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.