Nicola Thomas - Renal Nursing

This edition first published 2014, 2014 by John Wiley & Sons, Ltd.
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Library of Congress Cataloging-in-Publication Data
Renal nursing / edited by Nicola Thomas. Fourth edition.

p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-118-41064-6 (pbk.)
I. Thomas, Nicola, editor.
[DNLM: 1. Kidney Diseasesnursing. WY 164]
RC918.R4
616.6'140231dc23

2013019908

A catalogue record for this book is available from the British Library.

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Cover image: 123RF KrishnaKumar Sivaraman.

Cover design by Meaden Creative.

Contributors

Diane Blyton RN (Child), BN (Hons), MSc
Paediatric Renal Nurse Educator, Nottingham Children's Hospital, Nottingham, UK

Paul Challinor RN, BSc, DN
Nurse Director, B. Braun Avitum, UK

Charlotte Chalmers BSc (Hons), PhD
Lecturer in Biological Sciences, Edinburgh Napier University, Edinburgh, UK

Ratna Das

Annette Davies RGN, BSc (Hons), PGCAP, MSc
Tutor in Acute Care, University of Surrey, Guildford, UK

Victoria Dunsmore RGN

Clinical Nurse Specialist in Transplantation, Barts Health NHS Trust, London, UK

Barbara Engel BSc Biochem, RD, PhD Senior Tutor, Nutrition & Dietetics, Surrey University, Guildford, UK

Brian Gracey MA (Hons)
London, UK

Linda Gracey RGN
London, UK

Shelley Jepson RGN, RSCN, BSc (Hons), MSc
Lead Nurse, Children's Renal and Urology Unit, Nottingham Children's Hospital, Nottingham, UK

Fiona Loud BA (Hons)
Kidney Alliance and Lister Area Kidney Patients Association, West Herts Hospital, St Albans, UK

Althea Mahon RGN, BSc, MSc
Consultant Nurse, Denali Medical Services, Perth, Western Australia

Claire Main RN (Adult), BSc (Hons)
Clinical Education Manager for Renal Division, Baxter Healthcare, Newbury, UK

Shahid Muhammad BSc (Hons), BMS, MRes, LIBMS
Biomedical Scientist Practitioner, Renal Patient Support Group Chief in Research and Paediatric Nephrology Researcher, Bristol, UK

Fiona Murphy RGN, RNT, BSc (Hons) Renal Nurs, BSc (Hons) Health Stud, PGDip Adv Nurs Scie, PGDip CHSciEduc, MA, MSc, PhD (c)
Assistant Professor, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland

Fliss Murtagh PhD, MRCGP
Clinical Senior Lecturer and Consultant in Palliative Care, King's College London, Cicely Saunders Institute, London, UK

Nicola Thomas RGN, BSc (Hons), MA, PhD
Independent Renal Nursing Consultant and Senior Lecturer, London South Bank University, London, UK

Foreword

People with kidney disease have a wide range of needs. These needs include encouragement to achieve the behavioural change goals they have set themselves, support on dialysis, education about their condition, traditional basic care needs delivered with kindness and an understanding of the complexity of renal disease, often occurring with a range of other co-morbidities. The skills and competencies required to address these needs are the foundation of high quality renal nursing care. Looking after people with kidney disease is a hands-on' job requiring an understanding of psychology your own, the patients, the carers and the families; knowledge of the biology and pathophysiology of the kidney; expertise in the nursing of the acutely unwell and the management of complex long-term conditions, as well as emotional resilience.

People with kidney disease need to be involved in their care and decisions about their care if outcomes are to be optimised. Renal nurses are the leaders of the kidney care multiprofessional team. Not only do renal nurses bring their understanding of kidney disease and the experience of managing others in a similar situation they must also be the advocates for holistic care and involve patients and carers in shared decision making. They must be sensitive to the individual who has a disease that is common or rare, but whose experience is unique and who needs support and encouragement appropriate to his/her age, cultural background and degree of health literacy.

Kidney disease is common, harmful and often treatable. Although much progress has been made in identifying chronic kidney disease earlier and delaying the need for dialysis and transplantation, the number of people affected by kidney disease grows each year. In China alone there are 120 million people with kidney disease and it is expected that 1 million Chinese will be receiving dialysis by 2020. Globally 15 million people each year develop acute kidney injury resulting in over 1.5 million deaths. Many survivors of acute kidney injury do not recover completely and go on to develop progressive chronic kidney disease. In the United States, costs of end-stage kidney disease are over 6% of the total costs of healthcare. To change this trajectory we need to support our healthcare systems to address the increasing burden of hypertension, diabetes and obesity. That means helping individual people make healthier choices at whatever stage of kidney disease they are at. In healthcare, quality is added by the direct interactions between healthcare professionals and our patients. Renal nurses have a crucial role in adding quality to care.