title: National survey of palliative care in end-stage renal disease in the UK.
abstract: BACKGROUND
  Palliative care for patients with end-stage renal disease (ESRD) is a neglected aspect of nephrology. We carried out this survey to establish the current pattern of provision of palliative care for ESRD in the UK.
  
  
  METHODS
  An anonymous but numbered questionnaire concerning local palliative care provision was sent to clinical directors of all 69 UK renal units.
  
  
  RESULTS
  All the questionnaires were returned. Only 27 (39%) units employ nursing or Professions Allied to Medicine (PAM) staff with palliative care for ESRD patients as a specified part of their role. In 19 of these units, staff spend <4 h per week concerned with palliative care and only five units have staff working for >12 h a week in this role. Fifty-five (80%) units do not have a written protocol for palliative care. Anaemic ESRD patients with an expected survival of >3 months receive blood transfusion in 59 (86%) units, intravenous iron in 61 (88%) units and erythropoietin in 63 (91%) units. Only 37 (54%) units kept a record of patients seen by the unit staff but deemed not suitable for dialysis.
  
  
  CONCLUSIONS
  There is a significant variation in provision of palliative care services across the UK. In some areas, access to palliative care is restricted to patients with malignant disease, and ESRD patients are excluded.
authors.affiliation: Renal Unit, Birmingham Heartlands Hospital, Birmingham B9 5SS, UK.
authors.forename: Smita
authors.initials: S
authors.lastname: Gunda
authors.forename: Mark
authors.initials: M
authors.lastname: Thomas
authors.forename: Steve
authors.initials: S
authors.lastname: Smith
mesh_terms: D000740:Anemia / Q000209:etiology / Q000628:therapy; D006306:Health Surveys; D006801:Humans; D007676:Kidney Failure, Chronic / Q000451:nursing / Q000628:therapy*; D010166:Palliative Care / Q000379:methods / Q000706:statistics & numerical data*; D006435:Renal Dialysis; D011795:Surveys and Questionnaires; D006113:United Kingdom; D014481:United States