The peritoneum is the largest serous membrane in the body that covers the inner side of the abdominal wall and reflects over the abdominal viscera. Though the visceral peritoneum accounts for roughly four-fifth of the total surface area of the membrane, but the parietal peritoneum is the more important for peritoneal dialysis. Between the parietal and visceral layer of peritoneum there is potential space called peritoneal cavity, contain small amount of serous fluid. If dialysates remain more or less than (...) normal in the peritoneal cavity that may cause edema or hypovolemic shock. Hence transport across the peritoneal membrane need great attention to the nephrologist during dialysis. Solute and water transport from blood to peritoneal cavity by diffusion and osmic ultra-filtration whereas absorption to the blood via lymphatic has negatively affect between these two process. Another important thing that the peritoneum is lined by mesothelium. Therefore, primary complication of peritoneal dialysis is infection due to the presence of a permanent tube in the abdominal cavity. Mortality is higher in the elderly and if present in prolonged time. Peritoneal sclerosis is a fetal complication due to growth of a thick layer of fibrin within the peritoneum, in where every chance of the bowel obstruction. The fluids contain glucose for dialysis use as a primary osmotic agent but this may lead to peritonitis. The decline of kidney and peritoneal membrane function and negative health outcome. It is important to be aware about the sex difference of peritoneal membrane during dialysis. Retrograded menstruation may occur in any women as there is continuity of peritoneal membrane with the fallopian tube. If goes undetected will cause bloody dialysate and create concern of the patients. Therefore, anatomy of peritoneal membrane and its function has great value during peritoneal dialysis and thereby effecting its therapeutic efficacy. (shrink)

Every year, hundreds of patients in England die whilst waiting for a kidney transplant, and this is evidence that the current system of altruistic-based donation is not sufficient to address the shortage of kidneys available for transplant. To address this problem, we propose a monopsony system whereby kidney donors can opt-in to receive financial compensation, whilst still preserving the right of individuals to donate without receiving any compensation. A monopsony system describes a market structure where there is only one ‘buyer’—in (...) this case the National Health Service. By doing so, several hundred lives could be saved each year in England, wait times for a kidney transplant could be significantly reduced, and it would lessen the burden on dialysis services. Furthermore, compensation would help alleviate the common disincentives to living kidney donation, such as its potential associated health and psychological costs, and it would also help to increase awareness of living kidney donation. The proposed system would also result in significant cost savings that could then be redirected towards preventing kidney disease and reducing health disparities. While concerns about exploitation, coercion, and the ‘crowding out’ of altruistic donors exist, we believe that careful implementation can mitigate these issues. Therefore, we recommend piloting financial compensation for living kidney donors at a transplant centre in England. (shrink)

After a long search, Jonathan has finally found someone willing to donate a kidney to him and thereby free him from dialysis. Meredith is Jonathan's second cousin, and she considers herself a generous person, so although she barely knows Jonathan, she is willing to help. However, as Meredith learns more about the donation process, she begins to ask questions about Jonathan: “Is he HIV positive? I heard he got it using drugs. Has he been in jail? He's already had (...) one live donor, so what happened to the first kidney? Did he forget to take his drugs or something?” The transplant center must, then, decide if Meredith is, in fact, entitled to answers to these kinds of questions. According to the Consensus Statement on the Live Organ Donor, “It is incumbent on the transplant center to provide full and accurate disclosure to potential donors of all pertinent information regarding risk and benefit to the donor and recipient.” But whether answers to the Meredith's questions count as “pertinent information regarding the risk and benefit” is the issue at hand. (shrink)

Editorial on papers relating to among other infanticide and intersex.