Tag Archives: renal function

Background The Southern Health and Social Care Trust (SHSCT) in Northern Ireland has a nurse-led heart failure (HF) service, with seven band 7 heart failure nurse specialists (HFNS) serving a total of about 1,500 patients. All but two of the nurses are non-medical prescribers. The service is community-based with hospital in-reach, with each nurse managing a geographically defined caseload. This model allows patients with HF to be reviewed by a HFNS in either a domiciliary, clinic or acute setting. The nurses have access to, and support from, consultant cardiologists, renal consultants, GPs and a cardiology pharmacist, and also have access to

Introduction Therapeutic interventions in chronic heart failure (CHF) can lead to renal dysfunction. Combination of the aldosterone antagonist (AA) spironolactone with either angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs), reduced mortality and hospitalisation rates and improved the New York Heart Association (NYHA) functional class in patients recruited into the Randomised Aldactone Evaluation Study (RALES).1 That study showed no statistically significant difference in the incidence of hyperkalaemia between those on AA and those on placebo.1 However, when the results of the trial were implemented int