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Stevenage

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Address:

Coreys Mill Lane,
Stevenage,
Hertfordshire

Post Code:

SG1 4AB


Patients were first dialysed here in 1995

This unit has 360 haemodialysis and 50 peritoneal dialysis patients

This unit has the following transplant centres:

Cambridge - Addenbrooke's Hospital

London - West London Renal and Transplant Centre

This centre has the following satellite units:

Luton

St Alban's


unit image

Lister Hospital


Telephone number:

01438 781309

Holiday dialysis enquiries:

Fax:

01438 781174

Email Address:

Unit website:

Trust website:

Consultants:

Dr R N Greenwood
Prof K Farrington
Dr P Warwicker
Dr S Fluck (0.3 WTE)
Dr B Thompson (0.6 WTE)
Dr M Suresh
Dr M Siva
Dr S Chandna (Locum Consultant)

Page administered by:

Dr P Warwicker


About the unit

Renal services based at the Lister Hospital in Stevenage were introduced in December 1988 by Dr Roger Greenwood; the first patients receiving dialysis in May 1989.

The main haemodialysis unit, positioned adjacent to the main entrance of the Lister hospital comprises 20 stations. There are 24 beds dedicated to in-patient nephrology on level 6 of the main tower block of the hospital. This houses facilities for acute haemodialysis. The Renal Unit also houses a seminar room, a technical laboratory, patient examination rooms, and a number of offices. There is also a separate CAPD unit comprising an office and training area.

With dialysis facilities at St Albans City Hospital (16 stations) and Luton and Dunstable Hospital (23 stations), the Lister Renal Unit is recognised as an autonomous tertiary referral centre for renal medicine serving most of Hertfordshire and Bedfordshire, a catchment population of 1.2m. Patients are referred from East and North Herts (The Lister and QE2 Hospital, Welwyn), West Herts (St Albans and Hemel Hempstead Hospitals), South Beds (The Luton and Dunstable Hospital), and North Beds (Bedford General), with some support provided for West Essex(Princess Alexandra Hospital, Harlow).

The Lister Renal Unit pioneered high flux haemodialysis individualised by kinetic modelling and introduced haemodiafiltration as “standard” treatment for ESRD in the early 1990’s.

Currently there are around 360 patients on haemodialysis/haemodiafiltration and around 50 patients on CAPD/APD. The unit was one of the first in the UK to introduce non-dialytic conservative management as an alternative treatment modality in ERF.

Information technology is ingrained into the day to day running of the clinical service. A computer network (Renal Plus) links the haemodialysis units in St Albans, Luton and the Lister, Nephrology ward, CAPD unit and Outpatients areas. There are workstations in all offices, consulting rooms and clinical areas. The network provides a clinical computing system and facilities for resource management and audit. Pathology data are automatically downloaded into the network. The unit has played a leading role in clinical computing applied to renal failure and dialysis.

There are a number of developments which will take place during 2007/8. The dialysis unit at the Lister will be extended to 25 stations. An area adjacent to the Haemodialysis Unit on level 3 will be developed as the Home Therapies Unit (Peritoneal Dialysis and Home Haemodialysis). The development will also contain additional consulting rooms, training facilities and offices, and will house the Lee Haynes Renal Research Institute – a multidisciplinary facility dedicated to clinical and patient orientated research.


Research and special expertise

The Renal Unit at the Lister is regarded as one of the foremost centres for dialysis research in the UK, and enjoys an excellent reputation in the field both in Europe and the US. The level of expertise extends across the whole team - medical, nursing and technical.

Urea Kinetic Modelling:
There are several interrelated streams - all addressing the issue of applying, measuring and optimizing dialytic and haemofiltrative therapies. Our research into adequacy of dialysis, and calculating dialysis dose in haemodialysis has informed developments in the field since the early 90s and more recently highlighted the importance of residual kidney function in calculating adequacy. This urea kinetic modelling research, has underpinned our development.

Haemodiafiltration:
At the Lister we have pioneered the process of haemodiafiltration in the UK, and a majority of our patients receive this form of renal replacement therapy. There are at present only a handful of other centres that offer haemodiafiltration in the UK, although it is now rapidly gaining acceptance in mainland Europe and the US. We are currently undertaking studies into the advantages of the process, and auditing our 10 year experience.

’Renal Plus’:
This novel computer programme has been developed and modified over the last decade, and is designed to augment clinical practice, facilitate clinical audit and research, and track patient care pathways. Our unique approach to clinically applied computing is called Renal Plus. Within the system, applied mathematical modelling allows us to deliver individualised dialysis doses, and ensure we meet adequacy targets.
The system has been taken on by a commercial company (CHI) and is offered free to the NHS, which is looking to expand the system to other renal centres in the UK. At present the Renal Unit at Shrewsbury has recently acquired the system, and two other centres in the UK and one in the Republic of Ireland have expressed an interest.

Involvement in DOPPS:
Dr Greenwood is one of two National Coordinators for the DOPPS study which correlates outcomes with the practice of dialysis in the USA, 6 European countries, Scandinavia, Australasia and Japan and has led to several publications.

Plasma exchange therapy, and novel approaches to the treatment of non diarrhoeal factor H related haemolytic uraemic syndrome:
We have pioneered novel approaches to the treatment of non diarrhoeal factor H related haemolytic uraemic syndrome (H-HUS). Using our approach we have published a report of the successful treatment of a patient, who not only survived this dangerous condition but is only the second patient in the world to recover independent (dialysis free) kidney function.

The role of segmental bio-impedance in the determination of fluid status in haemodialysis patients.
This is being carried out in association with The Renal Research Institute in New York and the Fresenius Dialysis Company. This is a novel technique using electrodes attached to a patient’s calf area to assess fluid status, and is being validated partly by the direct assessment of body compartment size by magnetic resonance imaging (MRI) and classical tracer dilution studies. The aim is to produce an inexpensive and non-invasive device which can be used in routine practice to better control blood pressure and fluid overload in dialysis patients.

Mathematical modelling of phosphate and Beta-2 microglobulin kinetics during haemodialysis:
This is being carried out in association with Dr Paul Chamney from the University of Hertfordshire and The National Amyloid Centre at the Royal Free Hospital.

Conservative management:
Our dialysis liaison team, directly translate research on conservative management to clinical practice, enabling patients to make, evidence based, informed decisions about whether or not to embark on renal replacement therapy. Dr Chandna’s seminal BMJ paper on co-morbidities, outcomes and rational dialysis continues to be widely cited.
Pre-dialysis studies including assessment and outcomes of patients with end stage renal failure choosing palliative management is being led by Maria da Silva Gane.

Home therapies:
We are in the process of setting up a home therapies department to promote, facilitate and study home dialytic therapies including peritoneal dialysis and home haemodialysis. We aim to achieve 15% of our haemodialysis population on home haemodialysis.





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