General Hospital Services The Nephrology Department

This department provides care for patients with Kidney Disease and Hypertension. The main clinical areas are:

The Haemodialysis Unit
The Peritoneal Dialysis Service
The Renal Out- Patient service
Renal Transplant care

The Haemodialysis Unit.

This Unit is located in a dedicated floor above the Maternity Ward and hosts all aspects of the clinical and Administrative Renal Service excepting In-Patient admissions.

This unit opened in June 1998 and has grown into a 22 station facility. The Daisy Hill unit is one of 5 haemodialysis facilities in Northern Ireland, and provides haemodialysis treatment for patients in the Southern Board. This dialysis centre also caters for patients from North Louth and provides holiday dialysis.

The unit operates three shifts from 8am to 12pm Monday to Saturday. Haemodialysis therapy is currently provided to 93 patients.

Contact number: (028) 30835035, 30835036 or 30835000 ext. 2435

Fax number: (028) 30257307

Senior Personnel

Nurses	Kate Cunningham Joan O’Hagan	Ward Manager Clinical Sister
Medical Staff	John Harty Paul McKeveney Michelle Hollywood	Consultant Consultant Associate Specialist
Secretarial	Helen McCaul
Technical	Joe Smith
Dietician	Hiliary Mathieson
Pharmacy	Noreen Brown Cathy Thompson
Social work	Deidre Teer Edel Conn
Podiatrist	David McCurdy

The Peritoneal Dialysis (PD) Service

The Daisy Hill Site provides a comprehensive Peritoneal (Home) dialysis service. All aspects of peritoneal dialysis are catered for including; Home Training, Outpatient monitoring, In-Patient care and Peritoneal dialysis catheter placement. Peritoneal dialysis therapy is currently provided for 18 patients.

Contact number: (028) 30835170 or 30835000 ext 2257

Fax number: (028) 30257307

PD sister: Fiona Owens

The Renal Out-Patient service

The Renal Consultants provide this service on an alternative month basis (Dr Harty – Jan, Mar, May …, Dr McKeveney Feb, Apr, Jun …) Referrals should thus be directed to the “Nephrology Department”.

Both consultants encourage telephone consultation in cases where management advice rather than referral may be more appropriate.

This service caters for all aspects of medical renal disease and provides a comprehensive investigation programme including renal biopsy, CT renal angiography and Ambulatory Blood Pressure measurement.

Clinics take place in dedicated rooms on the Haemodialysis Unit. Renal Ultrasound and Phase contrast microscopy are available at the clinic. A Renal Dietician is available at the weekly clinics.

Contact number: (028) 30835036 or 30835000 ext 2436

Fax number: (028) 30257307

Referral criteria

Acute renal impairment or failure.
Advancing chronic renal failure – creatinine > 150
Proteinuria – Nephrotic syndrome
Difficult hypertension
Multisystem disease with suspected renal involvement.
Advancing diabetic nephropathy

Clinic Timetable

Monday

Tuesday

Wednesday

10am – 12pm

PD clinic – Week 1

Access clinic – Week 2

Drop in clinic

1.30pm– 4pm

General Nephrology

Low Clearance – week 1, 2, 3

Transplant clinic – week 4

New Patients

Low-Clearance Clinic

This clinic is dedicated to patients with advanced and progressive kidney disease who are likely to ultimately require dialysis therapy. Such patients receive specialist care including;

Education and counselling for dialysis including choice of dialysis modality (haemodialysis or peritoneal dialysis)
Anaemia management – intravenous iron and EPO treatment.
Local vascular access planning
Pre-dialysis transplant work-up

Virtual clinics

These include outpatient anaemia management and Nephrology Advice clinics. This is a telephone clinic set up in partnership with GP's providing advice on management of CKD in the community using eGFR guidelines as an alternative to clinic referral and hospital follow-up.

Renal Transplant Care

A dedicated Renal Transplant clinic is undertaken each month and currently facilitates 45 patients. Patients are usually transferred to this clinic 4 months after receiving a kidney transplant, for long term care.

Monitoring of immunosuppressive therapy.
Regular liaison with Transplant Surgeon.
Transplant biopsy – when required.

There is an active patient support group, which meets on the first Tuesday of each month at 7.30pm on the Renal Unit. This group provides feedback on all aspects of patient care (including use of patient satisfaction surveys) and guides the future development of the Renal Service.

Research

This Unit participates in collaborative research with the renal unit at Belfast City Hospital. Current work focuses on the epidemiology of chronic renal failure and its interface with Primary Care. This has led to the development of Chronic Kidney Disease management and referral guidelines.
There is active collaboration with the Clinical Biochemistry Department (Craigavon Area Hospital) into markers of cardiac disease in dialysis patients. This has led to published work on the utility of Troponins in haemodialysis patients.

There is a weekly renal teaching programme for non-nephrology medical staff. There is also regular multi-professional renal teaching for haemodialysis staff.
This unit participates in the Northern Ireland Nephrology SpR teaching programme and Regional Audit. Teaching is facilitated by the use of a video-conferencing link with the Belfast City Hospital Nephrology Unit.