Clinics

Our expert renal teams run a number of specialty clinics for our different patients and their different needs.Here is a full breakdown of those clinics.

Adolescent/adult interface clinic

Adolescent/adult interface clinic

Many children with chronic kidney disease and their parents develop close relationships with the specialist children's services.

As they grow up and enter young adulthood, it can sometimes be very daunting moving to the adult renal clinic. There are sometimes complex medical, social and psychological needs for adolescents and young adults with chronic kidney disease.

This clinic is run by a consultant paediatrician working alongside a consultant nephrologist who specialises in adult care.

The aim of this clinic is to introduce the young adult to the adult clinic so that the transition into on-going adult care can be as smooth as possible.

If needed, access to a specialist renal counsellor can be provided.

Combined renal and diabetes clinc

Many patients with kidney dysfunction also have diabetes. Diabetes is now the leading cause of renal failure in the UK.

Some patients with diabetes and renal disease have special medical needs, and combined clinics have been developed, staffed by consultant renal physicians, consultant diabetologists and specialist nurses in diabetes care.

The aim of these clinics is to firstly ensure that patients with diabetes and renal disease have the correct diagnosis for their renal problem, and then to establish a plan for ongoing management and surveillance.

It may be that after the initial assessment, a decision is made to continue surveillance in a specialist diabetes clinic, a specialist renal clinic, or if the needs of both diabetes and renal care are complex, to continue to attend the combined clinic so that you can receive consultant-led specialist care at a single visit.

As the renal unit serves such a large population, individual combined renal and diabetes clinics have been developed on three sites across south west London and Surrey.

Combined renal and rheumatology

A small number of patients with autoimmune conditions such as vasculitis, systemic lupus erythematosis, rheumatoid arthritis and mixed connective tissue disorders develop problems with kidney function. This needs specialist assessment by a nephrologist.

St Peter's Hospital has the facility to treat some of the complex problems associated with this condition. The renal unit at St Helier Hospital has developed a supra-regional clinic specialising in vasculitis and some of these rare conditions.

By combining the skills of a rheumatologist and a nephrologist from St Helier Hospital, it is possible to deliver co-ordinated specialist care closer to home.

This clinic runs monthly to facilitate the appropriate diagnosis of these underlying conditions, co-ordinate the complex treatment, and to offer on-going surveillance and support for patients.

In addition, this clinic offers support to renal patients who have developed rheumatological problems, and to patients with rheumatological disease who have developed deterioration in their kidney function.

This clinic facilitates treatment of very complex medical conditions in a local setting.

General nephrology clinics

If your doctor thinks you may have kidney problems, you may be referred to a general nephrology clinic where you will be seen by one of our consultant nephrologists or a specialist registrar.

The Trust manages over 20 clinics each week on 11 different sites. The philosophy of the renal unit is to deliver the services closer to your home.

Each of our consultant nephrologists has a geographical area that they are responsible for. This helps them to develop closer links with the local hospitals and the GPs in that area.

Within each area, the consultant nephrologists have tried to develop local referral and management guidelines with the GPs to help offer the most effective treatment and monitoring of chronic kidney disease in the community.

The Trust can also provide comprehensive on-going treatment for patients with renal failure and will continue to support you along this pathway with its many highly skilled doctors, nurses and support staff.

With the exception of some of our outreach clinics, you can expect to be seen within four weeks following your first GP referral to the department. We encourage as much of your care to be close to your own home.

Hypertension clinic

This is a service for patients with severe or poorly controlled hypertension or patients with suspected secondary causes of hypertension.

In addition, patients can be assessed for renal sympathetic denervation, a technology approved by NICE for treatment resistant hypertension.

Referrals

Referrals to the hypertension clinic can be made using the following form:

Hypertension clinic referral form[docx] 51KB.

Pre-dialysis clinics

The aim of this clinic is to provide co-ordinated care for patients with advanced renal disease who may require renal replacement therapy such as dialysis or transplantation.

The pre-dialysis clinics are staffed by a consultant nephrologist, a specialist registrar, a pre-dialysis nurse specialist, a renal specialist dietician, a renal anaemia nurse and a renal counsellor.

Patients with chronic kidney disease are usually referred to the clinic when their glomerular filtration rate (GFR) falls below 20ml/min.

By providing a clinic with a varied specialist staff, most aspects of kidney care can be addressed. There is a particular emphasis on education and counselling so that you can make an informed decision about what is the most appropriate form of long term treatment for your kidney disease. This is particularly important as it allows suitable preparation before the need for renal replacement therapy.

Initial assessment is done by the advanced kidney care team and patients are invited to a number of education sessions where they are provided with detailed information about all aspects of renal replacement therapy.

These sessions give you and your relatives the opportunity to have your questions answered, and help you to choose the type of treatment most suited to you.

Occasionally, the specialist pre-dialysis nurses and counsellor arrange to perform a home visit, or offer one-to-one education sessions if this is more useful to you.

Treatment of problems and complications associated with chronic kidney disease is optimised. Efforts are made to improve blood pressure control, promote a healthy life style and reduce the risk of cardiovascular disease.

Intravenous iron therapy and erythropoietin stimulating agents (ESA) to manage anaemia, and vitamin D for hyperparathyroidism are commenced as appropriate. Regular assessment by renal dieticians identifies malnourished patients who are given dietary advice and provided with food supplement if necessary.

Dieticians also provide verbal and written advice to keep the biochemical parameters such as potassium and phosphate at appropriate levels.

You may be assessed for either:

  • Haemodialysis - carried out at the main unit, a satellite unit or at your own home if appropriate
  • Peritoneal dialysis - either automated peritoneal dialysis or continuous ambulatory peritoneal dialysis

Renal transplant work-up is started in suitable patients and pre-emptive transplantation and live-donor transplantation is encouraged if appropriate.

The conservative management team assesses and looks after patients who are not suitable or have decided not to have renal replacement therapy.

We offer outreach pre-dialysis clinics in Mayday Hospital, and in the Royal Surrey Hospital to try and reduce the burden of travelling for some patients.

Renal anaemia clinics

We provide intravenous iron treatment for patients with kidney disease, as well as arranging for the administration of erythropoietin treatment.

We have introduced a new system of home delivery of erythropoietin to our patients to make the patient experience easier.

Surgical vascular access clinic

As the first complex vascular access service in the country, we cater for all type of vascular accesses and especially for patients who had been unsuitable for any kind of access.

We treat patients with central venous stenosis and obstruction and also provide an emergency failing access 24 hours a day, seven days a week. We have a very high success rate when treating thrombosed or failing accesses and are the only centre in the country with such a proactive policy advocating access rescue.

We have an international reputation and give lectures worldwide as well as receiving visitors from various countries.

In our network we have a number of vascular access coordinators who look after our patients and their accesses. They measure the access inflow for each patient every other month with a machine using the ultrasound dilution technique (transonic).

All results and pictures of problematic accesses are sent to the surgeon's handheld computer to avoid any delays in potential treatment for these fragile patients.

Transplant follow-up clinic

After a transplant, staff at St Helier will follow your progress for the first three to four months, and thereafter at one of a network of clinics across Surrey and Sussex.

This model of care allows close supervision in the early stages, when complications are most common, and local care for maximum convenience once the clinical status is stable.

The South West Thames Renal and Transplant Unit has consistently one of the best one and five-year outcomes in the UK, for both renal and patient survival.

Transplant donor and recipient work-up assessment

This assessment clinic helps to prepare the potential kidney donor and recipient for surgery. It includes an assessment of the medical, surgical and psychological aspects of transplantation.

The clinic incorporates a monthly transplant information evening where patients meet doctors and nurses involved in the preparation for transplantation, as well as people who have already been through the process.

The South West Thames Renal and Transplant Unit has consistently one of the best one and five-year outcomes in the UK, for both renal and patient survival.

We have a policy of early mobilisation and discharge (meaning that we want you on the road to recovery as soon as possible) and, on average, recipients of transplants spend less than half the time in hospital than any other unit in London.

We have high living donor transplant rates, a policy of laparoscopic (keyhole) surgery for donors, and are developing transplantation across blood group and antibody barriers.

For advice about donating or receiving a kidney, call:

Recipient co-ordinators 

Kirstie Ellis and Louise Lyons
Tel: 020 8296 4521

Living donor co-ordinator 

Tracey Norton-Smith
Tel: 020 8296 4521

Vasculitis

Patients with multisystem auto-immune disease, and often but not always, kidney involvement (typically, but not exclusively, anti-neutrophil cytoplasmic antibody associated vasculitis and lupus or systemic lupus erythematosus), are cared for in this clinic.

We provide a consultant delivered service with open access to existing patients.

In addition to standard treatments, we offer a number of specialised treatments for more complex cases, and have significant expertise in the management of this group of conditions and complications relating to therapy.

We also provide a 'treatment service' for other specialities who may occasionally require one of our services, such as plasma exchange or biological agents in the treatment of refractory autoimmune disease (without kidney involvement).

We have experience in using biological agents in the treatment of autoimmune disease as well as ready access to plasma exchange.

Get connected

  • Like us on Facebook 
  • Follow us on Twitter
  • Follow us on Linkedin 
  • Reviews on NHS Choices
  • Watch our videos

 

  • Like us on facebook
  • Follow us on Twitter 
  • Follow us on LinkedIn
  • Review on NHS Choices
  • Watch our videos

NHS image placement

Healthy Workplace Achievement Award 2016 NHS Choices