UK Renal Registry 11th Annual Report (December 2008): Chapter 8 Adequacy of haemodialysis in UK renal centres in 2007: national and centre-specific analyses.

BACKGROUND Outcome in patients treated with haemodialysis (HD) is influenced by the delivered dose of dialysis. The UK Renal Association (RA) publishes Clinical Practice Guidelines which include recommendations for dialysis dose. The urea reduction ratio (URR) is a widely used measure of dialysis dose. AIM To determine the extent to which patients received the recommended dose of HD in the UK. METHODS Seventy-one renal centres in the UK submit data electronically to the UK Renal Registry (UKRR). Two groups of patients were included in the analyses: the prevalent patient population on 31st December 2007 and the incident patient population for 2007. Centres returning data on <50% of their patient population were excluded from centre-specific comparisons. RESULTS Data regarding URR were available from 61 renal centres in the UK. Forty six centres provided URR data on more than 90% of prevalent patients. 81% of prevalent HD patients met the UK Clinical Practice Guideline for URR (>65%) in 2007. There has been an increase from 56% in 1998 to 81% in 2007 in the proportion of patients in the UK who achieved a URR >65%. The HD dose (URR) delivered to patients who have just started dialysis treatment is lower than that of patients who have been treated for longer and increases further with time. CONCLUSIONS The delivered dose of HD for patients with established renal failure has increased over 9 years. There was considerable variation from one centre to another, with 8 centres attaining the RA clinical practice guideline in >90% of patients and 7 centres attaining the standard in <60% of patients.