Vascular access hygiene is an integral component of haemodialysis care. Ensuring nurses possess sufficient knowledge and utilise recommended guidelines on infection control is essential for safe practice and patient safety. This study aimed to investigate nurses’ knowledge and practice of vascular access infection control among adult haemodialysis patients in the Republic of Ireland.

The paper describes the need for the introduction of an anaemia management algorithm. The method used to create and use the algorithm is explained. The findings demonstrate the beneficial effects of using the algorithm. The paper concludes with the recommendation that algorithms should be more widely used for better treatment outcomes.

Training provided by dialysis nurses to the patients is of great importance in peritoneal dialysis (PD). This study aimed to examine how PD patients continue with the training and practice taught in this unit and correlate these data with the incidence of peritonitis. Results showed that the dialysis environment is as important as the patient’s knowledge or skill in exchanges.

Milk Alkali Syndrome is a cause of hypercalcaemia, renal failure and alkalosis, and is potentially reversible if detected early and the calcium and alkali source withdrawn.  It was originally described in patients ingesting large amounts of calcium containing milk for the treatment of peptic ulcer disease.  We present a modern day version of the syndrome in three cases which were associated with excessive intake of Rennie^®, a calcium carbonate containing antacid.

Although traditionally considered the domain of the renal technologist, many units do not have technicians or may only have part time access to one. In these cases, it often falls to nursing staff to ensure that patients are dialysed safely. Water quality is an area in which some nurses do not feel confident. This article provides information about the importance of appropriate water treatment, water testing and monitoring and the implications to the patient if the water is not checked appropriately in accordance with the guidelines.

Antibodies in the blood of a kidney transplant recipient can provide a barrier to transplantation that is additional to the usual possibility of cellular rejection. About 250 living donor transplants each year in the UK have been stopped because of an antibody barrier. It is now possible to offer a choice of treatment modalities to these people, including exchange transplantation and antibody incompatible transplantation. It is likely both schemes will complement each other, and both are available in the UK. It is now possible to achieve excellent short term graft survival in patients who until recently were denied transplantation.

Little is known about those patients who withdraw from or decide not to commence dialysis. This literature review will advance understanding of dialysis refusal and withdrawal in relation to the experiences of patients and carers and explore the trajectory to death of those abating dialysis. It explores the needs of this population with regard to modern palliative medicine.

Vascular access for renal replacement therapy (RRT) is seen as one of the most challenging areas confronting the nephrology multidisciplinary team. A successful vascular access programme requires forward planning ensuring that enough time is available for the preservation of the access site, its creation and maturation. This paper will explore the part of the nephrology nurse’s clinical expertise and knowledge on the management of different types of vascular access including different cannulation techniques.

The paper discussed was a report entitled "Cannulating in haemodialysis: rope-ladder or buttonhole technique?" published in Nephrology Dialysis Transplantation. The authors agreed to follow the discussion and respond to points raised. Expert contributors from thirteen different countries provided evidence, opinion and historical insights into vascular access techniques for chronic haemodialysis patients. The discussion included expert advice on needling protocols, track formation and the sharp vs. blunt needles debate. The discussion covered some of the potential barriers to its introduction and offered advice on also how to overcome some of these issues.