Brian Rayner

Biography

Although there is currently only one permanent sub-specialist training post for a senior registrar/fellow, the division is fortunate to be able to access regular funding for 2 or 3 other trainees at most times, as well as providing training to International Society for Nephrology (ISN) sponsored trainees (1-3 at a time), of whom many have completed there training here. Registrars in internal medicine rotate through the unit every 3 months. Initially, surgeons of the general surgical service did renal transplants. This included a single kidney transplant carried out by Professor Christiaan Barnard. Since the early 1990s when he returned from the USA after completing his training as a transplant surgeon, till recently, Prof Del Kahn ran the kidney and liver transplant programme. Prof Elmi Muller has now taken over the running of this unit, and is doing pioneering work in HIV positive-to-positive kidney transplantation.

Research Interest

The Division provides a very active outpatient and consultative service, running busy outpatient clinics in hypertension (E17), "Under-10" (low clearance and immunosuppression) clinic, transplant follow up clinics, new renal patient clinic, HIV kidney disease clinics, adolescent clinic (E13), and general nephrology "nephritic" clinics in the OPD building. Dialysis makes up a big part of our service. Besides for dialysing all patients with acute renal failure/kidney injury who require dialysis in hospital, we maintain about 150 patients on chronic outpatient dialysis - around 100 on haemodialysis and 50 on peritoneal dialysis. This would be impossible without our dedicated nursing and technologist staff. The only way to get patients off dialysis is to transplant them, so the transplant team are critical in the ability of the service to accept new patients onto dialysis, which has a fixed maximum number of places available. They are involved in performing around 50 kidney transplants per year, about one third of them from living donors. Follow up takes place at the Renal Transplant Clinic in E13.