UK Renal Registry 19th Annual Report: Chapter 6 Adequacy of Haemodialysis in UK Adult Patients in 2015: National and Centre-specific Analyses.

BACKGROUND Outcomes in patients treated with haemodialysis(HD) are potentially influenced by the delivered dose of dialysis. The UK Renal Association publishes clinical practice guidelines recommendations for dialysis dose. The urea reduction ratio (URR) is a widely used measure of dialysis dose and has been historically the measure of adequacy reported by the UKRR. AIM To determine the extent to which patients achieved the recommended UK target. METHODS Two groups of patients were included in the analyses: the prevalent HD patients on 30th September 2013 and the incident HD patients for 2012. Centres returning data on ,50% of their patient population or centres with,20 patients with data were excluded from centre-specific comparisons. RESULTS Data regarding URR were available for analysis from 64 renal centres in the UK. The proportion of patients in the UK who met the UK clinical practice guideline for URR (.65%) increased from 69% in 2000 to 89% in 2013. There was persistent variation observed between centres, with 22 centres attaining the RA clinical practice guideline in .90% of patients and 37 centres attaining the guideline in 70–90% of patients. The overall proportion of prevalent HD patients with a URR .65% has continued to improve over time. CONCLUSIONS The delivered dose of HD,as measured by URR for patients with established renal failure,has increased over the last decade. Whilst the majority of UK patients achieved the target URR, there was wide variation between centres in the percentage of patients achieving the current guideline target.