Renal services at Royal Derby Hospital are based around a 24-bedded inpatient area (including a 4-bedded Renal high dependency area and another 4 bedded Medical high dependency area), and a 56-station chronic haemodialysis unit. With the reconfiguration of services in 2006, there has been increase in MDT involvement, both in in-patient and out-patient services.
The renal unit has a dedicated outpatient area with all the clinics held there. The outpatient area has treatment rooms where intravenous iron is administered by the kidney care team. The clinics are multi-disciplinary with involvement from dieticians, dialysis nurses, anaemia nurses, pharmacists, kidney care nurses and other professionals namely, vascular consultant and diabetologist. The unit has variety of clinics on various days: low clearance, nephrology, transplant, haemodialysis, peritoneal dialysis, home haemodialysis, anaemia, transplant transition, vascular access, joint renal and diabetes and anaemia clinics.
The in-patient area will have a higher skill mix related to acuity. The ward area has a procedure room, allowing for the placement of temporary lines and renal biopsies. Dedicated ultrasound equipment is based within this area. The High Dependency Unit is monitored, with the ability to deliver renal replacement therapy, plasma exchange or MARS therapy at the bedside. All beds are monitored with ability to measure intra-arterial BP with inotropic support. In addition the Intensive Care Unit is based below the renal ward. The Intensivists and Nephrologists manage all cases of acute kidney injury within the Intensive Care Unit jointly.
The unit covers a population of between 700,000-1,000,000, providing both acute and chronic renal failure support. 80% of the workload is based around Southern Derbyshire, but parts of South Staffordshire (Burton), North Derbyshire and North West Leicestershire are also served by the unit. The unit has dedicated home haemodialysis training facility and also has 9 isolation beds. The haemodialysis unit offers an adolescent service, daily HD, extend online convective therapies and have expanded isolation facilities. The community programme will continue to expand home HD by 4-6 patients per annum.
There are 210 patients on unit-based haemodialysis, 34 patients on home haemodialysis and 85 patients on peritoneal dialysis. The unit also follows approximately 200 transplant patients. The transplant patients are followed up 6 months after the transplant surgery.
The department carries out between 150-200 renal biopsies per year, and place 150-200 catheters (tunnelled haemodialysis or CAPD) under X-ray guidance.
A satellite medical school opened in September 2003, taking postgraduate students. In addition, Royal Derby Hospital provides placements for Nottingham University medical students. The renal department is at forefront in teaching both undergraduate, graduate entry medicine and postgraduate medical student
There are ample opportunities for involvement in medical education and clinical research. There are currently five research registrars in post, access to research nurses and one research dietician. Research interests within the dialysis unit include progression of chronic renal disease, acute kidney injury, renovascular disease, cardiovascular disease, dialysis stability and adequacy. In the last 6 years more than 120 peer reviewed articles have been accepted for publication. Professor Maarten Taal is the Chair of Medicine, and Dr. Nick Selby honorary associate professor, both at the University of Nottingham.