People with advanced kidney disease are required to make many choices about their treatment throughout the journey of this disease. Opting not to have dialysis or to withdraw from treatment is a difficult decision and there are many factors that influence patients’ decisions. For those who choose not to have dialysis, the implications need to be understood by the patient, their family and carers and healthcare professionals involved in their care. This article provides an update on this important issue to equip primary care professionals with a clear understanding of end-of-life care for patients with advanced kidney disease.
Making sense of chronic kidney disease
What exactly is chronic kidney disease (CKD), what causes it and how is it diagnosed? In this article we get down to the basics of defining what CKD is, and explore the stages of CKD. We review CKD progression and the assessment and management recommendations for each stage of CKD.
Kidney damage and what it means to you
Back to Basics: Secondary prevention for the four types of coronary artery disease
Back to Basics: What goes wrong in atrial fibrillation (updated September 2011)
Back to Basics: Using ABCD2 score to assess stroke risk in TIA
Back to Basics: Assessing risk of stroke in atrial fibrillation
Back to Basics: How to use the GRASP – AF tool to reduce risk in patients
Proteinuria: should it replace cholesterol as a marker for people at high risk of CVD?
We have all seen paintings of early physicians looking at flasks of urine to give an indication of a person’s health. And most of us can remember days of rows of urine pots lined up to test for new patients in primary care and in hospital outpatient clinics. We may assume that those days have gone in the era of blood testing and CT scans. So why are we suggesting that urine testing has a central role in finding patients with previously undiagnosed cardiovascular disease?
Editorial – Going back to basics in cardiovascular disease
There are 28 cardiac and stroke networks in the country. They play an important part in implementation of national strategies, enabling high-quality services to be planned and delivered to patients within the framework of primary and community care. One of the most useful contributions of the networks is provision of education and training for primary care staff. The “Back to Basics” material in this supplement forms the backbone of what is presented at study days. The articles cover some of the most common cardiovascular conditions that are seen in primary care, showing clearly what causes the symptoms, how best to assess and manage patients, and how the treatments actually work. They help healthcare workers both to understand these conditions and to explain them to patients, and therefore really improve patient care.
A primary care guide to chronic kidney disease
Chronic kidney disease (CKD) has shot up the primary care agenda over the last few years, and is now well recognised as an independent risk factor for cardiovascular disease (CVD). At the same time, CVD is a risk factor for progression of CKD. The close links between CKD and CVD mean we have to get […]
Why does atrial fibrillation increase the risk of stroke?
Each year there are 150,000 strokes in the UK. Nearly one in five (18%) of the people presenting with a stroke are in atrial fibrillation (AF) at the time of presentation, and one in six strokes are directly attributable to AF. The risk of stroke in AF is reduced by two-thirds with oral anticoagulation, while antiplatelet therapy reduces stroke by one-fifth. The reduction with antiplatelet therapy is broadly consistent with the stroke reduction seen with this therapy in patients with vascular disease or risk factors, and, given that AF largely coexists with vascular disease, the effect of antiplatelet therapy would probably reflect this. The risk of stroke is similar with paroxysmal or permanent AF, in the presence of associated risk factors.
