Renal

a sub topic of Clinical Transformation

Most recent entries |

  1. Clinical Transformation: The Key to Green Nephrology

    Andrew Connor, Frances Mortimer, Charles Tomson Nephron Clin Pract 2010;116:c200-c206 (DOI: 10.1159/000317200) Climate change represents a major global public health threat. The very provision of healthcare itself has a significant untoward effect on the environment, to which kidney care is likely to contribute disproportionately. In this article we describe the four principles we believe will underpin a successful transformation to lower carbon kidney care: disease prevention, patient empowerment, lean service delivery and the preferential use of low-carbon technologies. We illustrate their application and their co-benefits, such as improvements in patient care and reductions in cost, with examples.

    from SHEBA on 02 July 2010 | Download | Comment on this

  2. Reusing Dialysis Wastewater: The Elephant in the Room

    Despite widespread endemic drought conditions worldwide, most hemodialysis (HD) clinics still ignorantly discard daily to the sewer huge volumes of a reusable high-quality resource: dialysis process derived water.

    from SHEBA on 08 August 2009 | Direct link | Comment on this

  3. Using water wisely: New, affordable, and essential water conservation practices for facility and home hemodialysis

    John W. M. AGAR et al., Hemodialysis International 2009; 13:32–37 Despite a global focus on resource conservation, most hemodialysis (HD) services still wastefully or ignorantly discard reverse osmosis (R/O) "reject water" (RW) to the sewer. However, an R/O system is producing the highly purified water necessary for dialysis, it rejects any remaining dissolved salts from water already prefiltered through charcoal and sand filters in a high-volume effluent known as RW. Although the RW generated by most R/O systems lies well within globally accepted potable water criteria, it is legally "unacceptable" for drinking. Consequently, despite being extremely high-grade gray water, under current dialysis practices, it is thoughtlessly "lost-to-drain." Most current HD service designs neither specify nor routinely include RW-saving methodology, despite its simplicity and affordability. Since 2006, we have operated several locally designed, simple, cheap, and effective RW collection and distribution systems in our in-center, satellite, and home HD services. All our RW water is now…

    from SHEBA on 31 May 2009 | Direct link | Comment on this

  4. Clinical Waste Generation from Renal Units: Implications and Solutions

    Nicholas A. Hoenich et al., Seminars in Dialysis — Vol 18, No 5 (September–October) 2005 pp. 396–400. The treatment of end-stage renal disease (ESRD) makes extensive use of presterilized disposable items which, after use, are contaminated by bloo

    from SHEBA on 31 May 2009 | Direct link | Comment on this

  5. Single-Use versus Reusable Dialyzers: The Known Unknowns

    Ashish Upadhyay et al. in Clin J Am Soc Nephrol 2: 1079-1086, 2007 The practice of reusing dialyzers has been widespread in the United States for decades, with single use showing signs of resurgence in recent years. Reprocessing of dialyzers has traditio

    from SHEBA on 31 May 2009 | Direct link | Comment on this