Nearly a quarter of patients are referred for specialist nephrology treatment at a very late stage, within 1 month of RRT. They are less likely to receive interventions that could alter the progression of CRF or reduce its associated co-morbidity, have a worse clinical state at the start of RRT, longer hospitalization and poorer survival. These differences were much less marked for those referred within 1-4 months of starting RRT, although this is an insufficient time to prepare for RRT. Further research is needed to determine the missed opportunities for more proactive diagnosis and management of CRF.

Place names are often used to describe and to enquire about geographical information. It is common for users to employ vernacular names that have vague spatial extent and which do not correspond to the official and administrative place name terminology recorded within typical gazetteers. There is a need therefore to enrich gazetteers with knowledge of such vague places and hence improve the quality of place name-based information retrieval. Here we describe a method for modelling vague places using knowledge harvested from Web pages. It is found that vague place names are frequently accompanied in text by the names of more precise co-located places that lie within the extent of the target vague place. Density surface modelling of the frequency of co-occurrence of such names provides an effective method of representing the inherent uncertainty of the extent of the vague place while also enabling approximate crisp boundaries to be derived from contours if required. The method is evaluated using both precise and vague places. The use of the resulting approximate boundaries is demonstrated using an experimental geographical search engine.

Following nephrology referral, GFR decline slowed significantly and was associated with better survival. Earlier detection of patients with progressive CKD and interventions to slow progression may have benefits on both kidney and patient survival.

Bone deposition after 1 year of treatment with LC is low (highest concentration: 5.5 microg/g). There is a slow release of lanthanum from its bone deposits 2 years after the discontinuation of the treatment and no association with aluminium-like bone toxicity.

This study describes a large series of BBAVFs and makes an extensive comparison between the one-stage and two-stage operations. Significantly improved overall functional patency is demonstrated for the two-stage operation.

This model predicts a substantial growth in the RRT population to 2010 to a rate approaching 1000 p.m.p., particularly in the elderly and those on HD, with a steady state not being reached for at least 25 years.

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A significant proportion of patients are avoidably referred to a dialysing renal unit at a very late stage. Guidelines on referral should be developed by nephrologists, primary and secondary care physicians, and patient groups, and further research is needed into the cost-effectiveness of early referral strategies.