generally accepted, however, the well-being person related many different factors not just toxins. has been written with focus doing PD. proposed delivery should be...
Peritoneal dialysis (PD) catheter-related infections are important risk factors for catheter loss and peritonitis. The 2023 updated recommendations have revised clarified definitions classifications of exit site infection tunnel infection. A new target the overall rate should be no more than 0.40 episodes per year at risk. recommendation about topical antibiotic cream or ointment to has been downgraded. New include suggestion dressing cover treatment duration with emphasis on early clinical...
Individuals with kidney failure undergoing maintenance dialysis frequently report a high symptom burden that can interfere functioning and diminish life satisfaction. Until recently, the focus of nephrology care for patients has been related primarily to numerical targets laboratory measures, outcomes such as cardiovascular disease mortality. Routine assessment is not universal or standardized in care. Even when symptoms are identified, treatment options limited initiated infrequently, part...
eritoneal dialysis (PD) is a successful modal-ity that enables patients with end-stage kidneydisease to have home-based treatment many ad-vantages for their quality of life. In general, outcomes ofPD are equal those hemodialysis (HD). The reportedtechnique success PD is, however, shorter than ofHD. Whereas there “positive” reasons droppingout, such as transplantation or recovery renal function,some transfer HD because peritonitis, in-adequate small solute clearance and/or ultrafiltration,and...
In 2020, the UK’s National Health Service (NHS) braced itself for challenge of COVID pandemic. Older, frail adults were among those at highest risk morbidity and mortality. This study aimed to capture lived experiences patients, families/carers staff on a ward. Thirty participants included, data collected through in-depth unstructured interviews. The analyzed using interpretive phenomenology. Four main themes constructed, capturing collective participants. first theme, changing uncertain...
We performed a review of large incident peritoneal dialysis cohort to establish the impact current practice and that switching hemodialysis.Patients starting between 2004 2010 were included clinical data at start recorded. Competing risk analysis Cox proportional hazards model with time-varying covariate (technique failure) used.Of 286 patients (median age 57 years) followed for median 24.2 months, 76 transplanted 102 died. Outcome probabilities 3 5 years respectively 0.69 0.53 patient...
Open visiting refers to the principle of unrestricted hours in hospital setting enable relatives, families and carers visit at any time. There has been recognition that open supports patient family supported care improves communication. Despite this there difficulty implementing barriers identified. The aims study were therefore evaluate implementation visiting, implementation, sustainability impact on communication between health professionals, carers.The was conducted two large acute wards...
Peritoneal dialysis (PD) is only one component of care for older multimorbid, frail and/or palliative patients. Goals should be determined all patients by shared decision-making at the start during time on PD. Burden PD minimized individualizing prescription allowing residual renal function and tailored to what acceptable patient. facilities develop pathways needed this group including integration with local geriatric, social services
Life participation is an outcome of critical importance to patients receiving peritoneal dialysis (PD). However, there no widely accepted or validated tool for measuring life in PD.Online consensus workshop identify the essential characteristics as a core outcome, with goal establishing patient-reported measure use all trials PD. Thematic analysis transcripts was performed.Fifty-six participants, including 17 and caregivers, from 15 countries convened via online videoconference. Four themes...
Encapsulating peritoneal sclerosis (EPS) is a rare but serious complication of dialysis (PD). Gastrointestinal (GI) symptoms affect appetite and dietary intake. Adequate nutrition especially important if surgical interventions are required.To investigate the nutritional management 23 EPS patients that underwent intervention between 1999 2005 at Manchester Royal Infirmary, United Kingdom.EPS was recognized by GI diagnostically confirmed laparotomy, computed tomographic scanning, or...
The growing older population with advanced chronic kidney disease (ACKD stages 4-5) poses a challenge for healthcare worldwide. high prevalence of frailty and associated adverse health outcomes highlights concerns management interventions specific to this population. aim was objectively review the evidence relating people (≥65 years) living ACKD. More specifically how is identified, what have been studied reported including important patients, families carers. A scoping undertaken following...
Encapsulating peritoneal sclerosis (EPS) is an uncommon complication of dialysis (PD), with high mortality and morbidity. The peritoneum thickens, dysfunctions, forms a cocoon that progressively "strangulates" the small intestine, causing malnutrition, ischemia, infarction. There as yet no reliable noninvasive means diagnosis, but recent developments in image analysis cine magnetic resonance imaging for recognition adhesions offers way forward. We used this protocol before surgery 3 patients...
Hyperphosphataemia in dialysis subjects is associated with increased mortality. However cause and effect has not been proven, the ideal phosphate target range unknown despite KDOQI's call for studies over 12 years ago. The design conduct of a randomized controlled trial challenging because maintaining two groups within differing ranges serum achieved long follow-up 1 year, setting, before. SPIRiT study examines subject acceptance, recruitment retention rates such which were randomised to...
Background Although relatively rare, encapsulating peritoneal sclerosis (EPS) is nonetheless a major concern within the renal community. Risk of developing EPS associated with long-term dialysis (PD). High mortality was previously reported, although surgery has since improved outcomes. Research into focuses on imaging and early detection methods, genetics, biomarkers preventive strategies. No previous studies have examined patients’ experiences EPS. Aims The aim present study to explore...
Calcium and magnesium balance in continuous ambulatory peritoneal dialysis (CAPD) has been extensively studied with several of the different formulations fluid available. automated PD (APD) is less well effect on Ca Mg flux unknown. Data glucose polymer solutions are also lacking. This prospective observational study was undertaken to examine mass transfer APD patients.12 patients were for two 24-hour periods using, alternately, 1.75 mmol/L 1.25 (Dianeal PD1 Dianeal PD4; Baxter Healthcare,...