Search

Background: Renal biopsy is often required to obtain information for diagnosis, management and prognosis of kidney disease that can be broadly classified into acute kidney injury (AKI) and chronic kidney disease (CKD). The most common conditions identified on renal biopsy are glomerulonephritis and tubulo-interstitial disorders. There is a paucity of information on management strategies and therapeutic outcomes in AKI and CKD patients. A renal biopsy registry will provide information on biopsy-proven kidney disorders to improve disease understanding and tracking, healthcare planning, patient care and outcomes., Methods: A registry of patients, that includes biopsy-proven kidney disease, was established through the collaboration of nephrologists from Queensland Hospital and Health Services and pathologists from Pathology Queensland services. The registry is in keeping with directions of the Advancing Kidney Care 2026 Collaborative, established in September 2018 as a Queensland Health initiative. Phase 1 of the registry entailed retrospective acquisition of data from all adult native kidney biopsies performed in Queensland, Australia, from 2002 to 2018. Data were also linked with the existing CKD.QLD patient registry. From 2019 onwards, phase 2 of the registry involves prospective collection of all incident consenting patients referred to Queensland public hospitals and having a renal biopsy. Annual reports on patient outcomes will be generated and disseminated., Discussion: Establishment of the Queensland Renal Biopsy Registry (QRBR) aims to provide a profile of patients with biopsy-proven kidney disease that will lead to better understanding of clinico-pathological association and facilitate future research. It is expected to improve patient care and outcomes.

Background: Patients with end-stage kidney disease often have difficulty in adhering to aspects of their haemodialysis regimens., Objectives: This study aimed to quantify the number of patients who attended 100% of their scheduled haemodialysis sessions, and the number of patients who gained no more than one kilogram per day between dialysis sessions, over a three-month period., Design: Retrospective chart audit, Participants: Patients undergoing haemodialysis at an in-hospital centre in tropical Australia., Methods: A renal nurse audited the 72 charts pertaining to a 12-week period in 2013., Results: Patients attended 90.1% of all scheduled dialysis sessions. Forty-one patients attended all sessions, with the remaining 31 missing at least one scheduled session. One patient missed 16 scheduled sessions. The following were statistically less likely to attend all their scheduled sessions: Aboriginal and Torres Strait Islander patients; patients on a three times per week dialysis schedule; patients who had relocated from rural or regional towns and younger patients. The average daily weight gain ranged from 0.414 kg to 1.017 kg (mean = 0.885 kg). Younger patients were statistically less likely to adhere to fluid restrictions; patients without diabetes were more likely to adhere to the fluid allowances., Conclusions and Applications to Practice: Renal services need to assist patients to adhere to their regimens. Initially, this service will examine strategies to maximise the likelihood of patients attending all of their dialysis sessions. Such an outcome will help to delay deterioration in the patients' health status, while minimising additional strain on the health service., (© 2015 European Dialysis and Transplant Nurses Association/European Renal Care Association.)

Background: Buttonhole cannulation was introduced into this Queensland Renal Service in 2005. Contrary to published literature, a local review of cannulation outcomes found no greater likelihood of infections with the buttonhole technique., Objectives: To compare the outcomes of buttonhole and rope-ladder cannulation techniques., Design: Prospective cohort., Participants: Consenting patients attending for haemodialysis via an existing arteriovenous fistula (n = 104)., Measurements: Cannulation sites were assessed at every dialysis session for 12 weeks; fear and pain were scored by participants weekly., Results: No statistically significant differences in infection, haematoma formation, pain or fear between the techniques. Occurrence of aneurysm was higher (p < 0.05) in the rope-ladder group. More patients in buttonhole group required multiple cannulation attempts (p < 0.05). More of the rope-ladder group failed to attend their scheduled dialysis sessions (p < 0.05)., Conclusions and Applications to Practice: This study confirms that in this setting there are few negative outcomes of either technique of fistula cannulation. Specifically, buttonhole cannulation appears to be a safe alternative means of fistula access to the gold-standard cannulation technique. The Service is examining strategies to improve attendance., (© 2013 European Dialysis and Transplant Nurses Association/European Renal Care Association.)