The department of Renal Medicine provides the following services:
- Haemodialysis (for patients with both acute and end stage renal failure)
- Home haemodialysis
- Peritoneal Dialysis
- Pre-dialysis management and education
- Renal transplant follow-up management
Haemodialysis
The Wolverhampton Renal Services has more than 300 patients on haemodialysis. The main unit at New Cross Hospital opened in 1987 and has been relocated and enlarged twice in 1993 and 2002. There are 21 haemodialysis stations currently accommodating 88 chronic haemodialysis patients.
The Walsall satellite dialysis unit is run by commercial partners and managed by the Trust. There are approximately 90 patients dialysing at the Walsall unit. We have two further satellite dialysis units, one at Cannock Chase Hospital and another at Pond Lane, Wolverhampton. Both of these units are owned and managed by the Trust and provide care for 72 and 48 patients respectively.
Home Therapies
In 2011 the Peritoneal Dialysis (PD) service and the expanding Home Haemodialysis programme were merged into a single Home Therapies Team.
The PD service is located adjacent to the main Renal Haemodialysis Unit at New Cross Hospital. There are currently almost 90 PD patients. The nurse-led team offer training, support and advice both for patients and relatives. Continuous Ambulatory Peritoneal Dialysis (CAPD), Automated Peritoneal Dialysis (APD) and assisted APD are the treatment modalities offered.
The Home Haemodialysis programme is steadily increasing, with presently 22 patients being treated at home. Training is provided within a dedicated training area in the department with a choice of two machines based on patient choice and clinical suitability.
Chronic Kidney Disease (CKD) Team
Within Renal Services, there is a nurse-led Chronic Kidney Disease team and an active cadaveric and living-related transplant programme.
Transplantation is performed at University Hospital, Birmingham. Fifteen to twenty of our patients are transplanted each year who are referred back approximately three months post-transplantation for long term follow-up. Kidney-Pancreas transplantation is undertaken by Oxford (Churchill Hospital) with referral back at the time of discharge.
The nursing team also provide an inpatient and outpatient service to patients with chronic renal failure (CKD Stage 4/5). This comprises of pre-dialysis management, education, advice on the suitability of all treatment modalities plus coordinating the timing of vascular and PD access surgery.
In-patient facilities
There are two 28-bedded wards split on gender lines. The male ward uses one of its side rooms for elective renal biopsy procedures and emergency PD patients presenting out-of-hours. An electronic alerting system and out-reach service for Acute Kidney Injury is also provided by the Consultant body.
Out-patient clinics
In terms of outpatient care, dedicated general nephrology, transplant, low clearance, haemodialysis and PD review clinics take place. There is an extensive palliative care service for patients for whom dialysis is not appropriate. Out-patient Nephrology clinics are held at New Cross Hospital, Walsall Manor Hospital and Cannock Chase Hospital.
Support Services
Dietetic support is provided by one part-time and two full-time dieticians who all work with patients with chronic renal failure (Haemodialysis, PD and pre-dialysis patients).
A dedicated psychology service provided in conjunction with colleagues in Psychological Health.
A Welfare Rights service is provided for all patients requiring information and advice on benefit entitlement.
The Renal Unit has a full complement of dedicated technicians providing technical support to service haemodialysis machines, other associated equipment and utilities. A 24-hour blood pressure monitoring facility is also provided.
Vascular Access
Vascular access is provided by consultant vascular surgeons who advise on the suitability of patients and the nature and type of access procedure most appropriate to the individual patient to allow them to undergo haemodialysis or PD. This service works on a spoke and hub basis with the hub based at Russells Hall Hospital, Dudley.
Three interventional radiologists provide a service for the investigation and the treatment of various problems associated with A-V fistulae and grafts including dilatation of fistula/graft stenosis and mechanical thrombectomy of blocked fistulae and grafts.
Inpatient services are provided at New Cross Hospital, with outreach outpatient clinics at Cannock Chase Hospital and Walsall Manor Hospital. Provision of inpatient and outpatient haemodialysis services are at New Cross Hospital with satellite haemodialysis services at Cannock, Walsall and South Wolverhampton.
Clinics occur daily Tuesday to Friday and there is a walk-in facility for urgent reviews. The service provided from New Cross Hospital has a Renal Consultant on-call 24/7
