Wikipedia talk:WikiProject Medicine/Nephrology task force/Archive 1

Welcome to the Dialysis Unit

We're ready to start washing!

Welcome to Wikiproject Nephrology, and I hope we can improve the quality of kidney disease related articles, as well as add to the database of articles.

Your comments/suggestions are invited.

Nephron T|C 04:39, 14 June 2006 (UTC)[reply]

HRS

I expanded Hepatorenal syndrome tonight, but I think I made it too technical. I've also written it with an admitted GI bias (almost all refs are from the hepatology literature). Would appreciate if anyone gets a chance to review it. Thanks -- Samir धर्म 09:02, 20 July 2006 (UTC)[reply]

Dialysis

I think that the dialysis articles are fairly good, do we think that they need much improvement, or should they be taken off the needs improvement list? The transplantation article is diabolical so I've bunged it on the list too, as I lack the moral fibre to start editing tonight...Felix-felix 18:53, 13 August 2006 (UTC)[reply]

I put 'em on the list 'cause they could be much better and 'cause (with a million people on dialysis worldwide[1] --and the numbers increasing, but awareness among the public low[2]) I think they are the sort of stuff that could make it to the main page. Nephron T|C 07:16, 1 September 2006 (UTC)[reply]

Project directory

Hello. The WikiProject Council has recently updated the Wikipedia:WikiProject Council/Directory. This new directory includes a variety of categories and subcategories which will, with luck, potentially draw new members to the projects who are interested in those specific subjects. Please review the directory and make any changes to the entries for your project that you see fit. There is also a directory of portals, at User:B2T2/Portal, listing all the existing portals. Feel free to add any of them to the portals or comments section of your entries in the directory. The three columns regarding assessment, peer review, and collaboration are included in the directory for both the use of the projects themselves and for that of others. Having such departments will allow a project to more quickly and easily identify its most important articles and its articles in greatest need of improvement. If you have not already done so, please consider whether your project would benefit from having departments which deal in these matters. It is my hope that all the changes to the directory can be finished by the first of next month. Please feel free to make any changes you see fit to the entries for your project before then. If you should have any questions regarding this matter, please do not hesitate to contact me. Thank you. B2T2 00:17, 26 October 2006 (UTC)[reply]

WP:MEDMOS needs YOU!

The Manual of Style (Medicine-related articles) is entering a critical stage: I'm informing people to visit the page, make corrections where possible, and then state there support or disagreements on the talk page, so we can see if there is consensus to turn this proposed guideline into a consensus-supported guideline.--Steven Fruitsmaak (Reply) 21:33, 26 October 2006 (UTC)[reply]

Wikipedia Day Awards

Hello, all. It was initially my hope to try to have this done as part of Esperanza's proposal for an appreciation week to end on Wikipedia Day, January 15. However, several people have once again proposed the entirety of Esperanza for deletion, so that might not work. It was the intention of the Appreciation Week proposal to set aside a given time when the various individuals who have made significant, valuable contributions to the encyclopedia would be recognized and honored. I believe that, with some effort, this could still be done. My proposal is to, with luck, try to organize the various WikiProjects and other entities of wikipedia to take part in a larger celebrartion of its contributors to take place in January, probably beginning January 15, 2007. I have created yet another new subpage for myself (a weakness of mine, I'm afraid) at User talk:Badbilltucker/Appreciation Week where I would greatly appreciate any indications from the members of this project as to whether and how they might be willing and/or able to assist in recognizing the contributions of our editors. Thank you for your attention. Badbilltucker 18:14, 30 December 2006 (UTC)[reply]

Merging azotemia and uremia... ?

I put-up the merge tags. I think it would make sense to merge the two articles. Comments can be made on Talk:uremia. Nephron T|C 21:13, 1 January 2007 (UTC)[reply]

Categories - Nephrology, Kidney diseases, Renal dialysis

GermanX has been changing the categories of many nephrology articles.

I'd like to open a discussion about that because I'm wonder whether it is useful to subdivide the nephrology category. For technical reasons I think it sometimes easier to go with 'nephrology' than 'kidney diseases' -- acute renal failure for instance is often not a kidney disease per se... it is caused by another event i.e. hypovolemia, benign prostatic hypertrophy, blocked urinary catheter. Thoughts on the above would be appreciated. I'm not categorically opposed to subdividing the nephrology category--- but I think it should be planned-out a bit/discussed. I look forward to your comments. Nephron T|C 06:28, 19 January 2007 (UTC)[reply]

I think that the nephrology category must be subdivided in order to organize and group similar subjects (and not having all of them "mixed" and cluttering the main category). If, for example, I am interested on some article about a specific kidney disease and If all articles are in nephrology category, then it will be difficult to find it. It will be easy to have a subcategory for "kidney diseases" to isolate its articles from articles about "kidney anatomy", that belong to other very specific category.
Having articles in subcategories give us another very useful advantage, we can put the whole category in more than one place. For example, We can put Category:Kidney diseases into Category:Nephrology, and also inside Category:Diseases, and if in the future someone wants to put all kidney diseases into another category, he or she only has to move the whole category that comprises all the articles instead of moving each one at a time. This gives a great flexibility.
Additionally, categories not only organizes and group articles, they are useful for navigating too. I can go from nephrology to its subcategories and viceversa very easily.
I agree with you that categorizing articles should be planned out and discussed. I'm not the best one to categorize them (I'm not a physician). But I created these categories because I think the Category:Nephrology is a little bit messed and it has sufficient number of articles to justify grouping them in subcategories.
I also agree with you that it is necessary to fix the mistakes you mentioned above (and others) about wrongly classifying articles in the bad category. GermanX 13:48, 19 January 2007 (UTC)[reply]

Is there a way of displaying the sub-categories and categories together? The advantage of putting things in "nephrology" is they are all together... and if one clicks on the category one has the whole list-- like an appendix of a book. As for the subdividing... I think it would be good to go with something derived from the nephrology template-- i.e. a division based on the anatomy of the kidney. The other things I'm wondering about is-- whether it might be good to just include articles in the subcategory and category, i.e. post-infectious glomerulonephritis is included in the "nephrology" category and the category "glomerulonephritis". I'm going to leave message for User:Felix-felix... perhaps they will have a few more comments... Nephron T|C 02:59, 21 January 2007 (UTC)[reply]

Personally, I'd just leave everything in a single large category, I don't really see what subdividing into smaller (and necessarily arbitary) subcategories achieves, except making the subject more complex to navigate around. It's not like we're drowning in articles, so why bother?FelixFelix ^talk 23:11, 14 March 2007 (UTC)[reply]

Low-protein diet

Please see the discussion at Wikipedia talk:WikiProject Medicine#Low-protein diet on the above article. --Bduke 22:12, 14 March 2007 (UTC)[reply]

New page

For everyone's information, I've started a page on the Renal Association, which has transformed knowledge of chronic kidney disease amongst the profession in the UK through its 2005 guidelines. JFW | T@lk 19:50, 7 October 2007 (UTC)[reply]

Move to WPMED task force?

This project looks relatively inactive. Would anyone object to it being subsumed under WPMED as a task force? The changes are pretty minimal (talk-page banners get merged, this page gets renamed to a subpage of Wikipedia:WikiProject Medicine). This project would become a task force like the others listed at Wikipedia:WikiProject Medicine/Task forces. The advantages to Wikipedia is that we have fewer tiny projects hanging about. The advantage to members here is that they get somewhat greater visibility (e.g., a listing in the {{WPMED Navigation}} template) and don't have to mess with administrative stuff (e.g., article assessments).

Whether you're interested or not, please reply here or post a note at Wikipedia talk:WikiProject Medicine/Task forces#Conversion of medicine-related projects beneath the listing for this project. --Scott Alter 00:54, 15 December 2008 (UTC)[reply]

Support, without a doubt. JFW | T@lk 22:53, 15 December 2008 (UTC)[reply]

Sounds fine to me. Dan Levy (talk) 05:40, 16 December 2008 (UTC)[reply]

Welcome to WPMED!

This project has been moved to a new home under WikiProject Medicine. The primary goal of the merge is to let you get back to work on kidney-related articles. Members are invited to watchlist this page as well as the main project page, and to list themselves both at this project and also at the main project's list if they haven't already. Please feel free to leave a note here about what you're working on or to let other members know where you need help.

If anything got lost or broken during the transition, or if administrative tasks need done in the future, then please feel free to squawk at WT:MED or the task force page, and we'll try to fix it promptly. Thanks, WhatamIdoing (talk) 19:47, 13 January 2009 (UTC)[reply]

New Articles and Template

Hi i created the following template Template:Lupus nephritis, and the following articles Minimal mesangial glomerulonephritis, Focal proliferative nephritis, and Diffuse proliferative nephritis, please i need some reviews and opinions, thank you Maen. K. A. (talk) 19:29, 1 March 2009 (UTC)[reply]

Please reply to my message on my Talk Page.

Article alerts

This is a notice to let you know about Article alerts, a fully-automated subscription-based news delivery system designed to notify WikiProjects and Taskforces when articles are entering Articles for deletion, Requests for comment, Peer review and other workflows (full list). The reports are updated on a daily basis, and provide brief summaries of what happened, with relevant links to discussion or results when possible. A certain degree of customization is available; WikiProjects and Taskforces can choose which workflows to include, have individual reports generated for each workflow, have deletion discussion transcluded on the reports, and so on. An example of a customized report can be found here.

If you are already subscribed to Article Alerts, it is now easier to report bugs and request new features. We are also in the process of implementing a "news system", which would let projects know about ongoing discussions on a wikipedia-wide level, and other things of interest. The developers also note that some subscribing WikiProjects and Taskforces use the display=none parameter, but forget to give a link to their alert page. Your alert page should be located at "Wikipedia:PROJECT-OR-TASKFORCE-HOMEPAGE/Article alerts". Questions and feedback should be left at Wikipedia talk:Article alerts.

Message sent by User:Addbot to all active wiki projects per request, Comments on the message and bot are welcome here.

Thanks. — Headbomb {^ταλκ_{κοντριβς} – WP Physics} 09:28, 15 March, 2009 (UTC)

WP:PHARM:CAT

You may want to get involved in the categorization of nephrology-related pharmacology, which is occuring now at WP:PHARM:CAT. See that talk page for more information.

WP 1.0 bot announcement

This message is being sent to each WikiProject that participates in the WP 1.0 assessment system. On Saturday, January 23, 2010, the WP 1.0 bot will be upgraded. Your project does not need to take any action, but the appearance of your project's summary table will change. The upgrade will make many new, optional features available to all WikiProjects. Additional information is available at the WP 1.0 project homepage. — Carl (CBM · talk) 03:41, 22 January 2010 (UTC)[reply]

Nephrology articles have been selected for the Wikipedia 0.8 release

Version 0.8 is a collection of Wikipedia articles selected by the Wikipedia 1.0 team for offline release on USB key, DVD and mobile phone. Articles were selected based on their assessed importance and quality, then article versions (revisionIDs) were chosen for trustworthiness (freedom from vandalism) using an adaptation of the WikiTrust algorithm.

We would like to ask you to review the Nephrology articles and revisionIDs we have chosen. Selected articles are marked with a diamond symbol (♦) to the right of each article, and this symbol links to the selected version of each article. If you believe we have included or excluded articles inappropriately, please contact us at Wikipedia talk:Version 0.8 with the details. You may wish to look at your WikiProject's articles with cleanup tags and try to improve any that need work; if you do, please give us the new revisionID at Wikipedia talk:Version 0.8. We would like to complete this consultation period by midnight UTC on Monday, October 11th.

We have greatly streamlined the process since the Version 0.7 release, so we aim to have the collection ready for distribution by the end of October, 2010. As a result, we are planning to distribute the collection much more widely, while continuing to work with groups such as One Laptop per Child and Wikipedia for Schools to extend the reach of Wikipedia worldwide. Please help us, with your WikiProject's feedback!

For the Wikipedia 1.0 editorial team, SelectionBot 23:23, 19 September 2010 (UTC)[reply]

Citation templates now support more identifiers

Recent changes were made to citations templates (such as {{citation}}, {{cite journal}}, {{cite web}}...). In addition to what was previously supported (bibcode, doi, jstor, isbn, ...), templates now support arXiv, ASIN, JFM, LCCN, MR, OL, OSTI, RFC, SSRN and Zbl. Before, you needed to place |id={{arxiv|0123.4567}} (or worse |url=http://arxiv.org/abs/0123.4567), now you can simply use |arxiv=0123.4567, likewise for |id={{JSTOR|0123456789}} and |url=http://www.jstor.org/stable/0123456789 → |jstor=0123456789.

The full list of supported identifiers is given here (with dummy values):

{{cite journal |author=John Smith |year=2000 |title=How to Put Things into Other Things |journal=Journal of Foobar |volume=1 |issue=2 |pages=3–4 |arxiv=0123456789 |asin=0123456789 |bibcode=0123456789 |doi=0123456789 |jfm=0123456789 |jstor=0123456789 |lccn=0123456789 |isbn=0123456789 |issn=0123456789 |mr=0123456789 |oclc=0123456789 |ol=0123456789 |osti=0123456789 |rfc=0123456789 |pmc=0123456789 |pmid=0123456789 |ssrn=0123456789 |zbl=0123456789 |id={{para|id|____}} }}

Obviously not all citations needs all parameters, but this streamlines the most popular ones and gives both better metadata and better appearances when printed. Headbomb {talk / contribs / physics / books} 03:08, 8 March 2011 (UTC)[reply]

Living unrelated donor transplantation and Living anonymous donor transplantation

Interesting and hot topics currently. Probably enough for their own articles or significant section in kidney transplantation. PMID 16549137, PMID 16423173, PMID 16398708, PMID 12603214 -- Samir धर्म 06:12, 21 June 2006 (UTC)[reply]

I remember hearing an interesting story about that on the CBC a while back. Tons to write about on that subject. One topic to add to the list... along with writing an article about the sale of organs/buying organs. Nephron T|C 02:33, 25 June 2006 (UTC)[reply]

MARS

Anyone have a picture of MARS / liver dialysis for the Hepatorenal syndrome article (and, I guess, the liver dialysis article)? -- Samir धर्म 06:31, 20 July 2006 (UTC)[reply]

Food, diet, and dialysis

I think that an article about food, diet, and dialysis is missing. It will be util. Something like this one. GermanX 13:45, 15 January 2007 (UTC)[reply]

I have no objection personally, but I do wonder if it a HOWTO guide-- something WP is NOT (WP:NOT). Nephron T|C 01:57, 17 January 2007 (UTC)[reply]

Yep, perhaps an article on the principles of renal dietetics (although my skin crawls at the thought of even reading it, let alone editing it..) but not a recipe article, which the nephrology project seems to be plagued by (as well as step by step guides..)Felix-felix 08:53, 17 January 2007 (UTC)[reply]

Userbox

I created a Userbox for the project.

This user is a participant in the Nephrology task force

If there is strong feeling about its appearance, we can change it at: Template:User WikiProject Nephrology. To post it on your user page, paste {{User WikiProject Nephrology}} . —Gaff ^ταλκ 20:09, 22 May 2007 (UTC)[reply]

Looks good to me. Any case, I added a link to the page so any one can easily find it & modify it. Nephron T|C 07:17, 23 May 2007 (UTC)[reply]

I gave the WikiProject Nephrology notice an adrenalectomy... so it matches. :) Nephron T|C 07:32, 23 May 2007 (UTC)[reply]

Chronic renal disease conquered according to the USTPO

Good for a laugh --> [3] & [4]. It is amazing the crap the USTPO issues patents on. If this really worked you'd have heard it on the evening news and it would have been on the cover of Nature. Nephron T|C 18:41, 7 October 2007 (UTC)[reply]

I know. I told that fellow that he should be doing his fundraising elsewhere. JFW | T@lk 18:52, 7 October 2007 (UTC)[reply]

Maybe at the NIH? Cleveland Clinic Researcher Receives $3.2 Million NIH Grant To Develop Bio-Artificial Kidney BillpSea 16:32, 8 October 2007 (UTC)[reply]

We can all wish them good luck. There are still a lot of challenges ahead 'til it becomes a reality. When the break comes it will be big-- as I imagine it will also give the liver people (hepatologists) some cause for optimism-- currently, they often watch their acute failure patients die (what routinely happened 50 years ago with acute renal failure). Nephron T|C 05:11, 10 October 2007 (UTC)[reply]

The efforts referenced above seem to refer to implantable devices. The other direction I read about periodically is "wearable kidneys" which I take to mean something of a size that would fit in a belt pack. As someone who uses hemodialysis I just don't understand how this could be practicable - I'm trying to imagine doing my grocery shopping with needles in my arms. But then I was one who thought cell phones and bottled water would be a niche products. I can hardly wait to see what all these smart people are going to come up with. BillpSea 16:57, 10 October 2007 (UTC)[reply]

CKD stages

Copied from User talk:Nephron#CKD_stages

Someone recently pointed out to me that chronic renal failure doesn't actually list the 5 stages of CKD we now employ routinely in clinical practice. Do you have the NKDOQI reference and would you be able to add that information? I'd be utterly grateful - I still don't translate my patients' creatinines into eGFR and CKD stages often enough. JFW | T@lk 21:24, 6 October 2007 (UTC)[reply]

Renal function would be a good spot for the stages of CKD. There is some ambiguity on how the term CRF is used - it is sometimes used to mean earlier stages of CKD other times specifically for ESRD. For instance the FDA document Information for Healthcare Professionals: Erythropoiesis Stimulating Agents (ESA) uses the terms: Chronic Kidney/Renal Failure and Chronic Kidney/Renal Disease interchangeably. In my view they are not the same thing. It would be good to develop a constant lexicon, chronic renal failure is really just one stage of chronic kidney disease. I'd prefer removing failure form the labels and use CKD5 for CRF. Here is the NKDOQI jump page

BillpSea 22:24, 6 October 2007 (UTC)[reply]

Interesting Chronic kidney disease redirects to Chronic Renal Failure. I think this reflects common usage but it's doesn't reflect the standard proposed under NKDOQI. refChronic renal failure should be identified as CKD5. NKDOQI defines chronic kidney disease (CKD) as either kidney damage or a decreased kidney glomerular filtration rate (GFR) of <60 mL/min/1.73 m2 for 3 or more months. On February 2002 K/DOQI published a classification of the stages of CKD, as follows:

Stage 1: Slightly diminished function; Kidney damage with normal or increased GFR (>90 mL/min/1.73 m2)
Stage 2: Mild reduction in GFR (60-89 mL/min/1.73 m2)
Stage 3: Moderate reduction in GFR (30-59 mL/min/1.73 m2)
Stage 4: Severe reduction in GFR (15-29 mL/min/1.73 m2)
Stage 5: Kidney failure (GFR <15 mL/min/1.73 m2)

BillpSea 03:38, 7 October 2007 (UTC)[reply]

I think it makes sense to rename the article chronic renal disease and have "failure" redirect to "disease", i.e. reverse the article name and redirect. I see "failure" as a subset of CKD. Nephron T|C 18:11, 7 October 2007 (UTC)[reply]

As long as we're discussing lexicon what's your feeling re: kidney v. renal ? My view is that using the word "kidney" makes the article more accessible. So I would use Chronic Kidney Disease as an upper level category, under Nephrology; putting dialysis (various forms) and transplantation under CKD5.BillpSea 18:34, 7 October 2007 (UTC)[reply]

In the UK everyone who knows his stuff now studiously uses "chronic kidney disease" and "acute kidney injury" for CRF and ARF respectively. I agree with Nephron that the CRF page should be renamed, but certainly not to CKD5. Rather, we may actually need a new page on chronic kidney disease that disambiguates clearly between the levels of severity and follows the general K/DOQI guideline. JFW | T@lk 18:52, 7 October 2007 (UTC)[reply]

I was using CKD5 as a shorthand instead of writing out stage five chronic kidney disease, did not mean to suggest CKD5 as a article title. I'm not sure how to rename an article - would one cut and paste the text under the new heading? And then organize the redirects. BillpSea 16:38, 8 October 2007 (UTC)[reply]

I tend to think kidney should be the term used in Wikipedia -- at least for chronic failure -- it is less confusing for the target audience. That said, Google seems to like 'renal' over 'kidney' (chronic renal failure - 1,730,000 hits vs. chronic kidney failure - 173,000 hits). With regards to acute, ARF is more common if you do a search of google (acute renal failure - 1,560,000 hits vs. acute kidney failure - 142,000 hits). Nephron T|C 21:30, 8 October 2007 (UTC)[reply]

Not sure why but when I try Google I come with about,550,000 for both renal searches. Maybe one explanation is that kidney is the newer term, renal is the legacy term? Does wikipedia lead or follow? BillpSea 00:46, 9 October 2007 (UTC)[reply]

I enclosed the words in quotes when I did the searches -- if you click on the links in the previous post I made you'll see what I mean. As for leading vs. following, Wikipedia is an encyclopedia-- it follows what is the trend. Renal is the medical term. Like most medical terminology, it is derived from the Latin; renes is kidney in Latin.[5] Nephron T|C 04:02, 9 October 2007 (UTC)[reply]

I clicked the links I get "Results 1 - 50 of about 571,000 for "chronic renal failure". (0.11 seconds)" not sure why. "chronic kidney disease" - 242,000 hits; "chronic renal disease" - 121,000. BillpSea 06:44, 9 October 2007 (UTC)[reply]

We're using slightly different search terms -- your search is for chronic kidney disease, which really ought to be the title of the article, i.e. chronic renal failure should be renamed chronic kidney disease. Not thinking, my searches were for failure -- my bad.

Chronic renal disease is better as (1) it is the more general term (it encompasses failure) and (2) better understood as it avoids the word "renal" which may seem confusing amongst the general public. Nephron T|C 05:04, 10 October 2007 (UTC)[reply]

I'm not a big fan of the CKD stages. If you boil things down-- it is just a stratification of different GFRs.

I think the stages are worth mentioning. That said, I think ESRD can be discussed largely without invoking any discussion of the stages. The stages mirror a continuum/stratification -- that could just as well have been divided into four stages or six stages.

Vis-a-vis cancer staging, the CRD stages have less value IMHO. In CRD, progression is the rule and, currently, the question is just the rate of progression, i.e. how much can we slow down progression by better managing hypertension, managing autoimmune disease better, controlling diabetes mellitus etc.). Nephron T|C 07:40, 19 October 2007 (UTC)[reply]

That doesn't seem to be the view of the large national organisations, which both preach CKD staging like the new gospel. In the UK, the national service framework (NSF) has insisted routine reporting of eGFRs to improve this. Obviously, the renal clinics have exploded with referrals purely because people have a poor GFR but are otherwise well. JFW | T@lk 09:28, 19 October 2007 (UTC)[reply]

Chronic Kidney Disease Next Steps

This is not something I've done before, I want to make sure I understand the process. The first step would be to use the move command to move Chronic Renal Failure to Chronic Kidney Disease. At the same time rewriting the first paragraph to:

Chronic kidney disease (CKD), also know as chronic renal disease, is a slowly progressive loss of renal function over a period of months or years through five stages. Each stage is a progression through an abnormally low and progressively worse glomerular filtration rate, which is usually determined indirectly by the creatinine level in blood serum.

Stage 5 CKD is a severe illness and requires some form of renal replacement therapy (dialysis or transplant). This stage of kidney disease is also called end-stage renal disease (ESRD). ESRD is how the US Centers for Medicare and Medicaid Services and US federal legislation reference this stage of illness. Stage 5 CKD is also known as chronic kidney failure (CKF) or chronic renal failure (CRF) but these terms are sometimes used in reference to earlier stages of CKD.

The next step would be to edit the Diagnoses section to conform to KDOQI guidelines (signs and symptoms look to be alright).

Then an ongoing job would be to edit other Nephrology pages to be consistent with the CKD nomenclature. Thoughts? BillpSea 16:45, 10 October 2007 (UTC)[reply]

Moving an article is described here -- WP:MOVE. I'll point-out that as a regular user you cannot swap article names, i.e. since both chronic renal failure and chronic kidney disease exist you cannot do the move the official Wikipedia way. (It is possible to do a swap-- by just using copy 'n paste, i.e. copy the article over the redirect and turn the article into the redirect. However, this is frowned upon 'cause the edit history is then lost to the redirect.) I'd do the move... but I'm not an admin. Ask User:Jfdwolff-- or post to WP:CLINMED to ask that it is done. Nephron T|C 07:21, 19 October 2007 (UTC)[reply]

If you want to merge the articles, just copy the content from the one article to the other, and turn the first one into a redirect. In the case of CKD, I'm happy to action the move if there is sufficient consensus here or on the article's talkpage. JFW | T@lk 09:28, 19 October 2007 (UTC)[reply]

I went ahead and used the move command so that the edit history stays intact. I've caught a number of double redirects but there are some that still need to be edited. The article still needs sections on each of the stages per NKDOQI and other resources. How should Renal failure tie in?BillpSea 06:28, 20 October 2007 (UTC)[reply]

Renal diet, therapeutic diets

Based on some edits on nephritic syndrome, I realized there is no article that discusses the renal diet, i.e. the kidney disease diet or dietary restrictions of people with kidney disease. I think it is something for the 'todo', along with other therapeutic diets, e.g. cardiac diet, diabetic diet, low salt diet (used in cardiac disease and chronic liver failure).

I think kidney disease diet would be an interesting article, when I think about how the recommendations about protein intake have changed. In the bad 'ol 1970s they were telling renal patients to avoid protein-- to lower their urea levels; the patients that ignored this advice actually did better! Nephron T|C 03:52, 29 October 2007 (UTC)[reply]

A kidney disease diet article could be a spot to discuss dose of dialysis. The renal diet varies with dialysis dose. I see a continuum, from an incenter/three day a week/three hour treatment diet to diets with no real restrictions when combined with higher doses of treatment - those getting a daily nocturnal dose can eat pretty much a normal diet.BillpSea 06:04, 29 October 2007 (UTC)[reply]

There is already a rump of a dialysis adequacy article. (ASIDE: I think the nephrology community confuses 'dose' and 'adequacy'; adequacy is what is important.) Adequacy certainly is important; with adequate dialysis one doesn't have to mind their diet, blood pressure is better controlled and one doesn't need phosphate binders. Nephron T|C 04:29, 30 October 2007 (UTC)[reply]

Yes I think there is an opportunity to provide some clarity here - my impression is that often the nephrology community sees adequacy i.e. a KDOQI target Kt/v of 1.2 - as a ceiling rather than a floor. Many clinical improvements flow from higher doses of dialysis - my personal bias is for the hemodialysis product the one change that I would make to what Scribner proposed is that the HDP should be greater than or equal to ones weight in kg. I think Scrib thought of people as weighing 50 to 60 kgs. I know HDP is little used but it does capture my experience with length and frequency.BillpSea 19:42, 30 October 2007 (UTC)[reply]

Something else to include in a kidney disease diet article would be the instructions for an emergency diet - in events when one can not maintain their prescribed frequency/dose, especially if one needed to bridge several days without dialysis.BillpSea 07:49, 7 November 2007 (UTC)[reply]

In terms of adequacy if one uses edKt/v as a measure of adequacy then the weekly edKt/v should be no less than 1.2 per treatment times 3 treatments.Scott E Pace MD (talk) 12:36, 24 November 2007 (UTC)[reply]

Software

I have spent a great deal of time in composing software for use with Palm OS and Windows Mobile 5.0. This software will be completely void of advertisement and is free to everyone. Please do not delete without notifying me. Also if anyone needs any software or has an idea for software let me know, if the need is there I would do so free of charge--Scott E Pace MD (talk) 22:01, 23 November 2007 (UTC)[reply]

I don't think it has to be a commercial product to not fit the wikipedia guidelines or style standards. If you can find statements in the guidance that supports including your software link then I would quote from the published guidance to support including the link [[6]] My read of the guidance and understanding of what wikipedia is striving to be leaves me thinking that the link is inappropriate but I'm new to this too. I do know that removing your link is not a commentary on your software it is just saying that it is not appropriate for the article.BillpSea (talk) 08:13, 24 November 2007 (UTC)[reply]

Well I can see where this thing is going so never mind. Like I said, my programs are extremely time consuming and take a great deal of effort to write, but I get the feeling that no matter how hard I try to get useful tools in the hands of health care providers who (at least in my state) desperately need of them it is not worth the effort. I can't tell you how many times I see medications that are not dosed appropriately for renal function and the cases of permanent deafness, seizures, confusion, GI bleeding, etc. I have seen in 2007 alone. My primary goal was to educate not to have anyone visit my web site. I was planning on setting up a site identified by random initials like www.abc.com or www.gio.com or whatever so there would be no chance of any advertisement or sponsorship, a site dedicated to free educational tools for whoever might want them. I was hoping that the WikiProject Nephrology could be seen as the ultimate example of public service and education. I had been working most of the night to get one of my projects online but I'll instead release them at one the commercial sites (name withheld) as freeware.Scott E Pace MD (talk) 13:00, 24 November 2007 (UTC)[reply]

Scott, my admiration for your hard work on software tools to improve care for renal patients. The use of IT solutions to improve health care is in its infancy (especially here in the UK), and I agree that we can only get this right by bringing the data to the bedside.

You have correctly identified Wikipedia as a very popular source of free information, and I understand why you tried to spread the word about your project through this site. However, you are trying to reach medical professionals; Wikipedia is primarily for the lay reader who might not see the point in a computer program for doctors. I'm affraid I have to agree with BillpSea, who politely explained Wikipedia policy. At the same time, please do not see this as a indication that your work is not valued. Your intentions were certainly great.

Could we convince you to stay around at Wikipedia and help out with our nephrology content? JFW | T@lk 22:19, 24 November 2007 (UTC)[reply]

Thank you for your kind words Jfdwolff. I would be happy to help in anyway I can. If anyone needs any help, advice, etc. please let me know. If I cannot help I will try to find someone who can. I will attempt to start updating articles time permitting. Please note that my philosophy toward medical care in the U.S. does not appear typical for a U.S. physician as I feel our system has become dominated by the business of making money at the expense of patients and that we (U.S.Health care) are in need of changes so health care can be affordable for everyone.Scott E Pace MD (talk) 11:22, 27 November 2007 (UTC)[reply]

Helpful reference document

I came across this Word document from the FDA http://www.fda.gov/ohrms/dockets/ac/05/briefing/2005-4144b1_01_FDA%20brifing%20document.DOC It's a briefing document for the Gastroenterology and Urology devices panel of the FDA's medical devices advisory committee from June 2005; they're mostly discussing Nocturnal dialysis. Section 2.3 Device Description and Regulations has a great list of all that goes into a hemodialysis device as referenced by the code of Federal Regulations. Section 3 also has some great language around nocturnal dialysis. I think this document could inform and improve a number of hemodialysis articles (there is a typo in the dialysate pump section - reference blood instead of dialysate. Anyone want to take it on? Seems like it could inform a major rewrite, lots of good information. BillpSea (talk) 15:26, 5 January 2008 (UTC)[reply]

I skimmed through it briefly. It looks like a good place to find a few references--and something that could be used to create a section in the home hemodialysis article that specifically addresses the situation in the USA. You can slap it into the EL section of the home hemodialysis article for the time being. Nephron T|C 16:53, 7 January 2008 (UTC)[reply]

Please expand

International Society of Nephrology has been created. The website is vague about its officers and the year of its establishment. Anyone have some sources? JFW | T@lk 11:48, 2 March 2008 (UTC)[reply]

Nuclear imaging & MAG3

I had a go at expanding the stub of MAG3 scan (renaming in the process). Its better than it was and with quite a few refs added, but style of language could have a freshen up. Also I now lack the technical specialist knowledge to correctly add much about its modern role (vs US/S, CT, MRI) both within the article itself and in inserting mentions of the scan into chronic kidney disease (as here), renal artery stenosis (as here) etc. Also I've long since forgotten the role for DMSA scan (which is redlinked - only DMSA exists as an article).

Could people have a look please :-) David Ruben ^Talk 21:02, 14 March 2008 (UTC)[reply]