Advanced kidney care

An Advanced Kidney Care (AKC) clinic is held at Kent and Canterbury Hospital on Wednesday mornings, Maidstone on Friday mornings and twice a month at Medway. Within this clinic patients may see a Consultant Nephrologist, an Advanced Kidney Care Nurse, a Dietician and a Renal Counsellor. 

These clinics are held for people with Chronic Kidney Disease (CKD) when their kidney function starts falling and blood tests show an estimated glomerular filtration rate (eGFR) below 15ml/min (or eGFR less than 25 ml/min and declining).

We aim to offer patients and their families the benefit of a full range of professional support from our multidisciplinary team.

Treatment of problems and complications associated with chronic kidney disease is optimised within the AKC Clinic. Efforts are made to improve blood pressure control, effectively manage anaemia and bone disease and reduce the risk of cardiovascular disease. Dieticians provide verbal and written advice to keep the biochemical parameters such as potassium and phosphate at appropriate levels, and identify malnourished patients who are provided with food supplements if necessary.

Initial assessment is done by the advanced kidney care team in an Assessment and Support Kidney Care (ASK) Clinic. These 45 minute appointments give patients and their relatives an overview of the treatment options available and the opportunity to have their questions answered. We also invite patients to attend our interactive education session where they are provided with more detailed information about all aspects of renal replacement therapy (RRT), transplantation or conservative management, thus enabling them to choose the type of treatment most suited to their lifestyle.

Following assessment and education, discussion will take place about treatment choices and a plan of care will be agreed.

Please use the links on the left for more specific information.

What is Chronic Kidney Disease?

Chronic Kidney Disease (CKD) is a long-term health problem where the kidneys slowly stop working. About 8 people out of every 100 (8%) in the UK have CKD. As people get older, they are more likely to get CKD. People are more likely to have CKD if they are South Asian or Black African. Many diseases can cause the kidneys to stop working properly. The most common causes are diabetes and high blood pressure.

What do Kidneys do?

Kidneys act as a filter and “clean” the blood. Waste products and excess water leave the body in people’s urine.

Kidney’s control the levels of water and different minerals needed for good health e.g salt and potassium.

Kidney’s make hormones to control other bodily functions such as blood pressure and anaemia.

Kidney’s keep the acid-base levels of the blood constant

Kidney’s control the body’s calcium levels and bone health

Symptoms of Chronic kidney disease

Usually people with early stage chronic kidney disease have no symptoms and feel quite well. As the disease get worse, people can experience some symptoms such as:

Weakness, tiredness, Itching, loss of appetite, headaches, weight loss, nausea, swollen ankles or hands

Coping with chronic kidney disease

People with chronic kidney disease can lead full lives but they often need to make changes to manage their disease. People choose to cope with their illness in different ways. Being active in choosing treatments and managing the illness helps maintain a feeling of being in control and helps people make sure they get the treatment that best suits their lives. People with CKD who become more involved in the management of their care have better health outcomes.

*Information coming soon*

Kent Kidney Care Centre Education Programme

So you can be involved in the decisions about your future treatment you are invited to an information morning to find out more about kidney disease and the treatment choices available to you. Attending this event is as important as coming to the kidney clinic.

The aim of the morning is for you to meet members of the team such as our pharmacist, dietician, counsellor and specialist nurses who will talk informally about:

  • How kidney disease may affect you and the support the Kent Kidney Care Centre can offer you and those closest to you.
  • The treatments available such as: haemodialysis, home haemodialysis, peritoneal dialysis, not having dialysis and transplantation
  • Maintaining a healthy diet
  • Understanding the medicines you take

It is also an opportunity to meet our expert patients who can share their knowledge and experiences with you. You are welcome to bring someone with you.

Parking and disabled facilities available. Refreshments will also be provided.

Kidney Transplantation

Information evenings regarding Kidney Transplantation are also held in Canterbury.

The aim of the evening is for you to meet members of the team such as our Transplant Doctors, Dietician, Counsellor, Social Services Assessment Officer and Specialist nurses who will talk informally about: 

  • The processes involved in kidney transplantation
  • Advantages and disadvantages of a kidney transplant
  • The tests involved preparing you for transplantation
  • The waiting list for kidney transplants
  • Living donation: related, non-related 
  • The actual operation 
  • Importance of the medications
  • Care of the new kidney and yourself – short and long term
  • Post-Transplant expectations

It is also an opportunity to meet our expert patients who can share their knowledge and experiences with you. You are welcome to bring family or friends with you

Thinking about dialysis decisions

For most people all four dialysis options work equally well. All dialysis options have side effects, long term health problems and are equally life-changing. People need to think about which dialysis treatment fits best into their life.

The Advanced kidney care nurses will meet with people making this decision and their families to help make sure the dialysis treatment chosen fits their lifestyle. Most people will be able to have the dialysis treatment they prefer .However some people have a medical reason which means one dialysis option is better for them than another. Many people with established kidney disease will have more than one type of dialysis during their lives.

When to make a choice

People need to make the decision about which type of dialysis to have before their kidneys fail for the following reasons:

To decide for themselves which dialysis treatment is best suited to their lifestyle

To give surgeons time to plan and perform an operation to make an access point to perform dialysis

A person’s health is better if dialysis is planned and started before the kidney’s fail

Making the dialysis decision

Some people find it useful to hear other patient’s stories of living with dialysis and support groups are available within the renal service to meet and talk about living with the disease

It is useful to understand the differences between the types of dialysis how they work, making access, side effects, complications, places of dialysis care, equipment needed and what activities you want to keep doing when you are on dialysis