Renal Low Clearance Service

You have been referred to the Low Clearance Clinic by your GP, hospital physician or a renal doctor. The purpose of this clinic is to look after people whose chronic kidney disease (CKD) has caused their kidney function to decline to approximately 15% to 20% of normal. At this stage the possibility of problems from CKD is greater, and plans for additional treatments such as dialysis and transplantation will need to be made.

The team will discuss the range of treatments available, and decide with you which are best for you. There will be plenty of time for questions. You are welcome to bring any family members or friends with you.

About your clinic appointment

The clinic is held weekly on Thursday afternoons from 14.00 (2pm). At each visit you will be weighed and have your blood pressure checked. You will be asked to bring a small urine sample with you. You may be asked to collect urine samples over 24 hours. Blood tests will also be taken regularly to measure kidney function. These tests help us to monitor your general health and the progress of your kidney disease.

Please bring a list of your medication to every clinic appointment so that we can make sure that your GP has an accurate record from us, allowing them to prescribe the correct drugs for you. Your GP will receive a letter from the clinic detailing your progress and any changes in treatment required. You will also be sent a copy of this letter for your records. As everyone is different, the advice you will be given will be tailored to your needs.

At each clinic visit you will have the opportunity to see various members of the Renal Services team involved in your care.

About the team caring for you

Renal consultant/ specialist registrar

The renal doctors will explain your kidney disease and the consequences of reduced kidney function. Current and future treatments, such as dialysis options and transplantation, will be discussed with you. This is to make sure that you understand your condition and the actions required to keep you healthy. The doctors will give you as much information as you want and keep you informed about the timing of interventions required.

Renal nurse specialist

The renal nurse specialist will explain the treatment you need and help you make decisions about the options open to you. It is important that you understand your kidney condition. To help you with this, information is available in written format as leaflets and books, on DVDs, and as ongoing individual discussion with the healthcare professionals involved in your treatment. You will be invited to attend group or individual education sessions when necessary. The renal nurse specialist monitors your kidney function after every clinic visit and will arrange for medication changes, referrals to other team members or departments when required and will keep you informed of your progress and blood results. Information may be by phone, letter or email (whichever is easiest for you) and you are welcome to contact us with any questions you have.

Renal dietitian

You may need to make changes to your diet to help control the consequences of reduced kidney function. The dietitian will discuss these with you when necessary and advise you on which foods you should reduce, increase or avoid. You may also need to limit the amount of fluid you drink. You will be given advice on how to adjust this without feeling too restricted.

One of the commonest problems with CKD is anaemia. When required, the anaemia nurse specialist will explain the process of anaemia and the connection with renal failure. There are various treatments available to correct anaemia. Ongoing monitoring of your blood results will enable us to determine which you need at which stage. These will be discussed with you as necessary.

Maintaining your privacy and dignity during dialysis

As an outpatient area, both sexes are usually dialysed together. However, if you wish to dialyse in a single sex area, we will try to accommodate this. Please ask a member of the nursing staff.

Useful links

• Dialysis: making the right choices for you (opens in a new tab) – Kidney Research UK
• Your guide to living with chronic kidney disease (CKD) (opens in a new tab) – Baxter
• Living with kidney disease (opens in a new tab) – Yorkshire Dialysis and Conservative Care Decision Aid (YoDCA) study team

Contact details

Renal nurse specialist: 01223 400183
Renal anaemia nurse specialist: 01223 400187
Renal dietitian: 01223 216655
Renal consultant: 01223 217821

Please call us with any queries you may have.