This clinic provides follow-up care for patients with kidney disease after they have been seen in the new patient clinic or after an admission to hospital. Most patients coming to the clinic have either had acute kidney injury or have chronic kidney disease. More information about these conditions is provided below.
Many people have kidney disease, but can live a healthy life despite this.
It is important that we know what has caused the kidney disease and prevent it from doing further damage. Therefore, the main aim of the general nephrology clinic is to investigate and the prevent kidney problems from getting worse.
Emphasis is placed on treatment of the kidney disease, control of blood pressure and the management of any problems that might arise as a consequent of the kidney disease.
Kidney disease can become quite advanced before it causes any symptoms. For this reason, regular blood and urine tests are required to monitor the condition, even if you feel completely well. Without this regular monitoring, your kidney condition may progress to a point where it’s too late to prevent serious damage.
Quite often, this monitoring can be done by your GP, so we will only ask you to continue attending the clinic if we think that you get extra value from coming. For instance, if your condition requires specialised tests that your GP can’t easily do, or if you require treatment that can only be prescribed by hospital doctors.
What you can expect
You will be asked to provide a urine sample for testing at each visit. Your weight and blood pressure will be checked the clinic nurse before you see the doctor. The consultation with the doctor will last 10-15 minutes at most. Once you have seen the doctor you will usually be asked to have a blood test. If you need to continue attending the clinic, you will usually be given a further appointment before you leave, but sometimes the appointment will be sent to you in the post.
Please bring a complete list, including doses, of all the medicines you are taking to the each clinic visit (not just the medicines for your kidney condition). This makes it much easier for us to advise on changes to your treatment. Every patient is different, so there is seldom one treatment that is right for everyone. So we encourage you to prepare questions in advance for your consultation. For instance
- What are my options?
- What are the benefits and possible risks?
- How likely are these risks and benefits?
After the clinic appointment you will receive a letter (also sent to your GP) to summarise what was agreed during the consultation. Depending on the results of the blood tests, your appointment may be changed, or you may be asked to have additional tests.
Acute kidney injury (AKI)
Acute kidney injury means a sudden reduction in kidney function. It does not mean a physical injury to the kidney. A good explanation can be found at: https://www.thinkkidneys.nhs.uk/information-for-the-public/
Many patients with acute kidney injury make a complete recovery. however, even if recovery appears complete, it is worth checking kidney function at least once a year with additional tests during acute illness, for instance stomach upsets or severe infections
Chronic kidney disease (CKD)
Chronic kidney disease is the accepted term for long-lasting kidney damage. The word ‘chronic’ doesn’t mean that the condition is severe, just that it is long-lasting (as opposed to ‘acute’ when it comes on suddenly).
The severity is graded by estimating how well the kidneys are clearing waste products from the blood stream, and by doing measurements of the amoung of albumin in the urine. Albumin is the main protein that leaks out into the urine when the kidney filters are damaged.
More information on CKD can be found at:
- NHS website
- National Institute for Health and Care Excellence (NICE). NICE provide guidelines on how many medical conditions should be treated in the NHS
Further resources
The more patients understand their condition, the better it is for the patient and the medical team. So we encourage patients to know the results of the blood tests we do in clinic, and what these tests mean. the easiest way to do this is for patients to be given access to their own test results on a website called PatientView: https://www.patientview.org/#/
If you are interested in this, please ask in clinic and you will be given a form to sign.
http://healthtalk.org/peoples-experiences/long-term-conditions/kidney-health/overview – a series of videos of people explaining kidney disease, including patients talking about their experiences
