Events diary The 37th EDTN/ ERCA International Conference 6- 9 September, Prague, Czech Republic www. edtnaerca. org The theme for this year's conference is ' Improving the quality of renal care in Europe: building a bridge between theory and practice'. West Midlands Renal Audit 10 September, Walsall An all- day meeting for the West Midlands Renal Network covering dialysis, transplantation and nephrology issues. British Association of Critical Care Nurses - the 23rd National Conference 15- 17 September, York www. baccnconference. org. uk On stand 36 Gambro will be demonstrating our Prismaflex machine, the latest generation of CRRT equipment, and discussing the various therapies that can be delivered. We will also feature Taurosept, a catheter locking solution that helps to increase catheter patency. The 5th International Symposium on Clinical Applications of Serum Free Light Chain Analysis 18- 19 September, Bath www. biennial2008. org This conference will present the latest information on both heavy and light chain analysis for applications in monoclonal gammopathies and renal disease. Data from a trial of Gambro's HCO 1100 dialyser will also be highlighted. The 4th St George's Vascular Access Meeting 19 September, London www. vascularaccesssociety. com A one- day symposium on vascular access monitoring and methods. NKF Annual Patients' Conference 3- 5 October, Kenilworth www. kidney. org. uk/ conf08/ A varied programme including workshops on live donation and how to avoid muscle wastage. The Association of Renal Technologists National Meeting and Exhibition 29- 31 October, Northampton www. artery. org. uk The programme for this event includes international speakers and a technical workshop. ContactLouise Young 01480 444033 louise. young@ gambro. com 3 Customer survey shows service improvements Gambro DNA is about service development as well as product innovation. So we were especially interested in the results of the recent independent survey of renal physicians, managers, pharmacists, nurses and technicians. The results were encouraging, with an improvement on our performance compared with the previous year. We saw improvements in vital areas including the quality of our products, education and training. In fact our clinical nurses and trainers achieved the highest satisfaction rating, scoring half- way between the highest possible satisfaction level and the next second highest. This was the seventh such survey completed on behalf of Gambro, the first of which was initiated in 2002. Areas investigated included satisfaction with Gambro's products, customer communications, technical support, customer service, and the overall perception of us as a healthcare provider. For your copy of a report outlining the key findings of the survey, please contact Louise Young 01480 444033 louise. young@ gambro. com Gareth JonesCountry Manager, UK & Ireland by the liver is severely compromised. MARS therapy permits the transport of these toxins carried by an albumin dialysate via a special membrane, thus eliminating them from the blood. " It combines the benefits of customary extracorporeal renal substitution therapies with the possibility of removing albumin- bound substances. Water- soluble and albumin- bound toxins of small and medium size can be removed from the blood selectively and in a single step. The system means that the liver can be supported in detoxifying the blood and the prognosis and condition can be improved significantly." Clinical efficiency and cost benefits The major complications typical of severe liver failure, such as renal dysfunction or hepatic encephalopathy, increase the cost of treating each patient. The treatment cost further increases with multiple complications, taking up extensive ITU resources or on transplantation. By making use of MARS, these complications can be avoided or dealt with more quickly and effectively, and so the cost- effectiveness is clear. Gina Greenwood is in contact with intensive care units, transplantation centres and dialysis units to explain the excellent results that have been reported internationally. She is also delivering training on the use of MARS in all these settings and welcomes enquiries along these lines. ContactGina Greenwood 01480 444000 gina. greenwood@ gambro. com Visit www. gambroDNA. co. ukfor more details about our programme of innovation.

Self- locating catheters give excellent access to the peritoneum Gambro PDCATH- Self locating has been developed in response to the fact that the success of a PD programme depends largely on the quality of the peritoneal access by avoiding catheter dislocation. " The consequences of dislocation are many," says Gambro's Home Care Team Leader, Sally Oldroyd. " It can increase infusion time and drainage difficulties, leading to a breakdown or slowing down of the dialysis process. There can also be considerable discomfort for the patient. " The new catheter increases weight at the tip, creating gentle gravitation towards the Douglas pouch to counter the external forces that cause cuff extension at the exit site." Some highlights include: • Biocampatible. The catheter is made of implant- grade silicone for superior flexibility to avoid any outgrow or rejection. • Worry- free peritoneal access. It's compatible with Gambro's titanium adapter for a sealed connection and the radiopaque marker allows easy identification on plain radiography during use. An accurate hole positioning technique avoids any holes on the radiopaque stripe and prevents the catheter from splitting. • Selected for patient compliance. The bevelled tip avoids discomfort on abdominal tissues. Different designs are available to fit with your patients' needs and your implementation technique. Precision holes also provide improved dialysate flow. In a two- year study, self- locating catheters had higher long- term survival rate than traditional Tenckhoff catheters and there were fewer episodes of peritonitis, tunnel infection, cuff extrusion, catheter malfunction, obstruction and leakage. 1 ContactRob Fisher 01480 444000 rob. fisher@ gambro. com 1Di Paolo N et al. The self- locating catheter: clinical experience and follow up. Perit Dial Int 2004; 24( 4): 359- 64. Overall, the quality of dialysis individuals with a fistula receive is better and this may also, in part, explain the better outcomes in those who start dialysis via a fistula rather than line. The national service framework for renal services guarantees that ' renal services are to ensure the delivery of high quality, clinically appropriate forms of dialysis which are designed around individual needs and preferences and are available to patients of all ages throughout their lives' ( standard 4). It goes on to state that ' all dialysis methods should be available for all patients interchangeably including home haemodialysis'. Home dialysis has many advantages - not least no travelling, but more about transport later. One of the main advantages of home haemodialysis, for many people, is often the independence that it gives. With that comes the opportunity to really tailor the prescription around the preferences of the individual. At the recent British Renal Society - Renal Association joint conference in Glasgow, there was much talk about home haemodialysis. Quotidian, or daily - meaning five or more times per week - and nocturnal, slow overnight dialysis, are options that are being increasingly made available to people on home haemodialysis. There were fantastic presentations from the Manchester team led by Dr. Sandip Mitra and from Dr. Cormac Breen's team at Guy's on these topics. The words of patients are however most powerful - one of the Guy's patients said: " Dialysing six nights a week for eight hours each time has made an amazing difference to my health. The toxins in my blood are really low, I'm taking no medication, my blood pressure is normal and my haemoglobin levels have stabilised without injections." In recognition of the importance of quotidian dialysis we have built more frequent dialysis into the Payment by Results modelling of the proposed tariff for home haemodialysis. This form of therapy should be available now for any patient who is suitable for home haemodialysis. Technical advances, quieter reverse osmosis machines, routine blood volume monitoring and infusion pumps for heprin and bicarbonate designed for easy home use need to keep pace with the aspirations of our service users - people on dialysis. Transplantation and dialysis So the ' chronic kidney disease' agenda will increase renal replacement therapy demand. Paradoxically, the focus on transplantation is also increasing dialysis 4 continued from front cover... The growing need for home haemodialysis Gambro's home, in- centre and acute care machines and water plant systems are all covered by the new Partnership Support Agreements