Out-patient clinics

This clinic will probably be the first time you meet the kidney team. Your GP or another hospital specialist will have made the referral to us and should have explained the reasons why.

We will review you and make a detailed assessment to try to address the reason for referral.

You may want to bring a relative or friend – if so they are very welcome. If you have any questions or concerns it might be worth writing them down before you come. The doctor may ask you this at the start consultation. Hopefully we should be able to provide you with some of the answers to them by the end or, if not, explain about further tests that might be needed.

Please bring the following:

1. A list of your current medications

2. Urine sample – about 10-20 mls in a clean container.

Some patients will have a kidney scan booked on the same day and you should receive a separate appointment time for this.

Clinics

Tuesday

• City Hospital Renal out-patient clinic 09.00 - 12.00
• King's Mill Renal out-patient clinic 14.00 - 17.00

Thursday

• King's Mill Renal out-patient clinic 14.00 - 17.00
• Lings Bar Renal out-patient clinic 14.00 - 17.00

Friday

• City Hospital Renal out-patient clinic 09.00 - 12.00

Consultant review clinics are where the majority of patients receive their follow up care.

Patients will be under the care of a named consultant. The consultant will often be working alongside a specialist registrar. At the end of each clinic the doctor will arrange your next appointment. Appointments may also be made by the ward teams at the end of a hospital admission.

Monday

• Dr Devonald
  • City Hospital Renal out-patient clinic 13.30 - 17.00
• Dr Bissett
  • City Hospital Renal out-patient clinic 14.00 - 17.00

Tuesday

• Dr McHaffie
  • City Hospital Renal out-patient clinic 14.00 - 17.00
• Dr Bebb
  • City Hospital Renal out-patient clinic 14.00 - 17.00
• Dr Hall
  • City Hospital Renal out-patient clinic 14.00 - 17.00
• Dr Byrne
  • King's Mill Renal out-patient clinic 14.00 - 17.00
• Dr Allen
  • King's Mill Renal out-patient clinic 14.00 - 17.00

Wednesday

• Dr Ferraro
  • City Hospital Renal out-patient clinic 14.00 - 17.00
• Dr Roe
  • City Hospital Renal out-patient clinic 14.00 - 17.00

Thursday

• Dr Jesky
  • King's Mill Renal out-patient clinic 14.00 - 17.00
• Dr Poduval
  • King's Mill Renal out-patient clinic 14.00 - 17.00
• Dr Patel
  • Lings Bar out-patient clinic 14.00 - 17.00

Patients who have advanced impairment of their kidney function need specialist care to manage their health, as well as plan for the future.

This is obviously a concerning time for anyone in this situation. We provide a programme to help you understand what is going on and help manage your care. This may involve some or all of the following:

• One to one consultations with the nurse specialist
• Home visits
• Group information sessions
• Regular clinic consultations with your renal consultant or their registrar
• Dietician support

We aim to encourage patient empowerment and facilitate shared decision making to get the right decision for you.

Your kidney consultant will discuss this programme with you when they think it’s necessary.

The team is led by Sister Maria Fish and she is supported by Sisters Jo Prest, Helen Kirkman and Jane Pikett.

Clinics

• City Hospital renal out-patient clinic
  • Monday 09.00-12.00
  • Tuesday 09.00-12.00
  • Friday 09.00-17.00
• King's Mill Hospital renal out-patient clinic
  • Tuesday 14.00-17.00

We have a team of specialist nurses who manage this part of your treatment. They are all fully qualified prescribers. They review your blood tests regularly and decide on the treatment required.

More information is available here

If you need to have an intravenous infusion of iron you will be sent an appointment to attend this clinic.

Clinics

• City Hospital Renal out-patient clinic
  • Daily Monday-Friday
• King's Mill Hospital out-patient clinic
  • Tuesday 14.00-17.00

Anaemia team – Di O’Donnell, Kate Taylor, Glen Weston and Kat Kalinowska

Patients with kidney disease can develop problems with their bones and skeleton. This might cause no symptoms but could result in pain in your bones or joints. It can also increase the risk of a broken bone.

This clinic provides expert assessment of patients who are at risk or have suffered kidney related bone disease. The doctor will review your background health conditions and assess you bone health based on blood tests, bone scans or x-rays.

Recommendation about your treatment will be discussed with you and advice then forwarded to your GP.

• Dr Simon Roe
  • City Hospital Renal out-patient clinic
  • Friday 14.00 - 17.00 (once per month)

For women with kidney disease, pregnancy can be complicated by the body not responding as normal to hormonal changes that stimulate changes in body fluid and salts. In the past, some women with kidney disease would have been told that pregnancy would be too dangerous to contemplate. Over the last few decades there have been massive improvements in pregnancy success rates for women with kidney disease, and it is very rare for women to be advised that having a baby is not an option nowadays. This is even the case for women who have had kidney transplants and for some women receiving dialysis.

There are increased risks of babies being born smaller and earlier than normal at all stages of kidney disease however. Medicines that women with kidney disease are commonly prescribed are not always suitable during pregnancy either. For women with more severe kidney disease, pregnancies may damage their kidney function more quickly than expected and a condition called pre-eclampsia is more common if women have kidney disease.

Nottingham Kidney and Transplant Centre work with Nottingham City Maternity Unit to run a renal-obstetric clinic. This service is run by Miss Suzanne Wallace, Dr Alastair Ferraro, Dr Matt Hall and Dr Jenny Allen who each have specialist experience in looking after women with kidney disease before, during and after pregnancy. Clinic visits are run by renal and maternity consultants at the same time so that women do not need to attend separate appointments.

 

Referrals for pre-pregnancy counselling are particularly encouraged for all women with kidney disease and are accepted from renal and obstetric clinicians, GP practices and patients. The clinic offers:

• Medication management advice

• Advice on timing of a pregnancy and contraception

• Discussion regarding pregnancy risks, individualised to each patient

• Fertility and assisted conception advice

During pregnancy, the clinic co-ordinates care with community teams to complement standard care with additional monitoring visits and investigations, delivery planning and involvement of other specialist teams when required.

General advice for patients is available here in a leaflet designed by Kidney Care UK.

Clinic

• City Hospital Obstetric clinic
  • Thursday 14.00-17.00

Nottingham Renal Unit run a fortnightly clinic assessing and monitoring treatment with tolvaptan for patients with autosomal dominant polycystic kidney disease (ADPKD). Tolvaptan is a novel therapy shown to slow down the progression of kidney disease for certain patients with ADPKD.

Assessment for therapy includes evaluation of laboratory results, images from radiology procedures and collaboration with the clinical genetics team. The clinic also addresses broader elements of chronic kidney disease and ADPKD care including pain management, liver involvement, brain aneurysm screening and planning for renal replacement therapy.

Care is coordinated by Sr Maria Fish, Dr Mark Jesky and Dr Matt Hall. Referrals are welcomed from nephrology colleagues, clinical genetics and primary care providers.

• Dr Hall and Dr Jesky
  • City Hospital Renal out-patient clinic
  • Wednesday 14.00-17.00 (alternate weeks)