Access for dialysis

Two main forms:
  1. Using the peritoneal cavity in the abdomen for peritoneal dialysis and/or
  2. Using an artery and/or a major vein for haemodialysis.

ACE Inhibitor

A drug that slows (inhibits) the activity of the enzyme ACE, and commonly used to treat high blood pressure.


A word meaning ‘short term’ and of quick onset, usually requiring a quick response.

Acute kidney injury (AKI)

The abrupt weakness of the kidneys, resulting in the retention of waste products and in the dysregulation of extracellular volume and electrolytes.

Acute Kidney Injury Warning Algorithm

A national algorithm, standardising the definition of AKI. This provides the ability to ensure that a timely and consistent approach to the detection and diagnosis of patients with AKI is taken across the NHS.

Acute myeloid leukaemia

Cancer that affects the different type of cells that’s normally in blood. The cancer grows from cells that would normally turn into white blood cells, and starts in the bone marrow.

Acute myocardial infarction

Commonly called a ‘heart attack’. This is usually caused by a blood clot, which stops the blood flowing to a part of the heart muscle.

Acute renal failure

Another term for Acute Kidney injury. The abrupt weakness of the kidneys, resulting in the retention of waste products and in the dysregulation of extracellular volume and electrolytes.


A measure of how effective dialysis treatment is.


Not feverish or, with a normal temperature.


A drug - used treat osteoporosis and Paget's disease of bone.


Also known as Alport Syndrome. This hereditary condition is more severe in males. It is a cause of chronic kidney disease with deafness and sometimes eye problems

Alzheimers dementia

A disease effecting the brain causing a set of symptoms that may include memory loss and difficulties with thinking, problem-solving or language. Symptoms tend to get worse with time.


A disease caused by starch like strands of protein (glycoprotein). In Amyloidosis these can get into body tissues such as the chronic kidney disease and cause problems with the heart.


A shortage of red blood cells in the body causing tiredness, shortage of breath and pale skin. One of the functions of the kidneys is to make EPO (erythropoietin), which stimulates the bone marrow to make red blood cells. In kidney failure, EPO is not made and anaemia results.

Angiotensin receptor blocker (ARB)

A drug - medicines that are used to treat high blood pressure, similar to ACE Inhibitors.


A drug - (also commonly known as antiepileptic drugs or as anti-seizure drugs) - A group of pharmacological agents used in the treatment of epileptic seizures.


The kidneys not producing any urine, in practice is defined as passage of less than 100 millilitres of urine in a day.


The complete or partial failure of an organ or tissue to develop.

Arteriovenous (AV) fistula

A communication or link created between an artery and vein. Usually carried out as a day-case operation. The fistula issued for haemodialysis. Usually it is between the radial artery and the cephalic vein in the forearm that is used least.


A blood vessel composed of smooth muscle. The arteries carry oxygenated blood away from the heart.

Atherosclerosis or Atheroma

A disease of the arteries characterized by the deposition of fatty material on their inner walls This causes a restriction in blood flow and increases the risk of cardiac and circulation problems.

Atrial Fibrillation (AF)

An irregular and often rapid heart rate that commonly causes poor blood flow to the body. During atrial fibrillation, the heart's two upper chambers (the atria) beat chaotically and irregularly — out of coordination with the two lower chambers (the ventricles) of the heart.


(In context - Autoregulation of Organ Blood Flow). Autoregulation is a manifestation of local blood flow regulation. It is defined as the ability of an organ to maintain a constant blood flow despite changes in blood pressure.

Autoimmune disease

Is an attack on the body by the body’s own defence or immune system. Some of the forms of glomerulonephritis are autoimmune diseases.

Automated peritoneal dialysis (APD)

A form of peritoneal dialysis (PD) which uses a machine to drain the dialysis fluid out of the patient and replace it with fresh solution. APD is usually carried out overnight whilst the patient sleeps.


A starting point used for comparisons.

Benign prostatic hypertrophy

(BPH) is an enlarged prostate gland. The prostate gland surrounds the urethra, the tube that carries urine from the bladder out of the body.


A drug -A type of antibiotic used to treat infections.


A drug - any of a class of drugs which prevent the stimulation of the adrenergic receptors responsible for increased cardiac action, used to control heart rhythm, treat angina, and reduce high blood pressure.


A test involving the removal of a small piece of an organ or other body tissue so that it can be examined in more detail.

Bipolar affective disorder

A condition marked by alternating periods of elation and depression.


A drug - belonging to the group of beta-blockers, a class of medicines used primarily in cardiovascular diseases.


The organ in which urine is stored before being passed from the body.

Blood gas

A blood test taken from arteries. It is used to measure how much oxygen and carbon dioxide are in the blood.

Blood glucose

A ‘simple’ (small molecule) sugar carried in the blood.

Blood pressure

The pressure the blood exerts against the walls of the arteries as it flows through them. Blood pressure measurements consist of two numbers the first shows the “systolic” blood pressure, obtained when the heart contracts and blood is pumped into the arteries; the second number shows the “diastolic” blood pressure the pressure in the arteries just before a further pulse is transmitted from the heart. One of the functions of the kidneys is to help control blood pressure, so it tends to be high in patients with kidney failure.

Blood urea nitrogen (BUN)

Substances in the blood from the breakdown of food. The blood levels rise if kidney function is decreasing.

BMI (Body Mass Index)

BMI (Body Mass Index) An index of weight-for-height that is used to classify underweight, overweight and obesity in adults. It is defined as the weight in kilograms divided by the square of the height in metres (kg/m2)

Brain Death

A term indicating that the entire brain has permanently stopped working and that further life is only possible on a life support machine. A person must be “braindead” before their organs can be removed for a cadaveric transplant.


The body of someone who has died.

Cadaveric transplant

A transplant in which the kidney is removed from someone who had died.


A plastic tube used to drain fluid from an organ. In patients on peritoneal dialysis it to allow a fluid to be put into and removed from the peritoneal cavity. It can also be used to drain urine from the bladder.


Long term and of slow onset.

Chronic kidney disease (CKD)

Also called chronic kidney failure. Describes the gradual loss of kidney function.


The removal of the toxic waste products from the body. It is one of the main functions of the kidney, and in kidney failure toxins build up in the blood.


The presence of one or more additional disorders (or diseases) co-occurring with a primary disease or disorder; or the effect of such additional disorders or diseases. The additional disorder may also be a behavioural or mental disorder.


The translation of medical terminology as written by the clinician to describe a patient's complaint, problem, diagnosis, treatment or reason for seeking medical attention, into a coded format which is nationally and internationally recognised.

Community acquired

Occurs whilst the patient is at home.

Community psychiatric liaison

The branch of psychiatry that specialises in the interface between medicine and psychiatry, usually taking place in a hospital or medical setting.

Continuous ambulatory peritoneal dialysis (CAPD)

A form of Peritoneal Dialysis in which patients perform exchanges of dialysis fluid manually, usually four times a day. The fluid is left inside the patient overnight.

Coryzal symptoms

Acute inflammation of the mucous membrane of the nasal cavities. Commonly caused by viruses during the winter.


A waste substance produced by muscles and which can only be excreted by the kidneys. Creatinine can be measured in the blood. High levels indicate that the kidneys are not working. It can also be used to assess the function of a transplant, or the efficiency of dialysis.

Creatinine Clearance

This test measures how efficiently the kidneys filter creatinine and other wastes from the blood. If the clearance is low, the kidneys are not working well. See Creatinine above.

Critical care outreach

A multidisciplinary team comprising of senior nurses with a background in intensive care.


The final blood test before a transplant operation to check whether the patient has any antibodies to the donor kidney. The operation can only proceed if this test is negative.

Cutaneous purpura

Red or purple discolorations on the skin that do not blanch on applying pressure. They are caused by bleeding underneath the skin usually secondary to vasculitis or dietary deficiency of vitamin C.


A drug with immunosuppressive properties used to prevent the rejection of grafts and transplants.


The excessive loss of body water caused by events such as diarrhoea/vomiting, or not been able to drink water for pro-longed periods.

DHS (Dynamic Hip Screw) for fractured neck of femur

A surgical procedure where a screw is used fix fractures to the hip.

Diabetes Mellitus

Also known as sugar diabetes (or just diabetes), in which there is too much sugar in the blood. It is usually controlled by insulin, tablets or diet but it can cause kidney failure, most often in those who have had diabetes for more than ten years.

Diabetic sick day rules

Guidelines for patients with diabetes providing advice on how to manage blood sugars and insulin/tablets during times of illness, especially illnesses that lead to reduced food intake and/or vomiting.


An artificial process to remove toxic waste products and excess water, from the body. Needed when the kidneys stop working.


A drug - used in the treatment of heart failure and irregular heartbeat.

Diuretic Drugs (water tablets)

A drug - promotes the formation of urine by the kidney. Water tablets – increase the amount of urine that is passed.


A drug - used to treat dementia associated with Alzheimer's disease.

Dysplasia (dysplastic kidneys)

Not the same as multicystic dyspastic kidneys. Dysplastic is a descriptive term for dysplasia, an abnormal development of skin, bone, or other tissues, in this case, the kidneys. The Structural as well as functioning parts of the kidney are affected. Sometimes the condition is not detected until adulthood; sometimes it is more severe, resulting in kidney failure in early childhood. This is an extremely rare condition.

Early Warning Scores

A national system for standardising the assessment of acute-illness severity in the NHS.


A test of the action of the heart using ultrasound waves to produce a visual display, for the diagnosis or monitoring of heart disease.

Erythropoietin (EPO)

A hormone secreted by the kidneys that controls the production of red blood cells in the bone marrow. Anaemia can result if this process is not working properly.

Established renal failure (ERF)

A term for advanced chronic kidney failure. People who develop ERF will die from kidney failure unless treated by dialysis or transplantation.

Exacerbations of COPD (Chronic Obstructive Pulmonary Disease)

A sustained worsening of the respiratory symptoms in a patient with a history of lung disease.


Extreme tiredness resulting from mental or physical exertion or illness.

Febrile illness

Acute onset of fever (high temperature), can be cause by many things.


A drug - for the treatment of benign prostatic hyperplasia.


A fistula is created by a surgeon in a small operation to create a connection between an artery and vein. The increased blood flow through the vein causes it to enlarge and therefore become more suitable for haemodialysis needles.


A drug - an antibiotic commonly used to treat skin infections.


A drug - a diuretic (water tablet) used in the treatment of congestive heart failure and oedema.


A drug - an anticonvulsant and analgesic - used to relieve neuropathic pain.


A potentially serious condition that arises when a considerable mass of body tissue dies (necrosis). This may occur after an injury or infection.


Inflammation of the stomach and intestines, typically resulting from bacterial toxins or viral infection and causing vomiting and diarrhoea.


A drug - an antibiotic used to treat infections.


Glomerular Filtration Rate – A test to measure the level of kidney function and determine the presence of kidney disease.


Inflammation of the glomeruli (filters) in the kidney, which can cause of kidney disease.


One of the tiny filtering units inside the kidney.

Glycaemic control

The typical levels of blood sugar (glucose) in a person with diabetes mellitus (sugar diabetes).

Guided fluid management

Promotion of fluid balance and prevention of complications resulting from abnormal or undesired fluid levels.


A procedure to remove fluid and waste products from the blood and to correct electrolyte imbalances. A form of dialysis in which the blood is cleaned outside the body in a dialysis or kidney machine. It contains a filter called a dialyser or artificial kidney. Each dialysis session lasts for three to five hours, three times a week.

Haemolytic Strep

A gram-positive bacterium responsible for a wide range of both invasive and non-invasive infections.


Glycated haemoglobin. It develops when haemoglobin, a protein within red blood cells that carries oxygen throughout your body, joins with glucose in the blood, becoming 'glycated'. By measuring glycated haemoglobin (HbA1c), clinicians are able to get an overall picture of what our average blood sugar levels have been over a period of weeks/months. It can be used to help diagnose diabetes.

Heart-beating Donor

A donor whose heart is still beating after brain death has occurred. Most cadaveric transplants come from heart-beating donors.

Henoch Schonleinpurpura (HSP)

A disease of the skin and other organs that most commonly affects children. In the skin, the disease causes palpable purpura (small haemorrhages); often with joint and abdominal pain. It can also cause some blood to appear in the urine.

Home haemodialysis

Available for suitable patients with support at home. Home haemodialysis users benefit from increased freedom in their daily lives, and don’t have to spend time travelling to hospital or dialysis centres.


The tubes draining urine out of the kidney are stretched by a blockage to the flow of urine through the ureter or bladder. If this lasts for too long, damage to the kidneys can result.


Abnormally high blood pressure.


Prefix meaning low, under, beneath, down, or below normal.


Systolic blood pressure of less than 90 mm Hg or mean arterial blood pressure less than 60 mm Hg.

Hypovolemic shock

An emergency condition in which severe blood loss causes low blood pressure.


The suppression of the immune system of an individual. Often done with medication for patients who have had a transplant operation.

Immunosuppressive drugs

Drugs used to suppress the body’s immune system, and so un-wanted reaction to a transplant kidney.

Inotropic support

Medication used to help maintain blood pressure at times of illness.

Insulin Aspart

A drug - a man-made form of human insulin; a single amino acid has been slightly changed in its molecular structure.

Insulin Glargine

A drug - a long-acting basal insulin analogue, given once daily to help control the blood sugar level of those with diabetes.

Intravenous pyelogram (IVP)

Also known as intravenous urogram (IVU) A special xray of the kidneys using a dye to show up the kidneys and their drainage system. The dye is injected into the arm, travels in the blood to the kidneys and is passed out of the body in the urine.


When a patient is very unwell and needs help with breathing, a tube is placed into the throat. This is always done with the patient asleep after been given an anaesthetic agent.

IV (Intravenous) fluids

Fluids administered directly into the veins.

Kidney Biopsy

Removal of a small piece of kidney through a hollow needle for examination under a microscope. It is often needed to diagnose different forms of kidney disease.

Kidney Failure

A condition where the kidneys are less able to perform their normal functions. It can be acute or chronic. Advanced longterm kidney failure is called established renal failure (ERF).

Kidney function

Analysis of blood and urine samples for the evaluation of kidney (renal) function. Blood tests provides a rough measurement of the glomerular filtration rate, the rate at which blood is filtered in the kidneys.


The two bean shaped organs where urine is made. They are located at the back of the body, below the ribs. The main functions are to remove toxic wastes and excess water. They also help to control blood pressure and the manufacture of red blood cells, and to keep bones strong and healthy.

Left ventricular damage

A condition in which the heart muscle has been damaged. This can lead to heart failure.


A drug of the angiotensin-converting enzyme (ACE) inhibitor class used primarily in treatment of hypertension, congestive heart failure, and heart attacks, and in preventing renal and retinal complications of diabetes.

Living Related Transplant (LRT)

A transplant kidney donated by a living relative of the recipient. A well-matched living related transplant is likely to last longer than either a living unrelated or cadaveric transplant.

Living Unrelated Transplant (LUT)

A kidney transplant from a living person who is biologically unrelated to the recipient (such as a spouse or friend).


A drug - is an angiotensin II receptor antagonist drug used mainly to treat high blood pressure

LV systolic dysfunction

A condition in which the heart has lost the ability to pump enough blood to the body's tissues. With too little blood being delivered, the organs and other tissues do not receive enough oxygen and nutrients to function properly. Otherwise known as heart failure.


A general feeling of discomfort, illness, or unease whose exact cause is difficult to identify.

Mesangiocapilliary glomerular nephritis (MCGN)

A type of glomerulonephritis (kidney inflammation).


A drug - is an oral anti-diabetic drug in the biguanide class. It is the first-line drug of choice for the treatment of type 2 diabetes, in particular, in overweight and obese people and those with normal kidney function.


A small amount of protein detected in the urine, often an early sign of diabetic kidney disease.


During development in the womb, the ureters grow up from the bladder, forming connections with the kidneys. However, in this condition, one of the ureters fails to connect with the kidney. Because that kidney cannot work, a number of cysts form; hence the term ‘multicystic’. Most usually, one kidney is affected while the other is normal. MCDK is a developmental problem and is not the same as polycystic kidneys, an inherited condition.

Multi-organ failure

Failure of multiple organs in a patient who is unwell. A very serious condition.

Myocardial infarction

A heart attack usually caused by a blood clot, which stops the blood flowing to a part of the heart muscle.

Needlestick injuries

A piercing wound typically set by a needle point, but possibly also by other sharp instruments or objects.


An operation to remove a kidney from the body – this can be done by ‘keyhole’ or ‘open’ surgery


A general term for inflammation of the kidneys. Sometimes used as an abbreviation for glomerulonephritis (GN).


The study of the kidneys.

Neuropathic pain

Chronic pain resulting from injury to the nervous system. The injury can be to the central nervous system (brain and spinal cord) or the peripheral nervous system (nerves outside the brain and spinal cord).


The National Institute for Health and Care Excellence is an executive non-departmental public body of the Department of Health in the United Kingdom. It serves both the English NHS and the Welsh NHS.

Non-oliguric acute kidney injury

Acute kidney injury with urine output > 1 ml/kg per hour after the 1st day.


A group of drugs - Non-steroidal anti-inflammatory drugs is a class of analgesic medication that reduces pain, fever and inflammation.


Structural or functional hindrance of normal urine flow, sometimes leading to renal dysfunction.


An abnormal build up of fluid in the body, which shows itself in swelling of the ankles or, if it is in the lungs, breathlessness. People with kidney failure have an impaired ability to excrete salt and water, and are therefore prone to fluid overload leading to oedema.


The production of abnormally small amounts of urine.

Opioid analgesics

A group of drugs - The analgesic (painkiller) effects of opioids are due to decreased perception of pain, decreased reaction to pain as well as increased pain tolerance.


Degeneration of joint cartilage and the underlying bone, most common from middle age onward. It causes pain and stiffness, especially in the hip, knee, and thumb joints.


Increased or excessive production of urine, often as a results of been given a diuretic medication.


Noticeably rapid, strong, or irregular heartbeat due to agitation, exertion, or illness. Can be normal.

Peripheral neuropathy

Damage or disease affecting nerves, which may impair sensation, movement, gland or organ function, or other aspects of health, depending on the type of nerve affected.

Peritoneal Dialysis (PD)

A form of dialysis that takes place inside the patient’s peritoneal cavity (the area between the two layers of the peritoneum inside the abdomen, containing the abdominal organs). Using the peritoneum (the lining of the inside wall of the abdomen) as the dialysis membrane, bags of dialysis fluid containing glucose and various toxic and waste substances are drained in and out of the peritoneal cavity via a PD catheter.

Peritoneal membrane

The lining of the abdomen that is used in peritoneal dialysis.


When peritoneal dialysis is being carried out, it is an inflammation of the peritoneal membrane caused by infection. Common symptoms are pain and tenderness with cloudiness in the dialysis solution.


A piece of plastic tubing - very similar to a jugular catheter - and is used for haemodialysis. The permacath has a cuff that holds the catheter in place under the skin and acts as a barrier to infection.

Polycystic Kidney Disease (PKD)

An inherited disease in which both kidneys become full of cysts. PKD is one of the causes of kidney failure.


A drug - a synthetic steroid with similar properties and uses to those of prednisone, of which it is a reduced derivative.


A drug - lithium

Primary Care (1°)

Health care provided in the community, in the NHS GPs carry out this role.


A Latin term that stands for “pro re nata” in medication prescribed to be taken when required.


A molecule made in the body, constructed from amino acid ‘building blocks’, from the breakdown of food in digestion.


The presence of abnormal quantities of protein in the urine, which may indicate damage to the kidneys.

Pulmonary damage

Damage to the lungs.

Purpuric rash

Red or purple discolorations on the skin that do not blanch on applying pressure. They are caused by bleeding underneath the skin usually secondary to vasculitis or dietary deficiency of vitamin C.


Inflammation of the kidneys, usually caused by bacterial infection.


A drug - an ACE inhibitor used especially to treat hypertension


A backflow of urine or liquid in the wrong direction. See also vesicoureteral reflux (VUR).

Renal Artery

An artery in the renal system. See also Artery.

Renal Dietician

A dietician who specialises in nutrition for those with renal problems.

Renal replacement therapy

Renal replacement therapy is a term used to encompass life-supporting treatments for renal failure. It includes: haemodialysis, peritoneal dialysis, haemofiltration and renal transplantation.

Renal unit

A hospital department that treats disorders of the kidney.


A hormone secreted by the kidneys that keeps blood pressure normal. If blood pressure falls, renin is secreted that will narrow the blood vessels and so push blood pressure up.

Renovascular disease

‘Reno’ means of the kidney and ‘vascular’ means veins. Renovascular disease is caused by a blockage or restriction in the blood vessels in the kidneys.

Residual renal function

A term for the small amount of renal function that remains in some people on dialysis.


Situated or occurring behind the peritoneum.


A drug - an oral anticoagulant

Secondary Care (2°)

Medical care provided by doctors working in a hospital.


The presence in tissues of harmful bacteria and their toxins, typically through infection of a wound.


Blood poisoning, especially that caused by bacteria or their toxins. Destruction of tissues due to disease causing bacteria or their toxins from the blood stream. This term can also describe any form of blood poisoning.

Serum creatinine

The level of creatinine in the blood and gives an estimate of how well the kidneys filter.

Serum potassium

This test measures the amount of potassium in the fluid portion (serum) of the blood.


A drug - semisynthetic drug that decreases the level of cholesterol in the bloodstream.


A metallic element found in the body and in many foods.

Stage 3 CKD

A person with stage 3 chronic kidney disease (CKD) has moderate kidney damage. This stage is broken up into two: a decrease in glomerular filtration rate (GFR) for Stage 3A is 45-59 mL/min and a decrease in GFR for Stage 3B is 30-44 mL/min. As kidney function declines waste products can build up in the blood causing a condition known as “uraemia.” In stage 3 a person is more likely to develop complications of kidney disease such as high blood pressure, anaemia (a shortage of red blood cells) and/or early bone disease.


A splint placed temporarily inside a duct, canal, or blood vessel to aid healing or relieve an obstruction.

STING Procedure

Teflon paste is injected into the bladder via a tube through the urethra, to modify the shape of the ureter. This is done to improve problems with urinary reflux. See also reflux.

Subclavian/subclavian vein

Carries deoxygenated blood back from the arms and neck to the heart.

Tertiary Care (3°)

A specialist centre that has facilities for special investigation and treatment.

Tissue Typing

A blood test that identifies a person’s tissue type. This is important when trying to find the best match for a kidney transplant.


A poison of plant or animal origin, especially one produced by or derived from microorganisms and acting as an antigen in the body. Poisons. One of the main functions of the kidneys is to remove toxins from the blood.


A drug - a synthetic opioid analgesic administered orally to treat moderate to severe pain.

Transplant Waiting List

A system that seeks to find the right transplant organ for the right patient. It is coordinated nationally by NHS Blood and Transplant, a Special Health Authority ( ) whose database compares patients’ details with those of cadaveric organs that become available. The average waiting time for a new kidney is about two years.


The replacement of an organ in the body by another person’s organ. Many different organs can now be successfully transplanted including the kidneys, bowel, liver, heart, lungs, pancreas, skin and bones.

Type two diabetes

The most common form of diabetes. The body does not use insulin properly. This is called insulin resistance.


An excess of urea and nitrogen based wastes in the blood. It can cause sickness, vomiting, drowsiness, eventually death if not treated.


A breakdown product of protein. Urea is produced in the liver and is normally excreted in the urine.


The muscular tubes that squeeze and push urine into the bladder.


The analysis of urine with a range of tests.

Urinary Tract Infection (UTI)

This occurs in the lower urinary tract – the bladder and urethra are affected. Symptoms can include urgent need to pass urine, a burning sensation on passing urine, discomfort in the lower abdomen, cloudy smelly urine and sometimes, blood in urine. In a few instances, the infection can spread to the kidneys, which is more serious.

Vascular Access

Access using a vein for haemodialysis. See access above.


A group of disorders that cause inflammation of a blood vessel or blood vessels.


The blood vessels that carry blood towards the heart. The exception is the pulmonary vein.

Venous line

A line feeding fluids into a vein.


A drug - a water-soluble compound with anticoagulant properties, used in the treatment of thrombosis.

Wellness score

Wellness scores are meant to provide a graphical illustration or ranking of the participant's responses and test values consistent with national norms.


The transplanting of tissues or organs from one type of animal into a human or other animal.