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Kidney Failure Explained (Class Health)

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This is a book about kidney failure. It has been written primarily for people with kidney failure. But, as any partner, friend or family member of a kidney patient knows, kidney failure is a family business. ‘They’ also usually want to know as much as possible (sometimes even more than the patient) about the disease. So this book is also for ‘them’, the silent support that keeps a kidney patient alive.

The idea for this book came at the end of a dinner I had with a group of 20 or so peritoneal dialysis patients in 1995. I had gone away with them on an ‘adventure weekend’ to North Wales. It was a dark and blustery winter’s night. At the end of the meal, I asked them what they hated most about kidney failure. I expected answers like: ‘the arrogance of the doctors’, ‘having to take Calcichew tablets’, ‘the never ending drudgery of doing four peritoneal dialysis exchanges every day’. But I was wrong. The patients all said that the worst thing was the ‘lack of information on kidney failure’.

I knew I could give them what they wanted. So, that night, I promised them that I would write them a book describing all aspects of kidney failure. They said they wanted a book that was understandable, hard-hitting and truthful. They didn’t want to be patronised. They didn’t want wool pulling over their eyes. If kidney failure was to kill them, they wanted to know, and when, and why. So I make no apologies to those kidney patients who ‘don’t want’ to know. I believe that they are only a small proportion of the total and that they probably will not buy this book anyway.

The book would never have come to fruition without my co-author, Janet Wild, who has many years’ experience as a senior kidney nurse. Janet and I have written most of the book. Five of the other chapters have been written or co-written by friends of ours, all of whom currently work in kidney medicine: Gemma Bircher (Diet), Peter Ellis (Dialysis), Jean Hooper (Psychological Aspects), Ian Lawrence and Catherine Nelson-Piercy (Sexual Problems). The new chapter on ‘Death and Dying’ has been written by Juliet Auer who has a background in social work and is currently Renal Support Manager at the Oxford Kidney Unit.

As in all aspects of medicine, different doctors favour different ways of treating patients. I have tried to present the views of the majority in this book. I have also tried to point out controversial areas – either where we don’t really understand things (for example, why kidneys fail in the first place) or where there are real differences of opinion (such as which treatment is ‘the best’, or when a treatment is available in one kidney unit but not in another). The limitation of the treatments currently available is one of the themes of the book.

Over the past few years, whenever I get frustrated about the inadequacies of the NHS or the England cricket team, my mind turns back to that dark night in Wales. I am glad that my computer somehow drew me to fulfil my promise.
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