Low clearance service


This clinic is for patients who have Chronic Kidney Disease (CKD) which has caused their kidney function to fall to less than 20 per cent of the healthy level.

As the function of the kidneys declines, clearance of waste products falls and problems are more likely to arise. General wellbeing can suffer and patients can develop anaemia (low red blood cell count) and bone disease. A special diet is usually necessary to keep a healthy balance.

Kidney function which falls below 10 per cent is considered 'end stage'. At this level, the kidneys are unable to support good health. Treatment options include kidney replacement therapy, such as dialysis and transplantation.

More on what we do

The low clearance clinic is designed to help patients living with a severe level of decline in their kidney function. We will make sure you are receiving the most appropriate treatment to slow this process and prolong your kidney function as much as possible. However, there might come a point when you need dialysis or a kidney transplant. We will work through this with you and make sure that you are fully prepared. We will also talk to you about other ways of managing your condition.

Patients are reviewed by our doctors, renal dieticians and specialist nurses.

The clinics are run every Tuesday at the RD&E site from 9am-12.30pm. Clinic are held in North Devon District Hospital every 2nd and 3rd Wednesday of the month from 9am-12.30pm. Please note there is currently no dietician on site as North Devon but the RD&E dieticians contact you by phone, if needed.


Before you see our team, you will have your weight, blood pressure and urine tested. You will probably be asked to have blood test after your general appointment. Please allow up to two hours for your appointment.

Our team

Our team in Exeter

  • Dr Helen Clarke: Consultant Nephrologist
  • Dr Lucy Smyth Consultant Nephrologist
  • Dr David Meredith Consultant Nephrologist
  • Jane Tanasa Clinical Nurse Specialist
  • Anu Partanen-Wells Clinical Nurse Specialist
  • Kevin Wilson clinical Nurse Specialist
  • Jennie Brown Clinical Nurse Specialist
  • Renal Dieticians (see renal dietician page)

Our team in North Devon

  • Dr Jason Moore Consultant Nephrologist
  • Cathy Rowe Clinical Nurse Specialist
  • Charlotte Challaghan Clinical Nurse Specialist

Where to find us

RD&E Wonford, Barrack Rd, Exeter EX2 5DW

Exeter: Medical Out-patients Department, level 1, area D.

North Devon: General Out-patients Department, level 2 near the front entrance at North Devon District Hospital, Raleigh Heights, Barnstaple EX31 4JB.

Contact us


Telephone: 01392 411611 and ask switchboard for the Medical Out-patients Department.

North Devon

Telephone: 01271 322577 and ask for the General Outpatients Department.


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